Deep Transcranial Magnetic Stimulation in combination with symptom provocation: An effective treatment in patients with treatment-resistant Body Dysmorphic Disorder?

Body Dysmorphic Disorder (BDD) concerns an excessive preoccupation concerning a perceived physical defect, associated with function impairment. No FDA-approved treatment exists for BDD, and many patients are resistant to standard treatment. Neuromodulation, especially deep Transcranial Magnetic Stimulation (dTMS) represents an important option in treating resistant patients in the obsessive-compulsive spectrum. No previous studies adopted dTMS in BDD. In this case series we reported the cases of three patients with resistant BDD treated with dTMS in combination with symptom provocation, a cognitive-behavioural therapy technique. Symptoms severity decreased after the treatment in all the three patients. These preliminary data suggested that dTMS plus symptom provocation could be an effective treatment for treatment resistant BDD patients. Further prospective studies are needed.