Brain-Oscillation Synchronized Stimulation of the DMPFC

Who can take part

• Are 18-65 years old
• Have OCD as a primary disorder, confirmed by a MINI diagnosis of OCD
• Have OCD with treatment resistance as defined by failure of at least a course of cognitive-behavioural therapy or a single trial (≥4 weeks) of an SSRI
• Does not meet criteria for substance use disorder as determined by the MINI (with the exception of nicotine and caffeine)
• Have a Y-BOCS score ≥20
• Are fluent in the English language (spoken, written and reading)
• Have had no increase or initiation of any psychotropic medication in the 4 weeks prior to screening
• Must be deemed to have capacity to provide informed consent
• Must sign and date the informed consent form
• Stated willingness to comply with all study procedures

Who cannot take part

• Are pregnant or breast feeding. TMS is not unsafe in pregnancy and therefore we are not requiring a pregnancy test prior to entry. If patients become pregnant during the study they will not be excluded. We are not including patients who are currently aware of being pregnant as OCD can be affected during the later stages of pregnancy and therefore is a potential confound
• Have any metal implant or dentures
• Taking more than 2mg of lorazepam or equivalent benzodiazepine, or any anticonvulsant medication
• Have received any ablative neurological procedure (e.g., focused ultrasound)
• Have a history of a medical or neurological disorder that affects CNS (such as, traumatic brain injury, stroke, Parkinson)
• Have history of seizures
• Have serious or unstable medical condition requiring immediate investigation or treatment (e.g. severe or recent cardiac disease)
• Have cardiac pacemaker, cochlear implants, implanted electronic devices or non- electronic metallic implants or other contraindications for TMS
• Fulfill MINI criteria for Alcohol Use Disorder
• Have any contraindications to TMS as determined by the TASS questionnaire (18)