Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has been increasingly examined as an alternative treatment modality for Obsessive-Compulsive Disorder (OCD), due to its low costs, ease of use, and portability. Previous studies have suggested that tDCS m...

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Bibliographic Details
Published in:Neuropsychiatric disease and treatment 2019-09, Vol.15, p.2663-2669
Main Authors: da Silva, Renata de Melo Felipe, Brunoni, Andre Russowsky, Miguel, Eunpedes Constantino, Shavitt, Roseli Gedanke
Format: Article
Language:English
Subjects:
Adults
Breast feeding
Clinical trials
Comorbidity
Computer simulation
Drug therapy
Elderly
Electrical stimulation of the brain
ESB
Evidence-based medicine
Future predictions
Medical research
Mental disorders
Neuromodulation
Neurophysiology
Neurosciences
Neuroses
Obsessive compulsive disorder
Patients
Population studies
Pregnant women
Review
Systematic review
transcranial direct current stimulation
Youth
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Description
Summary:Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has been increasingly examined as an alternative treatment modality for Obsessive-Compulsive Disorder (OCD), due to its low costs, ease of use, and portability. Previous studies have suggested that tDCS may achieve a reasonably good response and present a safe tolerability profile. However, at this point there is not strong evidence for the use of this modality of treatment. Considering that OCD is very heterogeneous with regard to clinical presentation, clinical severity and comorbidities, we have conducted a systematic review of studies on tDCS for OCD aiming to evaluate the clinical characteristics of the selected patients and to discuss perspectives for future studies. A literature search was conducted from inception until March 2019 at PubMed/MedLine and Scielo using the following keywords: "tdcs" or "transcranial direct current stimulation" and "obsessive compulsive disorder". Out of 45 manuscripts, twelve were included. Most of the included studies are uncontrolled. A few controlled studies reported improvement of OCD, but some limitations need to be considered. Our main findings were that the selected patients were adults with severe OCD and psychiatric comorbidities, medicated at the time of assessment and resistant to at least one previous conventional treatment. We could not find any studies including specific populations such as adolescents, elderly, pregnant and breastfeeding participants. Similarly, the potential use of tDCS has not been tested in patients with less severe OCD, as a first treatment option, or for those who do not tolerate pharmacological treatments. These opportunities should be explored in future controlled trials. Keywords: obsessive-compulsive disorder, transcranial direct current stimulation, neuromodulation
ISSN:1178-2021
1176-6328
1178-2021
DOI:10.2147/NDT.S184839