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179
Obsessive-Compulsive Disorder
YiliangZhang, ShumingZhong, ShunkaiLai, DongHuang,
andYanbinJia
Abstract
Obsessive-compulsive disorder (OCD) is a prevalent and debilitating psychiatric
condition that profoundly impacts individuals’ lives. Its complex and multifactorial etiology presents signicant challenges for effective treatment. While many
patients benet from standard interventions such as pharmacological therapies
and psychotherapy, a substantial number remain resistant to treatment, resulting
in poor long-term outcomes. Emerging neurostimulation therapies, encompassing both noninvasive and invasive techniques, offer promising alternatives for
managing OCD.Numerous clinical trials have explored novel neurostimulation
protocols, aiming to improve treatment efcacy. However, ndings remain
inconsistent, and no universally accepted approach has been established. This
underscores the critical need for further research to rene stimulation parameters
and identify factors that inuence individual responsiveness to these interventions. This chapter provides a comprehensive overview of neuromodulation
strategies for OCD, highlighting current advancements, ongoing challenges, and
future directions in this rapidly evolving eld.
7
Keywords
OCD · rTMS · dTMS · TBS · tDCS
Y. Zhang · S. Zhong · S. Lai · D. Huang · Y. Jia (*)
Department of Psychiatry, First Afliated Hospital of Jinan University, Guangzhou, China
© The Author(s), under exclusive license to Springer Nature Singapore Pte
Ltd. 2025
W. Zheng, Y. Ning (eds.), TMS and tDCS for Psychiatric Disorders,
https://doi.org/10.1007/978-981-96-8504-2_7
181
182
Y. Zhang et al.
Abbreviations
ACC anterior cingulate cortex
ahTBS accelerated high-dose Theta Burst Stimulation
aiTBS asymmetric intermittent Theta Burst Stimulation
AMT active motor threshold
BAI Beck Anxiety Inventory
BD Bipolar Disorder
BDI-II Beck Depression Inventory II
CBT cognitive-behavioral therapy
CSTC cortico-striatal-thalamic-cortical
cTBS Continuous TBS
DBS deep brain stimulation
DLPFC dorsolateral prefrontal cortex
dmPFC dorsomedial prefrontal
dTMS Deep Transcranial Magnetic Stimulation
ECT electroconvulsive therapy
EEG electroencephalography
ERP exposure and response prevention
fMRI Functional Magnetic Resonance Imaging
HD-tDCS High-denition transcranial direct current stimulation
HF high-frequency
iTBS intermittent Theta Burst Stimulation
L-DLPFC left dorsolateral prefrontal cortex
LF-R-DLPFC left frontolateral region of the dorsolateral prefrontal cortex
MDD Major Depressive Disorder
MEP motor-evoked potential
MFG middle frontal gyrus
MST Magnetic Seizure Therapy
MT motor threshold
OCD Obsessive–compulsive disorder
OFC orbitofrontal cortex
RCTs Randomized Controlled Trials
RMT resting motor threshold
ROFC right orbitofrontal cortex
rTMS repetitive Transcranial Magnetic Stimulation
SFG superior frontal gyrus
SMA supplementary motor area
SSRIs serotonergic reuptake inhibitors
TBS Theta Burst Stimulation
tDCS transcranial direct current stimulation
TMS transcranial magnetic stimulation
VNS Vagus Nerve Stimulation
YBOCS Yale-Brown Obsessive Compulsive Scale