Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep 16:15:2663-2669.
doi: 10.2147/NDT.S184839. eCollection 2019.

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

Renata de Melo Felipe da Silva  1 , Andre Russowsky Brunoni  2 , Eurípedes Constantino Miguel  1 , Roseli Gedanke Shavitt  3
Affiliations

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

Renata de Melo Felipe da Silva et al. Neuropsychiatr Dis Treat. .

Abstract

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: neuromodulation; obsessive-compulsive disorder; transcranial direct current stimulation.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of the selection of studies according to PRISMA.
None
See this image and copyright information in PMC

References

    1. Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the national comorbidity survey replication. Mol Psychiatry. 2010;15:53–63. doi: 10.1038/mp.2008.94 - DOI - PMC - PubMed
    1. American Psychiatric Association. DSM-5 Task Force. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association; 2013.
    1. Shavitt RG, de Mathis MA, Oki F, et al. Phenomenology of OCD: lessons from a large multicenter study and implications for ICD-11. J Psychiatr Res. 2014;57:141–148. doi: 10.1016/j.jpsychires.2014.06.010 - DOI - PMC - PubMed
    1. Hirschtritt ME, Bloch MH, Mathews CA. Obsessive-compulsive disorder. JAMA. 2017;317(13):1358. doi: 10.1001/jama.2017.2200 - DOI - PubMed
    1. Simpson HB, Huppert JD, Petkova E, Foa EB, Liebowitz MR. Response versus remission in obsessive-compulsive disorder. J Clin Psychiatry. 2006;67(2):269–276. doi: 10.4088/JCP.v67n0214 - DOI - PubMed