Transcranial Direct Current Stimulation in Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, and Anxiety Disorders

Abstract

Obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and anxiety disorders share the basic clinical feature of anxiety, which probably explains their common response to similar pharmacological and psychological interventions. Transcranial direct current stimulation (tDCS) is a neuromodulation technique that has proved effective in reducing the symptoms of a number of neuropsychiatric disorders. It was also used in healthy subjects to modulate neuropsychological processes that are involved in the pathophysiology of anxiety. We review the published studies in which tDCS was administered to patients with OCD, PTSD, or anxiety disorders. Our systematic search in the major electronic databases resulted in 14 articles for OCD, 1 for an OCD-related disorder (ie, hoarding disorder), 2 for PTSD, and 2 for anxiety disorders. In the studies involving OCD patients, tDCS was targeted to either the dorsolateral prefrontal cortex or the orbitofrontal cortex or the pre-supplementary motor area and induced a clear reduction of obsessive-compulsive symptoms. However, the lack of sham control groups and the great diversity in sample selection and tDCS protocols among studies prevent us from generalizing these results. In the studies involving PTSD and anxiety disorders patients, tDCS was applied over the dorsolateral prefrontal cortex and reduced symptoms, but the number of treated patients is too little to draw any conclusion on efficacy. However, these reports highlighted the importance of combining tDCS with different procedures, including computerized tasks and behavioral paradigms. In conclusion, even in its infancy, the use of tDCS for the treatment of OCD, PTSD, and anxiety disorders does show promise and deserves extensive research effort.

Behavioral and Neurophysiological Effects of Transcranial Direct Current Stimulation (tDCS) in Fronto-Temporal Dementia

“…Massimo et al ( 2015 ) hypothesized that goal-directed behavior is supported by a network of multiple frontal brain regions. Overall, data from studies on psychiatric disorders suggest that tDCS over the dorsolateral prefrontal cortex (DLPFC) (Brunoni et al, 2010 , 2011 ; Kuo et al, 2014 ; D'Urso et al, 2017 , 2018 ) has the potential to induce clinically relevant behavioral changes in difficult-to-treat patient populations and could thus represent a valuable tool for intervention in a range of mental and neurological disorders.…”

Transcranial direct current stimulation in patients with obsessive compulsive disorder: A randomized controlled trial

“…tDCS has been shown to have clinical effectiveness in the treatment of various psychiatric disorders [22]. It has been suggested that tDCS might be useful in decreasing the symptoms of patients with treatment-resistant OCD [28, 29], but the optimal target locations and stimulation parameters remain under debate.…”

Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19

“…As opposed to rTMS, tDCS could safely be instituted in different environments, including the domestic or ICU setting. However, evidence of tDCS efficacy in anxiety and stress disorders is evolving ( 194 , 210 ). Bifrontal 2 mA stimulation with cathode over the right and anode over the left DLPFC was performed on a recently published controlled randomized trial, supporting the efficacy of tDCS in the treatment of PTSD ( 211 ).…”