Impact of serotonin transporter gene on rTMS augmentation of SSRIs for obsessive compulsive disorder

Figures & data

Figure 1 CONSORT diagram for a sham-controlled study of rTMS for patients with OCD.

Abbreviations: rTMS, repetitive transcranial magnetic stimulation; OCD, obsessive-compulsive disorder.

Table 1 Demographic and clinical data of the OCD patients at baseline

	Active rTMS group (n=25)	Sham rTMS group (n=24)	t	p-value
Gender (male/female)	15/10	14/10	0.014^a	0.906
Age (years)	32.20±13.25	39.38±17.04	−1.644	0.107
Education (years)	13.04±2.59	12.08±3.24	1.144	0.259
Y-BOCS	17.24±4.27	18.08±4.43	−1.264	0.213
HAMA	12.76±9.34	10.13±6.30	1.153	0.255
HAMD	16.16±9.54	11.88±7.82	1.715	0.093

Notes: ^aChi-square test. Data presented as mean±SD.

Abbreviations: OCD, obsessive-compulsive disorder; Y-BOCS, Yale-Brown obsessive compulsive scale; HAMA, Hamilton anxiety rating scale; HAMD, Hamilton depression rating scale; rTMS, repetitive transcranial magnetic stimulation.

Table 2 Assessment scores of OCD patients after treatment

		Baseline	Week 2	Week 4	Analyses (p-values)
					ME time	ME rTMS	Interaction
Y-BOCS	Active	17.24±4.27	13.44±4.64	11.72±3.78**	0.00	0.04	0.16
	Sham	18.08±4.43	16.08±4.54	14.58±3.72**
HAMA	Active	12.76±9.34	9.32±7.99	8.12±7.79	0.00	0.73	0.06
	Sham	10.13±6.30	9.50±5.42	8.58±5.54
HAMD	Active	16.16±9.54	12.52±8.79	8.36±8.19**	0.00	0.95	0.06
	Sham	13.96±6.31	12.17±4.55	10.58±4.81*

Notes: **p<0.01 compared with the baseline *p<0.05 compared with the baseline. Data presented as mean±SD. The analysis method used was repeated measures ANOVA. The bold values are statistically significant.

Abbreviations: OCD, obsessive-compulsive disorder; Y-BOCS, Yale-Brown obsessive compulsive scale; HAMA, Hamilton anxiety rating scale; HAMD, Hamilton depression rating scale; ME time, main effect of time (baseline and follow-up); ME rTMS, main effect of rTMS status (active and sham).

Figure 2 Change in Y-BOCS scores in patients with OCD during the study. Data are shown at the time of inclusion in the study (baseline) and after the period of active or sham stimulation (weeks 2 and 4). *p<0.05 compared with sham rTMS group.

Abbreviaions: Y-BOCS, Yale-Brown obsessive compulsive scale; OCD, obsessive-compulsive disorder; rTMS, repetitive transcranial magnetic stimulation.

Figure 3 Impacts of 5-HTTLPR on the beneficial effects of rTMS. OCD patients with the LL genotype in the 5-HTTLPR gene (n=4) showed greater improvement in obsessive and compulsive symptoms from low-frequency rTMS than from sham rTMS in patients (n=3) with the LL genotype. Conversely, no significance difference was noted between the active rTMS group in S allele carriers compared with the sham rTMS S allele carrier group (*p<0.05).

Abbreviations: Y-BOCS, Yale-Brown obsessive compulsive scale; OCD, obsessive-compulsive disorder; rTMS, repetitive transcranial magnetic stimulation.