An update on ‚non-invasive’ neuromodulation treatments in OCD
This advanced workshop is for academics and clinicians who already use ‘non-invasive’ neuromodulation techniques as rTMS and tDCS in the treatment of Obsessive Compulsive Disorder (OCD) as well as for researchers who use rTMS in OCD research-settings.
Obsessive-Compulsive Disorder (OCD) affects 2 - 3 % of the population, but only 40 - 60 % are effectively treated with available interventions. Thus, the search for a clearer understanding of disease etiology and the need for new approaches to treatment-resistant patients are paramount.
It has been proposed that OCD results from malfunctioning of cortico-striato-thalamo-cortical (CSTC) circuitry. This model informed neurosurgical approaches to OCD, and resulted in effective invasive treatments as evidenced by the humanitarian use approval for high frequency deep brain stimulation (DBS) in treatment-resistant OCD. However, the need for noninvasive alternatives for patients who do not respond to standard treatments (e.g. serotonin reuptake inhibitors or cognitive behavioral therapy) remains.
Non-invasive brain stimulation techniques, such as Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), have shown promise when stimulating lateral cortical regions in depression, but classical targets of OCD (e.g. orbito-frontal cortex) are too deep to be reached. Addressing this problem, we identified a putative alternative target, the supplementary motor area (SMA) that is accessible to TMS and tDCS, and has connections with the anterior cingulate cortex (ACC), and striatal and thalamic regions of interest in OCD.
Both open-label and sham-controlled trials of TMS and recently of tDCS applied to the pre-SMA in severe OCD are very promising. Here we review research to date on these approaches in OCD and discuss how this work may advance knowledge and test hypotheses about the neural circuitry underlying such a disabling condition.
There will be room for discussion and the newest findings in clinical practice will be shared.
Location: neuroCademy Nijmegen, The Netherlands
Presenter: Dr. Antonio Mantovani
Price: 650 euro