Journal: Curr Neuropharmacol
Authors: Rapinesi C, Kotzalidis GD, Ferracuti S, Sani G, Girardi P, Del Casale A.
Background:
A substantial proportion of patients with OCD remain symptomatic despite pharmacotherapy and psychotherapy. Brain stimulation approaches have therefore been investigated as adjunctive strategies for refractory illness.
Objective:
This systematic review examined the evidence for brain stimulation techniques in OCD, including transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), transcranial direct current stimulation (tDCS), and electroconvulsive therapy (ECT).
Methods:
The authors reviewed published studies evaluating brain stimulation interventions in OCD, summarizing findings across stimulation modalities, targets, and study designs. The review placed particular attention on treatment-resistant populations and on the methodological heterogeneity of the available literature.
Results:
The strongest body of evidence at the time was for DBS and TMS, while evidence for tDCS and ECT was more limited. Across studies, brain stimulation techniques appeared promising as add-on options for severely ill or treatment-refractory patients, but findings were inconsistent and protocols varied considerably by target, frequency, intensity, and treatment schedule. The review emphasized the absence of standardization and the need for larger controlled trials.
Conclusions:
Brain stimulation modalities show promise as adjunctive treatments for refractory OCD, but the field remained methodologically heterogeneous in 2019. The authors concluded that TMS, DBS, and possibly tDCS may have clinical utility, although standardized methods and stronger comparative evidence were still needed.
