Transcranial direct current stimulation in obsessive-compulsive disorder: emerging clinical evidence and considerations for optimal montage of electrodes

Expert Rev Med Devices. 2015 Jul;12(4):381-91. doi: 10.1586/17434440.2015.1037832. Epub 2015 May 17.

Abstract

Background: Neuromodulation techniques for obsessive-compulsive disorder (OCD) treatment have expanded with greater understanding of the brain circuits involved. Transcranial direct current stimulation (tDCS) might be a potential new treatment for OCD, although the optimal montage is unclear.

Objective: To perform a systematic review on meta-analyses of repetitive transcranianal magnetic stimulation (rTMS) and deep brain stimulation (DBS) trials for OCD, aiming to identify brain stimulation targets for future tDCS trials and to support the empirical evidence with computer head modeling analysis.

Methods: Systematic reviews of rTMS and DBS trials on OCD in Pubmed/MEDLINE were searched. For the tDCS computational analysis, we employed head models with the goal of optimally targeting current delivery to structures of interest.

Results: Only three references matched our eligibility criteria. We simulated four different electrodes montages and analyzed current direction and intensity.

Conclusion: Although DBS, rTMS and tDCS are not directly comparable and our theoretical model, based on DBS and rTMS targets, needs empirical validation, we found that the tDCS montage with the cathode over the pre-supplementary motor area and extra-cephalic anode seems to activate most of the areas related to OCD.

Keywords: computer-based modeling; non-invasive brain stimulation; obsessive–compulsive disorder; repetitive transcranial magnetic stimulation; transcranial direct current stimulation.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Electrodes
  • Female
  • Humans
  • MEDLINE
  • Magnetic Field Therapy / instrumentation*
  • Magnetic Field Therapy / methods*
  • Male
  • Models, Biological*
  • Motor Cortex / physiopathology
  • Obsessive-Compulsive Disorder / physiopathology
  • Obsessive-Compulsive Disorder / therapy*
  • Transcranial Direct Current Stimulation / instrumentation*
  • Transcranial Direct Current Stimulation / methods*