Service de Psychiatrie, AP-HP, Hôpitaux Universitaires Henri-Mondor, Créteil, 94000, France,
Curr Psychiatry Rep. 2015 May;17(5):36. doi: 10.1007/s11920-015-0571-3.
Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation methods that became widely used as therapeutic tools during the past two decades especially in cases of depression and schizophrenia. Low frequency rTMS and cathodal effect of tDCS inhibits cortical functioning while high frequency and anodal effect of tDCS have the opposite effect. Prolonged and repetitive application of either methods leads to changes in excitability of the human cortex that outlast the period of stimulation. Both rTMS and tDCS induce functional changes in the brain-modulating neural activity at cortical level. This paper reviews rTMS and tDCS effects in clinical trials for obsessive-compulsive disorder (OCD). Low frequency rTMS, particularly targeting the supplementary motor area and the orbital frontal cortex, seems to be the most promising in terms of therapeutic efficacy while older studies targeting the prefrontal dorsal cortex were not as successful. tDCS clearly needs to be investigated in large scale and sufficiently powered randomized control studies. From a general point of view, these non-invasive techniques hold promise as novel therapeutic tools for OCD patients.
重复经颅磁刺激（rTMS）和经颅直流电刺激（tDCS）是两种非侵入性脑刺激方法，在过去二十年中已广泛用作治疗工具，特别是在抑郁症和精神分裂症的治疗中。低频 rTMS 和 tDCS 的阴极效应抑制皮质功能，而高频和 tDCS 的阳极效应则产生相反的效果。长时间、重复地应用这两种方法会导致人类皮质兴奋性发生变化，这种变化会持续刺激后一段时间。rTMS 和 tDCS 都能引起大脑功能的变化，调节皮质水平的神经活动。本文综述了 rTMS 和 tDCS 在强迫症（OCD）临床试验中的作用。低频 rTMS，特别是针对辅助运动区和眶额皮质的 rTMS，在治疗效果方面似乎最有前途，而针对前额叶背外侧皮质的早期研究则没有那么成功。tDCS 显然需要在大规模和充分功率的随机对照研究中进行研究。从一般角度来看，这些非侵入性技术有望成为 OCD 患者的新型治疗工具。
