TMS with Neuronavigation › Obsessive-compulsive disorder
When intrusive thoughts and rituals will not let go.
Transcranial magnetic stimulation (TMS) acts on the brain circuit that, in obsessive-compulsive disorder, stays stuck on alert. It is added to medication and exposure therapy as a further step when current treatment is not enough.
A lasting effect
31
randomised studies analysed together (2025) show that TMS reduces obsessive-compulsive symptoms, and the effect lasts after treatment ends.
Source: Revista Brasileira de Psiquiatria, 2025 (meta-analysis, 31 studies)
In OCD, the loop between the frontal cortex, striatum and thalamus is overactive. TMS calms it directly, where medication only partly reaches.
TMS is added to exposure and response prevention therapy, the recommended psychological treatment for OCD, which we offer in the same clinic.
The stimulated area is small and varies from person to person. Neuronavigation shows us in real time whether the coil is exactly on it.
What the research shows
OCD is the second most researched psychiatric indication for TMS, with dozens of randomised studies.
3 times
the chance of response
Across 25 randomised studies (860 patients), TMS tripled the likelihood of response compared with placebo.
Source: Steuber and McGuire, Biological Psychiatry: CNNI, 2023
1 in 6
additional patients respond
For every six patients treated, one more responds thanks to TMS compared with placebo, and the effect holds at follow-up visits.
Source: Revista Brasileira de Psiquiatria, 2025 (meta-analysis, 31 studies)
34
studies, 1,089 patients
A comparative analysis of 24 stimulation methods in OCD confirmed the efficacy of prefrontal stimulation, including the right-hemisphere protocol.
well tolerated
dropout similar to placebo
Patients stopped treatment as rarely as in the placebo group, a sign that TMS is well tolerated.
Source: Revista Brasileira de Psiquiatria, 2025 (meta-analysis, 31 studies)
In brief, with Dr Nadia Gorduza
Dr Nadia Gorduza explains how TMS works together with medication and exposure therapy for intrusive thoughts and rituals.
The doctor chooses the target after the assessment. Both protocols use gentle, low-frequency stimulation.
Target 1
Right prefrontal area
Involved in controlling intrusive thoughts. About 25 minutes per session.
Target 2
Pre-supplementary motor area
Involved in stopping rituals. About 25 minutes per session.
Recommended course
at least 30 sessions
Usually 5 days a week for 6 weeks or more.
Alongside
exposure therapy
You continue medication and exposure and response prevention therapy.
The doctor sets the session frequency and the exact protocol after the initial assessment. Reassessment on clinical scales after 10, 20 and 30 sessions.
The protocols we use
We use protocols validated in clinical studies and in the European recommendations for TMS. The doctor chooses the right protocol for you at the initial assessment.
Dr Nadia Gorduza, Academy of Brain Stimulation member 2026, certified Clinical TMS Practitioner · View the certificate
In OCD, the European recommendations place these protocols at Level C: study results are encouraging but still building. That is why the doctor explains at the assessment what you can expect, and TMS is always given together with medication and exposure therapy.
Progress you can measure, not just feel
We carry out the clinical assessment with standardised test batteries at the start of treatment and then after 10, 20 and 30 sessions. You see your progress in numbers, and the doctor adjusts the plan.
Intrusive thoughts
how often they come and how much they upset you
Rituals
how much time they take and how hard they are to stop
Mood
mood, which often changes with OCD
Everyday life
how well you keep up with everyday tasks
Ongoing research
The international clinical trials registry (ClinicalTrials.gov) lists 23 ongoing TMS studies in OCD, most not yet published. Here are some of them:
Amsterdam UMC, 8 centres in the Netherlands · 250 patients · phase 3
OCD that has not responded to exposure therapy
A large multicentre study using exactly the pre-supplementary motor area protocol we use.
Stanford University · 212 patients
Who responds best to TMS in OCD
Looks for signs on brain images that predict response, so that treatment can be chosen individually.
Champalimaud Foundation, Lisbon · ongoing
New targets found with Neuronavigation
Uses MRI and Neuronavigation to identify the brain networks involved in OCD and stimulate them precisely.
Ghent University Hospital, Belgium · 60 patients
Accelerated TMS together with exposure therapy
Tests whether intensive stimulation given just before exposure therapy speeds up improvement.
In OCD, the number of sessions and the right package are set at the initial assessment, according to the chosen protocol. The price per session starts from the launch price.
No. In OCD, TMS is added to your treatment. The best results come in combination with exposure therapy.
Improvement usually comes gradually, after 4–6 weeks. We reassess you after 10, 20 and 30 sessions.
You feel a light tapping on the scalp and hear a click with each pulse. You are awake and can go home on your own after the session.
The first step is the initial assessment. Tap “Book now!” and choose your time directly on WhatsApp. Bring your medical records, your list of medications and your MRI, if you have one.
3 Aviator Jean Texier Street, 1st floor, apt. 2, Sector 1, Bucharest · Monday–Friday, 10:00–20:00
Results vary from patient to patient. The indication for TMS is set by the doctor after an assessment. Sources: Steuber and McGuire, Biol Psychiatry CNNI 2023 · Rev Bras Psiquiatr 2025 · Tseng et al., Acta Psychiatr Scand 2025 · ClinicalTrials.gov, November 2026 · Academy of Brain Stimulation, TMS Protocols 08/2026.
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