Continuous Theta Rhythm Stimulation And 1Hz Repetitive Transcranial Magnetic Stimulation A Controlled Study On The Treatment Of Obsessive-compulsive Disorder

Purpose: Obsessive-compulsive disorder is a common mental illness with obsessive-compulsive thinking and compulsive behavior as the main clinical features.The course of the disease is protracted and difficult to cure.Symptoms often cause damage to the social functions of the patient such as social and professional.The executive function deficit and cognitive dysfunction of OCD have been proved by a large number of studies.However,there are still various problems in the treatment of obsessive-compulsive disorder.Transcranial magnetic stimulation is considered a non-invasive,safe and green physical therapy method.Among them,1Hz-r TMS has been widely used in research on the treatment of OCD,but there are few studies on the pre-SMA of cTBS intervention in OCD,and there is insufficient evidence on the clinical efficacy of the two stimulation modes.In this study,OCD patients were divided into cTBS group,1Hz-r TMS group and sham stimulation control group to compare the clinical effects of these two stimulation modes in the treatment of OCD and the intervention effects on cognitive flexibility.Methods: 45 OCD patients were enrolled and divided into three groups: cTBS group,1Hz-r TMS group,and sham stimulation control group.Transcranial magnetic stimulation was used to stimulate the patient’s Pre-SMA position,1Hz-r TMS group:stimulation frequency was 1Hz,The stimulation intensity is 110% RMT(rest motor threshold),the time is 30 minutes,and the total number of stimulation pulses is 1800.cTBS: The frequency within the cluster is 50 Hz,the number within the cluster is 3,the frequency between clusters is 5Hz,the number between clusters is 200,the stimulation intensity is 80% RMT,the stimulation time is 40 s,the total number of pulses is 600,and rest after completing one treatment 14 minutes,a total of 3 treatments,the total treatment time is about 3 minutes,the total number of stimulation pulses and1Hz-r TMS is the same as 1800 times.The pseudo-stimulation group uses pseudo-stimulation coils and the process is the same.Each subject was treated for 15 consecutive days.The three groups completed the symptomatic evaluation,emotional assessment and cognitive flexibility test before and after stimulation,and compared the changes in symptoms and cognitive flexibility after the intervention treatment in the three groups.Results: The three groups had no significant difference in the symptom scale,emotional state and cognitive flexibility results before the intervention,except for the compulsive behavior subscale of the Y-BOCS scale(P<0.05),but no significant difference(P>0.05).).In terms of symptoms,the three groups had an interactive effect on the total score of Y-BOCS before and after treatment(P<0.05),and the total score of Y-BOCS in the cTBS group and 1Hz-r TMS group decreased significantly after treatment(P<0.05)and The scores of cTBS group and 1Hz-r TMS group were statistically significant(P<0.05).The three groups had no interaction on the PI-WSUR scale,the HAMA scale and the HAMD scale(P>0.05);in terms of cognitive flexibility,the three groups had interaction on the Stroop paradigm before and after treatment(P<0.05),The interference response time of the cTBS group was significantly decreased(P<0.05).The three groups had no interaction in the connection test before and after treatment,the digital breadth test,the Wisconsin card sorting task and the task switching paradigm(P>0.05),but the main effect in the task switching paradigm was significant(P<0.05),further analysis It was found that the cTBS group had a significant decrease in the response under repeated conditions and switching conditions after treatment(P<0.05),and the 1Hz-r TMS group had a significant decrease in the response under repeated conditions and switching conditions after treatment,and the accuracy rate was significantly improved(P<0.05).Conclusion: The results found that both cTBS and 1Hz-r TMS can improve the obsessive-compulsive symptoms and cognitive flexibility of OCD patients,but the cTBS stimulation mode is better than the 1Hz-r TMS stimulation mode in improving the obsessive-compulsive symptoms.