While medications and psychotherapy can each help about 60% of OCD patients, troubling symptoms can often persist even among treatment responders. New therapeutic strategies are urgently needed. The top therapeutic treatment for OCD is exposure and response prevention (ERP), which is likely dependent upon extinction learning – training and maintenance to face fear triggers and not respond to them with compulsive behaviors over time. In the brain, extinction learning is mediated by a well-defined circuit encompassing the medial prefrontal cortex (mPFC; cognition and decision-making), amygdala (emotion regulation), and hippocampus (memory). This raises the exciting possibility that direct engagement of this circuitry might enhance therapeutic learning and memory. Transcranial direct current stimulation (tDCS) is a neuromodulation technology that can enhance the connections between brain regions, learning, and memory.
Dr. Adams and his team enrolled 24 OCD patients who completed a procedure that took the core features of ERP and tested whether tDCS applied to the mPFC after exposure would boost the effects of extinction learning. The study found that tDCS actually interfered with extinction learning in OCD patients, contrasting with prior research that showed tDCS’s potential to improve it while supporting a more recent study that had similar outcomes. Although this procedure did not enhance ERP as hypothesized, this study led to further research that tested tDCS application before ERP and generated promising results for boosting the efficacy of therapy. More research is needed into how tDCS can be used to enhance therapy for OCD patients.