Transcranial Direct Current Stimulation Potentiation of Fear Extinction in OCD
Obsessive-Compulsive Disorder
About this trial
This is an interventional other trial for Obsessive-Compulsive Disorder focused on measuring Obsessive-Compulsive Disorder, OCD, Fear extinction, tDCS, transcranial Direct Current Stimulation, Randomized controlled trial, Fear conditioning
Eligibility Criteria
Inclusion Criteria:
- Fluent in English, willing to provide informed consent, and willing to comply with the study protocol
- Primary OCD that causes at least moderate distress and/or impairment (Y-BOCS total score ≥ 16)
- Comfortable and capable of using a computer and completing computerized tasks
Exclusion Criteria:
- History of head injury resulting in prolonged (i.e., >1h) loss of consciousness and/or neurological sequelae; history of stroke; signs of increased intracranial pressure; prior neurosurgical procedure (e.g., DBS, aneurysm clips)
- Contraindications to participate in tDCS including: metallic implants in head or neck; ventriculoperitoneal (VP) shunts; pacemakers; pregnancy; epilepsy.
- Current or history of neurologic or psychiatric disease (e.g., mental retardation, dementia, brain damage, or other cognitive impairment) that would interfere with ability to participate in the study
- Impaired (or uncorrected) vision that would interfere with participation.
- Current clinically significant suicidality that requires psychiatric hospitalization, as indicated by clinical judgment.
- Current substance use disorder (within the past 12 months)
- Lifetime manic episode or psychosis
- Documented resistance to 4 or more valid pharmacological trials and previous treatment with ≥12 sessions of cognitive behavioral therapy for OCD with no response (or worsening symptoms)
- Use of most psychotropic medications (e.g., SSRIs and atypical antipsychotics) will be allowed. However, use of benzodiazepines within 2 weeks prior to the study is exclusionary (and participants will be asked to refrain from use of such medications during the study as they may interfere with the fear extinction paradigm).
- Unable to obtain low enough impedance values to ensure safe and effective application of tDCS/EEG.
Sites / Locations
- Massachusetts General HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Sham Comparator
Active tDCS administered before extinction phase
Active tDCS administered during extinction phase
Active tDCS administered after extinction phase
Sham tDCS
The investigators will stimulate using 2mA of direct current during 20 min before the extinction phase of the fear conditioning and extinction paradigm.
The investigators will stimulate using 2mA of direct current during 20 min during the extinction phase of the fear conditioning and extinction paradigm.
The investigators will stimulate using 2mA of direct current during 20 min after the extinction phase of the fear conditioning and extinction paradigm.
Sham will consist of a ramp up and down of activity (from 0 to 2mA and back to 0mA) in the first 30sec and again in the last 30 sec of the 20min stimulation period (which will occur before/during/after the extinction phase). No active tDCS will occur.