Transcranial Direct Current Stimulation and Extinction in Obsessive Compulsive Disorder
Characterization and Modulation of Functional Connectivity and Fear Extinction Abnormalities in Obsessive-Compulsive Disorder
Yale University
180 participants
Sep 12, 2025
INTERVENTIONAL
Conditions
Summary
Obsessive-compulsive disorder (OCD) is associated with substantial impairments in quality of life and is among the most disabling psychiatric disorders. Exposure therapy is among the first-line of treatments for obsessive-compulsive disorder (OCD) . Extinction learning is thought to be a core mechanism of therapeutic exposure. Fear and safety signal learning are traditionally associated with activity and connectivity within the canonical corticolimbic "fear circuit", which includes the amygdala, medial prefrontal cortex (mPFC), and hippocampus. Transcranial direct current stimulation (tDCS) is a neuromodulation technology that can augment brain plasticity, learning, and memory. The proposed study will test if obsessive-compulsive disorder (OCD) is associated with inhibitory safety learning deficits and if transcranial direct current stimulation (tDCS) normalizes functional connectivity and safety signal processing to recover extinction deficits in obsessive-compulsive disorder (OCD).
Eligibility
Inclusion Criteria8
- years of age or older
- speak English fluently, and
- able to provide written and verbal informed consent.
- meet criteria for OCD as determined by structured clinical interview
- exhibit significant current symptoms of OCD
- report duration of OCD symptoms of at least 1-year
- OCD symptoms are primary or co-primary relative to other psychiatric diagnoses
- stable psychiatric treatment (≥8-weeks) or no active treatment.
Exclusion Criteria13
- active severe substance use disorder(s)
- acute suicidality
- history of bipolar or psychotic disorder(s)
- significant developmental disabilities
- loss of consciousness \> 10 minutes
- history of traumatic brain injury
- major neurological disease
- a positive pregnancy test
- other brain stimulation or magnetic resonance imaging contraindications
- new psychological treatment within the past 8 weeks
- active anxiolytic medication use (e.g., benzodiazepine).
- meet current criteria for a psychiatric disorder as determined by structured clinical interview
- active-psychotropic medications.
Interventions
Multifocal transcranial direct current stimulation will be delivered. The anode will be placed over the frontal pole (Fpz, 10-20 electroencephalogram \[EEG\]) and will be surrounded by 5 return electrodes (cathodes). Current will be set at 1.5mA and will be ramped in and out for 30 seconds at the beginning and end of a 20-minute stimulation period.
Multifocal transcranial direct current stimulation will be delivered. The anode will be placed over the frontal pole (Fpz, 10-20 electroencephalogram \[EEG\]) and will be surrounded by 5 return electrodes (cathodes). Current will be set at 1.5mA and will be ramped in and out for 30 seconds at the beginning of a 20-minute period.
Locations(1)
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NCT06834217