Open AccessTreating refractory obsessive–compulsive disorder with transcranial direct current stimulation: An open label study
Author(s) -
HarikaGermaneau Ghina,
Heit Damien,
Chatard Armand,
Thirioux Berangere,
Langbour Nicolas,
Jaafari Nemat
Publication year - 2020
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.1648
Subject(s) - transcranial direct current stimulation , tolerability , sma* , supplementary motor area , refractory (planetary science) , medicine , obsessive compulsive , concomitant , stimulation , anesthesia , adverse effect , psychiatry , physics , mathematics , combinatorics , astrobiology
Background Obsessive–compulsive disorder (OCD) is a complex disorder with 40%–60% of patients' refractory to treatment. Transcranial direct current stimulation (tDCS) has been shown to induce potent and long‐lasting effects on cortical excitability. The aim of the present clinical trial was to evaluate the therapeutic efficacy and tolerability of cathodal tDCS over the supplementary motor area (SMA) in treatment‐resistant OCD patients. Methods Twenty‐one treatment‐resistant OCD outpatients received 10 sessions of tDCS. Each treatment session consisted of 2 mA stimuli for 30 min. The cathode was positioned over the bilateral SMA and the anode over the right supraorbital area. Patients were evaluated at baseline, end of treatment, one‐month follow‐up, and three‐month follow‐up. Response to treatment was defined as at least a decrease of 35% on the Yale–Brown Obsessive–Compulsive Scale (YBOCS) and a score of 2 or less on the Clinical Global Impressions‐Improvement (CGI‐I) between baseline and 1‐month follow‐up. Results There was a significant decrease of YBOCS scores between baseline and one‐month assessment. At one month, five patients (24%) were considered as responders and 3 (15%) at 3 months. We also observed concomitant changes in depressive symptoms, and insight. The treatment was well tolerated. Short‐lasting side effects were reported as localized tingling sensation and skin redness. Conclusion Our results suggest that the use of cathodal tDCS over the SMA and anodal tDCS over the right supraorbital area in OCD treatment‐refractory patients is safe and promising to improve obsessive and compulsive symptoms. Large randomized controlled trials are needed to confirm this positive result.