A NEW systematic review and meta-analysis sheds light on how brain state during treatment might influence the success of transcranial magnetic stimulation (TMS) for obsessive-compulsive disorder (OCD) and nicotine dependence. Researchers found that TMS led to better clinical outcomes than sham treatment in both conditions, whether or not symptom provocation was used.
TMS is a non-invasive brain stimulation technique increasingly used for mental health and addiction disorders. In OCD and nicotine dependence, treatment protocols often involve deliberately triggering symptoms—such as cravings or obsessive thoughts—before or during stimulation, with the aim of enhancing therapeutic effect.
The analysis pooled data from 71 randomized clinical trials involving over 3,200 participants. While TMS consistently outperformed sham treatments, the additional benefit of symptom provocation was not statistically significant. However, the data hinted at stronger treatment effects when provocation was used, suggesting more research is needed to confirm whether this strategy meaningfully boosts outcomes.
The findings are relevant across psychiatry, addiction medicine, and neurology as researchers continue to refine brain stimulation therapies for complex conditions.
Reference
Bello D et al. Symptom Provocation and Clinical Response to Transcranial Magnetic Stimulation: A Systematic Review and Meta-Analysis. JAMA Psychiatry. 2025;DOI: 10.1001/jamapsychiatry.2025.0792.
