Transcranial Magnetic Stimulation + Exposure Therapy for Pediatric OCD

(NExT Trial)

The trial aims to explore whether adding transcranial magnetic stimulation (TMS) to Exposure with Response Prevention (ERP) therapy can improve outcomes for young people with Obsessive-Compulsive Disorder (OCD). Participants will divide into two groups: one will receive real TMS, and the other will receive a sham version, both alongside ERP therapy. The researchers aim to determine if TMS can reduce OCD symptoms by altering brain activity. This trial suits individuals aged 12 to 21 who experience moderate OCD symptoms and have motor compulsions affecting daily life. As an unphased trial, it offers a unique opportunity to contribute to groundbreaking research that could enhance treatment options for OCD.

Research has shown that transcranial magnetic stimulation (TMS) is generally safe for treating obsessive-compulsive disorder (OCD) in both adults and children. Studies have found that TMS can help reduce OCD symptoms and is usually well-tolerated, with most side effects being mild. This trial uses a specific type of TMS called continuous theta burst stimulation (cTBS), which has proven effective without causing significant side effects. While the FDA has approved TMS for adults with OCD, research suggests it is also safe for children and teenagers. Therefore, participation in this trial is supported by a strong safety record from previous studies.¹²³⁴⁵

Researchers are excited about the potential of combining transcranial magnetic stimulation (TMS) with exposure therapy for pediatric OCD because it introduces a novel approach to treatment. Traditional OCD treatments often rely on medications like SSRIs or cognitive-behavioral therapy alone. Unlike these options, this treatment uses continuous theta burst stimulation (cTBS), a form of TMS, targeting the presupplementary motor area to potentially enhance the effects of Exposure with Response Prevention (ERP). Additionally, the innovative use of TMS could expedite treatment results, possibly reducing the time needed to see improvements in symptoms. This approach not only offers a different mechanism of action but also provides a non-invasive option that may benefit those who have not responded well to standard treatments.

This trial will compare the effects of combining transcranial magnetic stimulation (TMS) with exposure therapy for pediatric OCD. Research has shown that TMS can help treat obsessive-compulsive disorder (OCD), especially when combined with exposure therapy. Participants in one arm of this trial will receive continuous theta burst stimulation (cTBS), a specific type of TMS, followed by Exposure Plus Response Prevention (ERP). Studies have found that TMS can reduce OCD symptoms and improve brain function linked to compulsive behavior. In one study, TMS significantly reduced OCD symptoms compared to a placebo. Another study discovered that cTBS might be a helpful addition to regular OCD treatments. Overall, TMS is considered a safe and effective method that could enhance the benefits of exposure therapy for young people with OCD.¹²³⁴⁶