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Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has been increasingly examined as an alternative treatment modality for Obsessive-Compulsive Disorder (OCD), due to its low costs, ease of use, and portability. Previous studies have suggested that tDCS m...

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Autores principales: da Silva, Renata de Melo Felipe, Brunoni, Andre Russowsky, Miguel, Eurípedes Constantino, Shavitt, Roseli Gedanke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754675/
https://www.ncbi.nlm.nih.gov/pubmed/31571882
http://dx.doi.org/10.2147/NDT.S184839
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author da Silva, Renata de Melo Felipe
Brunoni, Andre Russowsky
Miguel, Eurípedes Constantino
Shavitt, Roseli Gedanke
author_facet da Silva, Renata de Melo Felipe
Brunoni, Andre Russowsky
Miguel, Eurípedes Constantino
Shavitt, Roseli Gedanke
author_sort da Silva, Renata de Melo Felipe
collection PubMed
description Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has been increasingly examined as an alternative treatment modality for Obsessive-Compulsive Disorder (OCD), due to its low costs, ease of use, and portability. Previous studies have suggested that tDCS may achieve a reasonably good response and present a safe tolerability profile. However, at this point there is not strong evidence for the use of this modality of treatment. Considering that OCD is very heterogeneous with regard to clinical presentation, clinical severity and comorbidities, we have conducted a systematic review of studies on tDCS for OCD aiming to evaluate the clinical characteristics of the selected patients and to discuss perspectives for future studies. A literature search was conducted from inception until March 2019 at PubMed/MedLine and Scielo using the following keywords: “tdcs” or “transcranial direct current stimulation” and “obsessive compulsive disorder”. Out of 45 manuscripts, twelve were included. Most of the included studies are uncontrolled. A few controlled studies reported improvement of OCD, but some limitations need to be considered. Our main findings were that the selected patients were adults with severe OCD and psychiatric comorbidities, medicated at the time of assessment and resistant to at least one previous conventional treatment. We could not find any studies including specific populations such as adolescents, elderly, pregnant and breastfeeding participants. Similarly, the potential use of tDCS has not been tested in patients with less severe OCD, as a first treatment option, or for those who do not tolerate pharmacological treatments. These opportunities should be explored in future controlled trials.
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spelling pubmed-67546752019-09-30 Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives da Silva, Renata de Melo Felipe Brunoni, Andre Russowsky Miguel, Eurípedes Constantino Shavitt, Roseli Gedanke Neuropsychiatr Dis Treat Review Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that has been increasingly examined as an alternative treatment modality for Obsessive-Compulsive Disorder (OCD), due to its low costs, ease of use, and portability. Previous studies have suggested that tDCS may achieve a reasonably good response and present a safe tolerability profile. However, at this point there is not strong evidence for the use of this modality of treatment. Considering that OCD is very heterogeneous with regard to clinical presentation, clinical severity and comorbidities, we have conducted a systematic review of studies on tDCS for OCD aiming to evaluate the clinical characteristics of the selected patients and to discuss perspectives for future studies. A literature search was conducted from inception until March 2019 at PubMed/MedLine and Scielo using the following keywords: “tdcs” or “transcranial direct current stimulation” and “obsessive compulsive disorder”. Out of 45 manuscripts, twelve were included. Most of the included studies are uncontrolled. A few controlled studies reported improvement of OCD, but some limitations need to be considered. Our main findings were that the selected patients were adults with severe OCD and psychiatric comorbidities, medicated at the time of assessment and resistant to at least one previous conventional treatment. We could not find any studies including specific populations such as adolescents, elderly, pregnant and breastfeeding participants. Similarly, the potential use of tDCS has not been tested in patients with less severe OCD, as a first treatment option, or for those who do not tolerate pharmacological treatments. These opportunities should be explored in future controlled trials. Dove 2019-09-16 /pmc/articles/PMC6754675/ /pubmed/31571882 http://dx.doi.org/10.2147/NDT.S184839 Text en © 2019 da Silva et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
da Silva, Renata de Melo Felipe
Brunoni, Andre Russowsky
Miguel, Eurípedes Constantino
Shavitt, Roseli Gedanke
Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives
title Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives
title_full Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives
title_fullStr Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives
title_full_unstemmed Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives
title_short Transcranial direct current stimulation for Obsessive-Compulsive Disorder: patient selection and perspectives
title_sort transcranial direct current stimulation for obsessive-compulsive disorder: patient selection and perspectives
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754675/
https://www.ncbi.nlm.nih.gov/pubmed/31571882
http://dx.doi.org/10.2147/NDT.S184839
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