Increases in functional connectivity between the default mode network and sensorimotor network correlate with symptomatic improvement after transcranial direct current stimulation for obsessive-compulsive disorder

Author(s)

Echevarria, M. A. N. ; Batistuzzo, M. C. ; Silva, R. M. F. ; Brunoni, A. R. ; Sato, J. R. ; Miguel, E. C. ; Hoexter, M. Q. ; Shavitt, R. G.

• Document type: Journal article
• Source: Journal of Affective Disorders; v. 355, p. 9-pg., 2024-04-01.

Abstract

Background: Non-invasive neuromodulation is a promising intervention for obsessive-compulsive disorder (OCD), although its neurobiological mechanisms of action are still poorly understood. Recent evidence suggests that abnormalities in the connectivity of the default mode network (DMN) and the supplementary motor area (SMA) with other brain regions and networks are involved in OCD pathophysiology. We examined if transcranial direct current stimulation (tDCS) alters these connectivity patterns and if they correlate with symptom improvement in treatment-resistant OCD. Methods: In 23 patients from a larger clinical trial (comparing active tDCS to sham) who underwent pre- and posttreatment MRI scans, we assessed resting-state functional MRI (rs-fMRI) data. The treatment involved 30-minute daily tDCS sessions for four weeks (weekdays only), with the cathode over the SMA and the anode over the left deltoid. We conducted whole-brain connectivity analysis comparing active tDCS-treated to sham-treated patients. Results: We found that active tDCS, but not sham, led to connectivity increasing between the DMN and the bilateral pre/postcentral gyri ( p = 0.004, FDR corrected) and temporal-auditory areas plus the SMA ( p = 0.028, FDR corrected). Also, symptom improvement was directly associated with connectivity increasing between the left lateral sensorimotor network and the left precuneus ( r = 0.589, p = 0.034). Limitations: Limited sample size (23 participants with resting-state neuroimaging), inability to analyze specific OCD symptom dimensions (e.g., harm, sexual/religious, symmetry/checking, cleaning/contamination). Conclusions: These data offer novel information concerning functional connectivity changes associated with noninvasive neuromodulation interventions in OCD and can guide new brain stimulation interventions in the framework of personalized interventions. (AU)

• FAPESP's process: 19/06009-6 - Non-implantable neuromodulation therapies: a perspective for the depressed brain
• Grantee: Geraldo Busatto Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 21/05332-8 - Brazilian high-risk cohort for psychiatric disorders: 10 years follow-up
• Grantee: Rodrigo Affonseca Bressan
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 14/50917-0 - INCT 2014: developmental psychiatry for children and adolescents
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 18/04654-9 - Time series, wavelets and high dimensional data
• Grantee: Pedro Alberto Morettin
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 18/21934-5 - Network statistics: theory, methods, and applications
• Grantee: André Fujita
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 19/27250-3 - Neurocircuit-based investigation of obsessive-compulsive disorder: a contribution to the study of disease mechanisms and the development of new treatments
• Grantee: Roseli Gedanke Shavitt
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 12/20911-5 - Escitalopram and transcranial direct current stimulation in major depressive disorder: a double blind, placebo-controlled, randomized, non-inferiority trial
• Grantee: Andre Russowsky Brunoni
• Support Opportunities: Research Grants - Young Investigators Grants