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Review
. 2021:49:399-436.
doi: 10.1007/7854_2020_206.

Invasive and Non-invasive Neurostimulation for OCD

Isidoor O Bergfeld  1   2 , Eva Dijkstra  1 , Ilse Graat  1 , Pelle de Koning  1 , Bastijn J G van den Boom  1   3 , Tara Arbab  1   3 , Nienke Vulink  1 , Damiaan Denys  1   2   3 , Ingo Willuhn  1   2   3 , Roel J T Mocking  4
Affiliations
Review

Invasive and Non-invasive Neurostimulation for OCD

Isidoor O Bergfeld et al. Curr Top Behav Neurosci. 2021.

Abstract

It becomes increasingly clear that (non-)invasive neurostimulation is an effective treatment for obsessive-compulsive disorder (OCD). In this chapter we review the available evidence on techniques and targets, clinical results including a meta-analysis, mechanisms of action, and animal research. We focus on deep brain stimulation (DBS), but also cover non-invasive neurostimulation including transcranial magnetic stimulation (TMS). Data shows that most DBS studies target the ventral capsule/ventral striatum (VC/VS), with an overall 76% response rate in treatment-refractory OCD. Also TMS holds clinical promise. Increased insight in the normalizing effects of neurostimulation on cortico-striatal-thalamic-cortical (CSTC) loops - through neuroimaging and animal research - provides novel opportunities to further optimize treatment strategies. Advancing clinical implementation of neurostimulation techniques is essential to ameliorate the lives of the many treatment-refractory OCD patients.

Keywords: Deep brain stimulation; Neuromodulation; Transcranial magnetic stimulation; Treatment outcome; Working mechanisms.

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