Efficacy and safety of transcranial direct current stimulation as an add-on treatment for obsessive-compulsive disorder: a randomized, sham-controlled trial

Autor(es)

Felipe da Silva, Renata de Melo ^[1] ; Brunoni, Andre R. ^{[2, 3, 4]} ; Goerigk, Stephan ^{[5, 6, 7]} ; Batistuzzo, Marcelo Camargo ^[1] ; da Conceicao Costa, Daniel Lucas ^[1] ; Diniz, Juliana Belo ^[1] ; Padberg, Frank ^[5] ; D'Urso, Giordano ^[8] ; Miguel, Euripedes Constantino ^[1] ; Shavitt, Roseli Gedanke ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Sch Med, Hosp Clin, Lab Psychopathol & Psychiat Treatment L, Dept & Inst Psychiat, Obsess Compuls Spectrum Diso, Ovidio Pires de Campos 785-3, BR-05403000 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Med, Natl Inst Biomarkers Psychiat, Dept Interdisciplinary Neuromodulat, Lab Neurosci, Ovidio Pires de Campos 785-3, BR-05403000 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Med, Dept & Inst Psychiat, Ovidio Pires de Campos 785-3, BR-05403000 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Sch Med, Hosp Clin, Dept Internal Med, Ovidio Pires de Campos 785-3, BR-05403000 Sao Paulo - Brazil

^[5] Ludwig Maximilians Univ Munchen, Dept Psychiat & Psychotherapy, Munich - Germany

^[6] Ludwig Maximilians Univ Munchen, Dept Psychol Methodol & Assessment, Munich - Germany

^[7] Univ Appl Sci, Hsch Fresenius, Munich - Germany

^[8] Univ Naples Federico II, Dept Neurosci Reprod Sci & Odontostomatol, Lab Neuromodulat, Unit Psychiat & Psychol, Naples - Italy

• Tipo de documento: Artigo Científico
• Fonte: NEUROPSYCHOPHARMACOLOGY; v. 46, n. 5 JAN 2021.
• Citações Web of Science: 0

Resumo

Obsessive-compulsive disorder (OCD) is a frequent, disabling disorder with high rates of treatment resistance. Transcranial direct current stimulation (tDCS) is a safe, tolerable noninvasive neuromodulation therapy with scarce evidence for OCD. This double-blind, randomized, and sham-controlled study investigates the efficacy of tDCS as add-on treatment for treatment-resistant OCD (failure to respond to at least one previous pharmacological treatment). On 20 consecutive weekdays (4 weeks), 43 patients with treatment-resistant OCD underwent 30 min active or sham tDCS sessions, followed by a 8 week follow-up. The cathode was positioned over the supplementary motor area (SMA) and the anode over the left deltoid. The primary outcome was the change in baseline Y-BOCS score at week 12. Secondary outcomes were changes in mood and anxiety and the occurrence of adverse events. Response was evaluated considering percent decrease of baseline Y-BOCS scores and the Improvement subscale of the Clinical Global Impression (CGI-I) between baseline and week 12. Patients that received active tDCS achieved a significant reduction of OCD symptoms than sham, with mean (SD) Y-BOCS score changes of 6.68 (5.83) and 2.84 (6.3) points, respectively (Cohen's d: 0.62 (0.06-1.18), p = 0.03). We found no between-group differences in responders (four patients in the active tDCS and one in the sham group). Active tDCS of the SMA was not superior to sham in reducing symptoms of depression or anxiety. Patients in both groups reported mild adverse events. Our results suggest that cathodal tDCS over the SMA is an effective add-on strategy in treatment-resistant OCD. (AU)

• Processo FAPESP: 11/21357-9 - Investigação de circuitos neuronais e marcadores biológicos envolvidos no transtorno obsessivo-compulsivo por meio de paradigmas comportamentais de medo e ansiedade
• Beneficiário: Eurípedes Constantino Miguel Filho
• Modalidade de apoio: Auxílio à Pesquisa - Temático
• Processo FAPESP: 14/50873-3 - INCT 2014: Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN)
• Beneficiário: Wagner Farid Gattaz
• Modalidade de apoio: Auxílio à Pesquisa - Temático
• Processo FAPESP: 18/10861-7 - Avaliação multimodal dos efeitos da estimulação transcraniana por corrente contínua e estimulação theta-burst no funcionamento do córtex pré-frontal: um estudo Fase-I bilateral, placebo-controlado, fatorial
• Beneficiário: Andre Russowsky Brunoni
• Modalidade de apoio: Auxílio à Pesquisa - Regular