Sleep predicts the response to rTMS and CBT in patients with OCD: an open label effectiveness study

Priya T. Gajadien; Tjardo S. Postma; Iris van Oostrom; Karel W. F. Scheepstra; Hanneke van Dijk; Alexander T. Sack; Odile A. van den Heuvel; Martijn Arns

doi:10.1016/j.ijchp.2022.100353

Sleep predicts the response to rTMS and CBT in patients with OCD: an open label effectiveness study

Priya T. Gajadien, Tjardo S. Postma, Iris van Oostrom, Karel W. F. Scheepstra, Hanneke van Dijk, Alexander T. Sack, Odile A. van den Heuvel, Martijn Arns^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Although many OCD patients benefit from repetitive transcranial magnetic stimulation (rTMS) as treatment, there is still a large group failing to achieve satisfactory response. Sleep problems have been considered transdiagnostic risk factors for psychiatric disorders, and prior work has shown comorbid sleep problems in OCD to be associated with non-response to rTMS in OCD. We therefore set out to investigate the utility of sleep problems in predicting response to rTMS in treatment resistant OCD.

METHOD: A sample of 61 patients (treated with 1-Hz SMA or sequential 1-Hz SMA+DLPFC rTMS, combined with cognitive behavioral therapy) were included. Sleep disturbances were measured using the PSQI, HSDQ and actigraphy. Treatment response was defined as a decrease of at least 35% in symptom severity as measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).

RESULTS: 32 of 61 patients (52.5%) responded to rTMS, and trajectories of response were similar for both rTMS protocols. Three PSQI items (Subjective Sleep Quality; Sleep Latency and Daytime Dysfunction) and the HSDQ-insomnia scale were found to predict TMS response. A discriminant model yielded a significant model, with an area under the curve of 0.813.

CONCLUSION: Future replication of these predictors could aid in a more personalized treatment for OCD.

Original language	English
Article number	100353
Number of pages	6
Journal	International Journal of Clinical and Health Psychology
Volume	23
Issue number	2
DOIs	https://doi.org/10.1016/j.ijchp.2022.100353
Publication status	Published - Apr 2023

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Cite this

@article{a3cec2cc269c43e8b5c4e5f4d2e2c671,

title = "Sleep predicts the response to rTMS and CBT in patients with OCD: an open label effectiveness study",

abstract = "BACKGROUND: Although many OCD patients benefit from repetitive transcranial magnetic stimulation (rTMS) as treatment, there is still a large group failing to achieve satisfactory response. Sleep problems have been considered transdiagnostic risk factors for psychiatric disorders, and prior work has shown comorbid sleep problems in OCD to be associated with non-response to rTMS in OCD. We therefore set out to investigate the utility of sleep problems in predicting response to rTMS in treatment resistant OCD.METHOD: A sample of 61 patients (treated with 1-Hz SMA or sequential 1-Hz SMA+DLPFC rTMS, combined with cognitive behavioral therapy) were included. Sleep disturbances were measured using the PSQI, HSDQ and actigraphy. Treatment response was defined as a decrease of at least 35% in symptom severity as measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).RESULTS: 32 of 61 patients (52.5%) responded to rTMS, and trajectories of response were similar for both rTMS protocols. Three PSQI items (Subjective Sleep Quality; Sleep Latency and Daytime Dysfunction) and the HSDQ-insomnia scale were found to predict TMS response. A discriminant model yielded a significant model, with an area under the curve of 0.813.CONCLUSION: Future replication of these predictors could aid in a more personalized treatment for OCD.",

author = "Gajadien, {Priya T.} and Postma, {Tjardo S.} and {van Oostrom}, Iris and Scheepstra, {Karel W. F.} and {van Dijk}, Hanneke and Sack, {Alexander T.} and {van den Heuvel}, {Odile A.} and Martijn Arns",

note = "{\textcopyright} 2022 The Author(s).",

year = "2023",

month = apr,

doi = "10.1016/j.ijchp.2022.100353",

language = "English",

volume = "23",

journal = "International Journal of Clinical and Health Psychology",

issn = "1697-2600",

publisher = "Facultad de Psicologia",

number = "2",

}

TY - JOUR

T1 - Sleep predicts the response to rTMS and CBT in patients with OCD

T2 - an open label effectiveness study

AU - Gajadien, Priya T.

AU - Postma, Tjardo S.

AU - van Oostrom, Iris

AU - Scheepstra, Karel W. F.

AU - van Dijk, Hanneke

AU - Sack, Alexander T.

AU - van den Heuvel, Odile A.

AU - Arns, Martijn

PY - 2023/4

Y1 - 2023/4

N2 - BACKGROUND: Although many OCD patients benefit from repetitive transcranial magnetic stimulation (rTMS) as treatment, there is still a large group failing to achieve satisfactory response. Sleep problems have been considered transdiagnostic risk factors for psychiatric disorders, and prior work has shown comorbid sleep problems in OCD to be associated with non-response to rTMS in OCD. We therefore set out to investigate the utility of sleep problems in predicting response to rTMS in treatment resistant OCD.METHOD: A sample of 61 patients (treated with 1-Hz SMA or sequential 1-Hz SMA+DLPFC rTMS, combined with cognitive behavioral therapy) were included. Sleep disturbances were measured using the PSQI, HSDQ and actigraphy. Treatment response was defined as a decrease of at least 35% in symptom severity as measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).RESULTS: 32 of 61 patients (52.5%) responded to rTMS, and trajectories of response were similar for both rTMS protocols. Three PSQI items (Subjective Sleep Quality; Sleep Latency and Daytime Dysfunction) and the HSDQ-insomnia scale were found to predict TMS response. A discriminant model yielded a significant model, with an area under the curve of 0.813.CONCLUSION: Future replication of these predictors could aid in a more personalized treatment for OCD.

AB - BACKGROUND: Although many OCD patients benefit from repetitive transcranial magnetic stimulation (rTMS) as treatment, there is still a large group failing to achieve satisfactory response. Sleep problems have been considered transdiagnostic risk factors for psychiatric disorders, and prior work has shown comorbid sleep problems in OCD to be associated with non-response to rTMS in OCD. We therefore set out to investigate the utility of sleep problems in predicting response to rTMS in treatment resistant OCD.METHOD: A sample of 61 patients (treated with 1-Hz SMA or sequential 1-Hz SMA+DLPFC rTMS, combined with cognitive behavioral therapy) were included. Sleep disturbances were measured using the PSQI, HSDQ and actigraphy. Treatment response was defined as a decrease of at least 35% in symptom severity as measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).RESULTS: 32 of 61 patients (52.5%) responded to rTMS, and trajectories of response were similar for both rTMS protocols. Three PSQI items (Subjective Sleep Quality; Sleep Latency and Daytime Dysfunction) and the HSDQ-insomnia scale were found to predict TMS response. A discriminant model yielded a significant model, with an area under the curve of 0.813.CONCLUSION: Future replication of these predictors could aid in a more personalized treatment for OCD.

U2 - 10.1016/j.ijchp.2022.100353

DO - 10.1016/j.ijchp.2022.100353

M3 - Article

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