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7 Obsessive-Compulsive Disorder
Table 7.2 tDCS in obsessive-compulsive disorder
Clinical recommendations
Anode
tDCS
Conventional
tDCS
HD-tDCS Not
The CINP Guidelines mention Conventional tDCS as possibly effective (Level C) in improving
OCD symptoms
Abbreviations: pre-SMA pre-supplementary motor area, SO supraorbital
position
Pre-
SMA
known
Cathode
position
SO
Not
known
Intensity
(mA)
≥0.571 ≥20
Not
known
Length
(min)
Not
known
Duration
(sessions)
10–22 Possibly effective
Not
known
Levels+references
(level C) [78]
Not known
213
of the treatment sequence. The number of treatment sequences can vary. In some
cases, a single course of treatment may be sufcient, while in others, multiple
courses may be required [96].
In conclusion, the treatment regimen for HD-tDCS in OCD is still being explored
and rened. Different studies have used various stimulation targets, intensities,
frequencies, times, and numbers of treatment sequences. Further research is needed
to determine the most effective and standardized treatment regimen for
HD-tDCS in OCD.
7.3.2.4 Clinical Recommendations
At present, the stimulation parameters of HD-tDCS in the treatment of OCD have
not been fully determined. Available practice guidelines for treatment of OCD currently do not recommend HD-tDCS [68]. Future studies are needed to further optimize the stimulation parameters, such as current intensity, stimulation duration, and
stimulation number, to improve the therapeutic effect.
In conclusion, HD-tDCS, as a noninvasive brain stimulation technique, has some
potential in the treatment of OCD.However, the current research on HD-tDCS in
the treatment of OCD is still in its preliminary stage, and further studies are needed
to optimize stimulation parameters, identify the best stimulation targets, explore
combined treatment methods, and evaluate long-term efcacy and safety (Table7.2).
7.4 TMS vs. tDCS
7.4.1 Efficacy
Currently, no studies directly compare the efcacy of TMS and tDCS in treating
OCD. However, the evidence supporting TMS, particularly rTMS, is relatively
robust. In contrast, while tDCS has shown some promise in treating OCD, the available research is limited by a smaller number of studies, inconsistent experimental
protocols, and ndings of limited signicance [101]. To better evaluate the
214
Y. Zhang et al.
therapeutic potential of tDCS, more high-quality, randomized, sham-controlled trials are needed in the future.
7.4.2 Safety
The adverse effects of TMS and tDCS are as described above. Relatively more
adverse effects occur with TMS than tDCS, but both are mild and short-lived.
Overall, both TMS and tDCS are safe and well tolerated, with few serious
adverse events.
7.5 Conclusion
Neuromodulation represents a promising therapeutic approach for managing OCD,
including treatment-resistant cases, offering a generally favorable safety and tolerability prole. Among noninvasive techniques, rTMS targeting the DLPFC and preSMA has demonstrated robust efcacy, supported by strong clinical evidence.
While dTMS shows some potential, additional high-quality studies are necessary to
establish its effectiveness more conclusively. Evidence for iTBS/cTBS in OCD
treatment remains limited, reecting a need for further research in this area. tDCS
is a notably safe and potentially effective intervention, particularly when targeting
the SMA, pre-SMA, and OFC with cathodal placement. However, the small sample
sizes and scarcity of randomized controlled trials limit the generalizability of current ndings. For invasive neuromodulation, DBS offers considerable promise for
refractory OCD, yet the optimization of protocols and broader consensus on its use
require further investigation. In summary, while neuromodulation holds signicant
potential for OCD treatment, ongoing research is essential to rene techniques, validate efcacy, and expand clinical applications.
Acknowledgments The authors thank all the patient volunteers and their families who partici-
pated in the literature for their support of the scientic research.
Disclosure/Conicts of Interest The authors of this chapter do not have any commercial associations that might pose a conict of interest in connection with this manuscript.
Financial Support We gratefully acknowledge funding provided by the following National
Natural Science Foundation of China, China (Nos.: 81801347; 81971597), Natural Science
Foundation of Guangdong Province, China (No.: 2021A1515011034), Planned Science and
Technology Project of Guangdong Province, China (No.: 2017B020227011), Jinan University
Central University project (No.: 11624320).
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221
Attention Deficit Hyperactivity Disorder
MengyueGu, JingyangGu, SongWang, YudongShi,
andHuanZhongLiu
Abstract
Attention Decit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental condition marked by inattentiveness, hyperactive behaviors, and impulsivity. While pharmacological treatments provide clinical benets for some
patients, many individuals experience suboptimal therapeutic outcomes or
adverse side effects. Emerging non-pharmacological approaches—particularly
transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS)—demonstrate promising potential for alleviating ADHD symptoms
through targeted neuromodulation. These techniques may offer viable alternatives for medication-resistant patients or those seeking to minimize pharmaceutical interventions. Nevertheless, considerable variability persists across studies
due to divergent treatment protocols (e.g., stimulation parameters, target brain
regions), participant demographics, and intervention durations. This chapter systematically examines these critical sources of heterogeneity.
8
Keywords
ADHD · TMS · tDCS
M. Gu · J. Gu · S. Wang · Y. Shi · H. Liu (*)
Department of Psychiatry, Chaohu Hospital of Anhui Medical University, AnHui, China
e-mail: huanzhongliu@ahmu.edu.cn
© 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_8
223