Will Transcranial Magnetic Stimulation Improve the Treatment of Obsessive–Compulsive Disorder? A Systematic Review and Meta-Analysis of Current Targets and Clinical Evidence

Background: Although in 2017 a repetitive transcranial magnetic stimulation (rTMS) protocol received Food and Drug Administration approval for the first time treatment of obsessive–compulsive disorder (OCD), which neural target should be used OCD are still debated. The aim present study was to perform systematic review meta-analysis available open sham-controlled trials. Methods: primary analysis included pairwise (over 31 trials), then subgroup analyses were performed each targeted brain area. Meta-regression explored possible moderators effect size. Results: showed significant reduction symptoms following active rTMS (g = −0.45 [95%CI: −0.62, −0.29]) with moderate heterogeneity (I2 34.9%). Subgroup over bilateral pre-SMA (supplementary motor area), DLPFC (dorsolateral prefrontal cortex), ACC/mPFC (anterior cingulate cortex medial OFC (orbitofrontal cortex). No size emerged. Conclusions: TMS several targets represents safe effective option patients. Further studies needed help clinicians individualize protocols patient.