Transcranial direct current stimulation improve symptoms and modulates cortical inhibition in obsessive-compulsive disorder: A TMS-EEG study

Jiayue Cheng; Puyu Li; Yingying Tang; Chen Zhang; Liangjun Lin; Jian Gao; Zhen Wang

doi:10.1016/j.jad.2021.11.043

Transcranial direct current stimulation improve symptoms and modulates cortical inhibition in obsessive-compulsive disorder: A TMS-EEG study

J Affect Disord. 2022 Feb 1;298(Pt A):558-564. doi: 10.1016/j.jad.2021.11.043. Epub 2021 Nov 18.

Authors

Jiayue Cheng¹, Puyu Li¹, Yingying Tang¹, Chen Zhang², Liangjun Lin¹, Jian Gao¹, Zhen Wang³

Affiliations

¹ Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China.
² Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; Schizophrenia Program, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, China; Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China. Electronic address: wangzhen@smhc.org.cn.

PMID: 34801604
DOI: 10.1016/j.jad.2021.11.043

Abstract

Background: Obsessive-compulsive disorder (OCD) is a disabling condition for which approximately 40% of patients do not respond to first-line treatment. Transcranial direct current stimulation (tDCS) is a safe and accessible technique that modulates cortical excitability and inhibition, but evidence of its efficacy for OCD is insufficient.

Objective: To investigate the efficacy of tDCS for OCD and alterations of cortical excitability and inhibition after treatment measured by concurrent transcranial magnetic stimulation-electroencephalography (TMS-EEG).

Methods: Twenty-four OCD patients underwent 10 20-min sessions of 1.5 mA high-definition tDCS with a cathode placed over the right orbitofrontal cortex (OFC) and anode electrodes set around the cathodal electrode. TMS-EEG was performed before and after tDCS treatment. OCD symptom severitys was assessed using Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and the Beck Depression Inventory-Ⅱ (BDI-Ⅱ), and Beck Anxiety Inventory (BAI) were used to assess the severity of depression and anxiety symptoms. Twenty-seven healthy controls were recruited with TMS-EEG recorded.

Results: Following tDCS, the Y-BOCS, BDI-Ⅱ, and BAI scores decreased significantly (all p = 0.000). TMS-evoked N100 amplitude, thought to be related to GABA_B receptor function, was significantly reduced after tDCS (Z = -2.143, p = 0.032) which was higher in OCD patients than in healthy controls at baseline (Z = -2.151, p = 0.031).

Limitations: Pharmacotherapy during tDCS treatment may influence the effect of tDCS and EEG.

Conclusions: Cathodal high-definition tDCS applied over the OFC could improve OCD, depression, and anxiety symptoms along with alleviation of GABA_B receptor function.

Keywords: GABA; Neuromodulation; Obsessive-compulsive disorder; TMS-EEG; Transcranial direct current stimulation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Electroencephalography
Humans
Obsessive-Compulsive Disorder* / therapy
Transcranial Direct Current Stimulation*
Transcranial Magnetic Stimulation
Treatment Outcome