期刊
BRAIN STIMULATION
卷 12, 期 4, 页码 922-929出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.brs.2019.02.005
关键词
Obsessive compulsive disorder; Transcranial direct current stimulation; Pre-supplementary motor area; Neuromodulation
资金
- Wellcome trust DBT India Alliance [IA/CPHI/16/1/502662]
- Department of Science and Technology [DST] (Government of India) [DST/SJF/LSA-02/2014-15]
- DST [DST/SJF/LSA-02/2014-15]
- Indian Council of Medical Research [DHR/HRD/Young Scientist/Type-VI-(2)/2015]
- Department of Biotechnology (DBT) (Government of India) [DBT/2015/NIM-HANS/345]
Background: A significant proportion of obsessive compulsive disorder (OCD) patients do not respond to specific serotonin reuptake inhibitors (SSRIs). There is a need to evaluate novel treatment options for OCD. Objective: In this double blinded, randomized, sham controlled study, we investigated the efficacy of add-on transcranial direct current stimulation (tDCS) in reducing the symptoms in SSRI-resistant OCD patients by employing anodal pre-supplementary motor area (pre-SMA) stimulation. Method: Twenty-five patients with DSM-IV OCD having persistent symptoms despite adequate and stable treatment with at least one SSRI were randomly allocated to receive 20 min of verum (active) 2-mA tDCS or sham stimulation twice daily on 5 consecutive days [anode over Pre-SMA; cathode over right supra-orbital area]. Response to treatment was defined as at least 35% reduction in the Yale-Brown Obsessive-Compulsive Scale (YBOCS) total score along with a Clinical Global Impression - Improvement (CGI-I) score of 1 (very much improved) or 2 (much improved). Results: The response rate was significantly greater in the verum tDCS(4 out of 12) compared to shamtDCS (0 out of 13) [Fisher's exact test, p = 0.04]. Repeated measures analysis of variance with tDCS type (verum vs. sham) as between subjects factor showed that there was a significant tDCS-type X time-point interaction with significantly greater reduction of YBOCS total score [F (1,22) = 4.95,p = 0.04,partial-eta(2) = 0.18] in verum-tDCS group. Conclusions: The results of this RCT suggest that tDCS may be effective in treating SSRI-resistant OCD. Future studies should examine the efficacy in larger samples of OCD and explore other potential target regions using randomized sham-controlled designs, in addition to examining the sustainability of the beneficial effects. (C) 2019 Elsevier Inc. All rights reserved.
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