Transcranial direct current stimulation in treatment-resistant obsessive-compulsive disorder: An open-label pilot study

被引:65
作者
Bation, Remy [1 ]
Poulet, Emmanuel [1 ,2 ]
Haesebaert, Frederic [1 ]
Saoud, Mohamed [1 ,3 ]
Brunelin, Jerome [1 ]
机构
[1] Univ Lyon 1, Ctr Hosp Vinatier, EA 4615, F-69003 Bron, France
[2] CHU Lyon, Groupement Hosp Edouard Herriot, Serv Psychiat Urgences, Lyon, France
[3] CHU Lyon, Hop Pierre Wertheimer Psychiat Adultes Consultat, Groupement Hosp Est, Lyon, France
关键词
Obsessive-compulsive disorder; OCD; tDCS; Transcranial direct current stimulation; Orbitofrontal cortex; OFC; Cerebellum; MAGNETIC STIMULATION; BRAIN ACTIVATION; CONTROLLED TRIAL; NETWORKS; CORTEX; TDCS; MODULATION; COGNITION; SYMPTOMS; EFFICACY;
D O I
10.1016/j.pnpbp.2015.10.001
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Obsessive-compulsive disorder (OCD) is a severe mental illness. OCD symptoms are often resistant to available treatments. Abnormalities within the orbitofronto-striato-pallido-thalamic circuitry, especially orbitofrontal cortex (OFC) hyperactivity and cerebellar hypoactivity have been observed in patients. Noninvasive brain stimulation studies have indicated that transcranial direct current stimulation (tDCS) may be a useful alternative to alleviate treatment-resistant symptoms in various neuropsychiatric conditions. Methods: In an open-label pilot study, 8 patients with treatment-resistant OCD received 10 sessions (twice a day) of 2 mA tDCS applied with the cathode over the left OFC and the anode over the right cerebellum. OCD (Y-BOCS and OCD-VAS) as well as depressive (MADRS) symptoms were measured 4 times: one time before tDCS and 3 times after (immediately after, 1 and 3 months after the 10th tDCS session). Results: We reported a significant 26.4% (+/- 15.8) decrease of Y-BOCS score (p = 0.002). The beneficial effect lasted during the 3 month follow-up. No effect of tDCS was observed on depressive symptoms. At end point, 5 out of 8 patients had a decrease of >= 25%; and 3 out of 8 patients had a decrease of >= 35% in Y-BOCS score. tDCS was well tolerated. Conclusion: tDCS with the cathode placed over the left OFC combined with the anode placed over the right cerebellum is a suitable and safe approach to decrease OCD symptoms in patients with treatment-resistant OCD. Large scale randomized controlled studies are needed to confirm this promising result. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:153 / 157
页数:5
相关论文
共 46 条
[1]   Global Resting-State Functional Magnetic Resonance Imaging Analysis Identifies Frontal Cortex, Striatal, and Cerebellar Dysconnectivity in Obsessive-Compulsive Disorder [J].
Anticevic, Alan ;
Hu, Sien ;
Zhang, Sheng ;
Savic, Aleksandar ;
Billingslea, Eileen ;
Wasylink, Suzanne ;
Repovs, Grega ;
Cole, Michael W. ;
Bednarski, Sarah ;
Krystal, John H. ;
Bloch, Michael H. ;
Li, Chiang-Shan R. ;
Pittenger, Christopher .
BIOLOGICAL PSYCHIATRY, 2014, 75 (08) :595-605
[2]   Repetitive transcranial magnetic stimulation (rTMS) for obsessive-compulsive disorder (OCD): An exploratory meta-analysis of randomized and sham-controlled trials [J].
Berlim, Marcelo T. ;
Neufeld, Nicholas H. ;
Van den Eynde, Frederique .
JOURNAL OF PSYCHIATRIC RESEARCH, 2013, 47 (08) :999-1006
[3]   Cerebellar Transcranial Direct Current Stimulation Modulates Verbal Working Memory [J].
Boehringer, Andreas ;
Macher, Katja ;
Dukart, Juergen ;
Villringer, Arno ;
Pleger, Burkhard .
BRAIN STIMULATION, 2013, 6 (04) :649-653
[4]   Cerebellar networks with the cerebral cortex and basal ganglia [J].
Bostan, Andreea C. ;
Dum, Richard P. ;
Strick, Peter L. .
TRENDS IN COGNITIVE SCIENCES, 2013, 17 (05) :241-254
[5]   Examining Transcranial Direct-Current Stimulation (tDCS) as a Treatment for Hallucinations in Schizophrenia [J].
Brunelin, Jerome ;
Mondino, Marine ;
Gassab, Leila ;
Haesebaert, Frederic ;
Gaha, Lofti ;
Suaud-Chagny, Marie-Francoise ;
Saoud, Mohamed ;
Mechri, Anwar ;
Poulet, Emmanuel .
AMERICAN JOURNAL OF PSYCHIATRY, 2012, 169 (07) :719-724
[6]   The Sertraline vs Electrical Current Therapy for Treating Depression Clinical Study Results From a Factorial, Randomized, Controlled Trial [J].
Brunoni, Andre R. ;
Valiengo, Leandro ;
Baccaro, Alessandra ;
Zanao, Tamires A. ;
de Oliveira, Janaina F. ;
Goulart, Alessandra ;
Boggio, Paulo S. ;
Lotufo, Paulo A. ;
Bensenor, Isabela M. ;
Fregni, Felipe .
JAMA PSYCHIATRY, 2013, 70 (04) :383-391
[7]   A systematic review on reporting and assessment of adverse effects associated with transcranial direct current stimulation [J].
Brunoni, Andre Russowsky ;
Amadera, Joao ;
Berbel, Bruna ;
Volz, Magdalena Sarah ;
Rizzerio, Brenno Gomes ;
Fregni, Felipe .
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY, 2011, 14 (08) :1133-1145
[8]   Habit learning dissociation in rats with lesions to the vermis and the interpositus of the cerebellum [J].
Callu, Delphine ;
Puget, Stephanie ;
Faure, Alexis ;
Guegan, Maryvonne ;
El Massioui, Nicole .
NEUROBIOLOGY OF DISEASE, 2007, 27 (02) :228-237
[9]   Polarity-dependent effects of transcranial direct current stimulation in obsessive-compulsive disorder [J].
D'Urso, Giordano ;
Brunoni, Andre Russowsky ;
Anastasia, Annalisa ;
Micillo, Marco ;
de Bartolomeis, Andrea ;
Mantovani, Antonio .
NEUROCASE, 2016, 22 (01) :60-64
[10]   The cerebellum: Its role in language and related cognitive and affective functions [J].
De Smet, Hyo Jung ;
Paquier, Philippe ;
Verhoeven, Jo ;
Marien, Peter .
BRAIN AND LANGUAGE, 2013, 127 (03) :334-342