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(MD PhD)",[139,140,142,143,145,147],{"name":58,"class":6},{"name":141,"class":6},"Radboud University Medical Center",{"name":113,"class":6},{"name":144,"class":6},"Maastricht University Medical Center",{"name":103,"class":146},"AMBIG",{"name":68,"class":6},"100464764","phase-3-tms-for-exposure-therapy-resistant-ocd-100464764",false,"NCT05331937","TMS for Exposure Therapy Resistant OCD","Transcranial Magnetic Stimulation (TMS) for Patients With Exposure Therapy-resistant Obsessive-compulsive Disorder (OCD): TETRO - a Multicenter Randomized Controlled Trial","TETRO","Inclusion Criteria:\n\n* OCD as current primary diagnosis\n* Age 18 and older\n* Yale-Brown Obsessive-Compulsive Scale (YBOCS) score of 16 or higher.\n* Insufficient response to state-of-the art exposure therapy with response prevention (ERP) and\u002For drop-out from ERP due to extreme anxiety\u002Favoidance\n* The following comorbid disorders are allowed (as long as OCD is the current primary diagnosis): depression, other anxiety disorders, ADHD, tic\u002FTourette's disorder, eating disorders, personality disorders, autism spectrum disorder (when this does not dominate the clinical profile, i.e. is not main diagnosis).\n* Commitment to actively undergo intensive exposure therapy (both supervised during ERP sessions, as well as unsupervised at home)\n* Unmedicated (for at least 8 weeks) or stable dosage of psychotropic medication (for at least 8 weeks), involving serotonergic antidepressants (SSRI, SNRI, clomipramine). Other psychotropic medication that is allowed (provided dosage is stably established for at least 8 weeks): methylphenidate, mood stabilizers, antipsychotic drugs\n* Ability to participate in frequent treatment sessions (4 days\u002Fweek, for 5 (or 6, or 7) weeks) at one of the 5 sites nearest to their home and\u002For work\n* Ability to participate in pre-treatment MRI session (for neuronavigation) at one of the 3 academic sites nearest to their home and\u002For work\n* Capacity for providing informed consent\n\nExclusion Criteria:\n\n* OCD patients with hoarding as main symptom dimension\n* The following comorbid disorders (current diagnosis) are not allowed: psychotic disorders, bipolar disorder, autism spectrum disorder (when this dominates the clinical profile, i.e. is diagnosed as main disorder), substance use disorder\n* Active suicidal thoughts and intent to act on it\n* Chronic use of benzodiazepines is not allowed\n* Cochlear implant\n* (History of) epilepsy\n* Pregnancy\n* Extreme claustrophobia or metallic objects in or on the body, preventing from participation in MRI session\n* Space-occupying lesion on MRI\n* Previous rTMS treatment (for blinding reasons)","ALL","18 Years",{"count":159,"type":160},250,"ESTIMATED","INTERVENTIONAL",[163],"PHASE3","TETRO is a multi-center placebo-controlled double-blind randomized controlled trial with an intervention phase of 5-7 weeks and a follow-up phase of 12 months in 250 adult (18 years and older) OCD patients who show no\u002Finsufficient response to ERP, aiming to establish the cost-effectiveness of low frequency (1 Hz) rTMS to the pre-SMA (compared to sham rTMS to the pre-SMA) as adjuvant treatment to exposure with response prevention (ERP). The treatment consists of 4 times\u002Fweek rTMS combined with ERP for at least 5 weeks (20 sessions), with optional extension phase of 1 or 2 weeks (maximum of 28 sessions in total).",[166,167],"1 Hz Real rTMS to the Pre-SMA","1 Hz Sham rTMS to the Pre-SMA","2026-03-01",{"date":170,"type":171},"2026-03-04","ACTUAL",{"date":173,"type":171},"2022-05-16",{"date":175,"type":160},"2027-12-01",{"name":5,"class":6},8]