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Dual Target Repetitive Transcranial Magnetic Stimulation In The Treatment Of Comorbid Obsessive-Compulsive Disorder In Patients With Anorexia Nervosa: Preliminary Results Of Two Case Reports

Published online by Cambridge University Press:  23 March 2020

G.M.D. Lemmens
Affiliation:
Universitair Ziekenhuis Gent, Psychiatry, Gent, Belgium
C. Baeken
Affiliation:
Universitair Ziekenhuis Gent, Psychiatry, Gent, Belgium
D. Van den Abbeele
Affiliation:
Universitair Ziekenhuis Gent, Psychiatry, Gent, Belgium

Abstract

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Introduction

Obsessive-compulsive disorder (OCD) is a frequently reported comorbid disorder (20–30%) in patients with anorexia nervosa (AN). Increasing evidence suggests that repetitive transcranial magnetic stimulation (r-TMS) may be effective in the treatment of refractory OCD and to a lesser extent in AN. Hereby, different target areas: supplemental motor area (SMA) and orbitofrontal cortex (OFC) and dorsolateral prefrontal cortex in AN. We report two patients with enduring AN and comorbid treatment resistant OCD treated with r-TMS.

Methods

Both female patients (34 and 26 years respectively) were hospitalized at the Eating Disorder Unit at the Ghent University Hospital. Treatment responses were evaluated with Yale Brown Obsessive Compulsive Scale (Y-BOCS) and weight gain. Inhibitory continuous thetaburst stimulation (cTBS) of the SMA followed by cTBS of the OFC was conducted during 20 sessions, 5 sessions a week, during 4 weeks. Stimulation intensity was respectively 100% and 80% of the motor treshold.

Results

After cTBS treatment Y-BOCS score of both patients decreased (31 to 24 and 31 to 23 respectively). Only one patient showed a 10% increase of weight. The treatment was well tolerated. No significant side effects were reported.

Conclusion

Treatment resistant comorbid OCD in patients with AN may be succesfully treated with cTBS.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV833
Copyright
Copyright © European Psychiatric Association 2016
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