This systematic review and network meta-analysis investigated the efficacy and tolerability of various repetitive transcranial magnetic stimulation (rTMS) strategies for treating obsessive-compulsive disorder (OCD). Twenty-two randomized controlled trials were included. Low-frequency (LF) rTMS over the dorsolateral prefrontal cortex (DLPFC) showed greater efficacy than sham rTMS, with a mean difference (MD) of 6.34 (95% credible interval [CrI] 2.12–10.47). High-frequency (HF) rTMS over the DLPFC also showed some efficacy (MD 3.75, 95% CrI 0.40–6.81). Tolerability was similar across all rTMS strategies. LF-rTMS over the DLPFC was ranked as potentially the most effective, but the quality of evidence was very low, highlighting the need for higher-quality trials to confirm these findings.

Kaili Liang, Hailong Li, Xuan Bu, Xue Li, Lingxiao Cao, Jing Liu, Yinxue Gao, Bin Li, Changjian Qiu, Weijie Bao, Suming Zhang, Xinyu Hu, Haoyang Xing, Qiyong Gong, Xiaoqi Huang