Add-on HD-tDCS for obsessive-compulsive disorder with comorbid bipolar affective disorder: A case series

Target specific effects of direct current stimulation in schizo-obsessive disorder: A case report

“…HD tDCS was administered by a 4 Â 1 ring montage configuration with 2mA current at the anodal central electrode (FCz) surrounded by À0.5mA current at four cathodal electrodes (Fz, FC3, FC4, and CPz) for 10 days. Two 20-min sessions with an intersession interval of 20min were provided by standard equipment (Soterix Medical MXN9-HD System; https://soterixmedical.com/research/hd/mxn) with stringent safety measures [6]. A significant reduction (38.5%) in the Yale brown obsessive-compulsive scale (YBOCS) scores from 26 to 16 were reported after 10 days.…”

“…Improvement in AVH and OC symptoms with respective tDCS montages applied sequentially might indicate the potential for utilizing the possible target specificity of non-invasive neuromodulation methods. For instance, the utility of anodal pre-SMA HD-tDCS to treat OCD symptoms in a patient with comorbid bipolar disorder has been recently reported [6]. Conditions with dual-diagnosis such as schizo-obsessive disorder might help to understand and examine the differential substrates of the individual comorbid disorders in question.…”

Could Transcranial Direct Current Stimulation Join the Therapeutic Armamentarium in Obsessive-Compulsive Disorder?

“…In fact, radiological studies have suggested abnormalities within a cortico-basal ganglia-thalamo-cortical loop that includes orbitofrontal-prefrontal areas, basal ganglia, thalamus, but also cerebellum, anterior cingulate cortex, insula, and temporal, parietal, and occipital regions [1,4]. In some of the studies that have adopted functional neuroimaging techniques, OCD was associated with abnormal activity in the orbitofrontal cortex (OFC), supplementary motor area (SMA), pre-SMA, and cerebellum [2,[6][7][8][9][10]. Therefore, one may hypothesize that improving obsessive-compulsive (OC) symptoms could be possible by targeting these cerebral areas.…”

“…tDCS literature in the context of OCD includes case reports, open-label studies, and few randomized controlled trials [2,[6][7][8][9][10]. Assessment included OC symptoms, by means of the Yale-Brown Obsessive and Compulsive Scale (YBOCS), as well as other comorbidities (i.e., anxiety and depressive symptoms).…”

“…To start, the majority of case reports and open-label studies have adopted 10-20 tDCS sessions (20-30 min per session, 1-2 sessions per day) using a current intensity of 2 mA delivered by 25-35 cm 2 electrodes [2]. YBOCS scores improved when targeting the DLPFC (anode over the left DLPFC, cathode over the right DLPFC/frontopolar region), OFC (cathode over left or right OFC; anode over contralateral cerebellar, occipital, cerebello-occipital, or parieto-temporo-occipital areas) and SMA or pre-SMA (cathode or anode over SMA/pre-SMA and reference electrode over the right OFC, occipital area, or deltoid) [2,6,7]. Conversely, cathodal stimulation of the left DLPFC (anode over the posterior neck-base) did not yield clinical benefits [2].…”