Transcranial direct current stimulation targeting the medial prefrontal cortex modulates functional connectivity and enhances safety learning in obsessive‐compulsive disorder: Results from two pilot studies

2021 ◽  
Author(s):  
Thomas G. Adams ◽  
Josh M. Cisler ◽  
Benjamin Kelmendi ◽  
Jamilah R. George ◽  
Stephen A. Kichuk ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Functional Connectivity ◽  
Obsessive Compulsive Disorder ◽  
Medial Prefrontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Obsessive Compulsive ◽  
Pilot Studies ◽  
Compulsive Disorder ◽  
Direct Current Stimulation

scholarly journals Transcranial direct current stimulation (tDCS) targeting the medial prefrontal cortex (mPFC) modulates functional connectivity and enhances inhibitory safety learning in obsessive-compulsive disorder (OCD)

2021 ◽  
Author(s):  
Thomas G. Adams ◽  
Josh M. Cisler ◽  
Benjamin Kelmendi ◽  
Jamilah R. George ◽  
Stephen A. Kichuk ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Functional Connectivity ◽  
Obsessive Compulsive Disorder ◽  
Medial Prefrontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Fear Extinction ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Direct Current Stimulation

AbstractBackgroundPsychotherapy based on fear extinction is a mainstay of treatment for obsessive-compulsive disorder (OCD). The default mode network (DMN) is important to safety signal processing, fear extinction, and exposure-based therapies. The medial prefrontal cortex (mPFC) is an anchor of the DMN. Neuromodulation targeting the mPFC might augment therapeutic learning and thereby enhance response to exposure-based therapies.MethodsTo characterize the effects of mPFC neuromodulation, 17 community volunteers completed resting-state fMRI scans before and after receiving 20 minutes of frontopolar multifocal transcranial direct current stimulation (tDCS). To examine the effects of tDCS on therapeutic learning, 24 patients with OCD were randomly assigned (double-blind, 50:50) to receive active or sham tDCS immediately before completing a two-day exposure and response prevention (ERP) challenge.ResultsAfter tDCS, frontal pole functional connectivity with regions in the anterior insula and basal ganglia decreased, while connectivity in the middle and superior frontal gyri increased (ps<.001, corrected). Functional connectivity between DMN and salience network (SN) increased after tDCS (ps<.001). OCD patients who received active tDCS exhibited more rapid within- and between-trial therapeutic extinction learning (ps<.05) during the ERP challenge compared to those who received sham tDCS.ConclusiontDCS targeting the mPFC may modulate SN and DMN functional connectivity and can accelerate therapeutic learning. Though limited by small samples, these promising findings motivate further exploration of the effects of tDCS on neural and behavioral targets associated with exposure-based treatments for OCD and for other anxiety and related disorders.

scholarly journals Protocol for Transcranial Direct Current Stimulation for Obsessive-Compulsive Disorder

2020 ◽  
Vol 10 (12) ◽  
pp. 1008
Author(s):  
Peta E. Green ◽  
Andrea Loftus ◽  
Rebecca A. Anderson
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Controlled Trial ◽  
Treatment Modalities ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Direct Current Stimulation

Obsessive-compulsive disorder (OCD) is a debilitating disorder with an approximate lifetime prevalence of 1–3%. Despite advances in leading treatment modalities, including pharmacotherapy and psychotherapy, some cases remain treatment resistant. Non-invasive brain stimulation has been explored in this treatment-resistant population with some promising findings; however, a lack of methodological rigor has reduced the quality of the findings. The current paper presents the protocol for conducting research into the efficacy of transcranial direct current stimulation (tDCS) in the treatment of OCD. A double-blind randomised controlled trial (RCT) will be conducted involving active tDCS vs. sham tDCS on 40 general OCD patients. The intervention consists of 2 mA anodal stimulation over the pre-supplementary motor area (pre-SMA) with the cathode positioned over the orbitofrontal cortex (OFC). Participants will receive 10 sessions of 20 min of either sham- or active-tDCS over 4 weeks. Outcomes will be categorical and dimensional measures of OCD, as well as related secondary clinical measures (depression, anxiety, quality of life), and neurocognitive functions (inhibitory control, cognitive flexibility).

Transcranial direct current stimulation for obsessive compulsive disorder

2019 ◽  
Vol 12 (2) ◽  
pp. 513
Author(s):  
J. Narayanaswamy ◽  
V. Shivakumar ◽  
V. HT ◽  
R. Parlikar ◽  
Y. Reddy ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Direct Current Stimulation

scholarly journals Transcranial Direct Current Stimulation for Obsessive-Compulsive Disorder: A Systematic Review

2018 ◽  
Vol 8 (2) ◽  
pp. 37 ◽  
Author(s):  
Jérôme Brunelin ◽  
Marine Mondino ◽  
Rémy Bation ◽  
Ulrich Palm ◽  
Mohamed Saoud ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Controlled Study ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Direct Current Stimulation ◽  
Manual Search ◽  
Pubmed Database

Despite the advances in psychopharmacology and established psychotherapeutic interventions, more than 40% of patients with obsessive-compulsive disorder (OCD) do not respond to conventional treatment approaches. Transcranial direct current stimulation (tDCS) has been recently proposed as a therapeutic tool to alleviate treatment-resistant symptoms in patients with OCD. The aim of this review was to provide a comprehensive overview of the current state of the art and future clinical applications of tDCS in patients with OCD. A literature search conducted on the PubMed database following PRISMA guidelines and completed by a manual search yielded 12 results: eight case reports, three open-label studies (with 5, 8, and 42 participants), and one randomized trial with two active conditions (12 patients). There was no sham-controlled study. A total of 77 patients received active tDCS with a large diversity of electrode montages mainly targeting the dorsolateral prefrontal cortex, the orbitofrontal cortex or the (pre-) supplementary motor area. Despite methodological limitations and the heterogeneity of stimulation parameters, tDCS appears to be a promising tool to decrease obsessive-compulsive symptoms as well as comorbid depression and anxiety in patients with treatment-resistant OCD. Further sham-controlled studies are needed to confirm these preliminary results.

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