Neurostimulation in Anxiety Disorders, Post-traumatic Stress Disorder, and Obsessive-Compulsive Disorder.


Author: Freire RC1,2, Cabrera-Abreu C3, Milev R4,5

Affiliation: <sup>1</sup>Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. rafaelcrfreire@gmail.com.

<sup>2</sup>Department of Psychiatry, Queen's University, Kingston, ON, Canada. rafaelcrfreire@gmail.com.

<sup>3</sup>Department of Psychiatry, Queen's University and Providence Care Hospital, Kingston, ON, Canada.

<sup>4</sup>Department of Psychiatry, Queen's University, Kingston, ON, Canada.

<sup>5</sup>Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
Conference/Journal: Adv Exp Med Biol.
Date published: 2020
Other:
 Volume ID: 1191   ,  Pages: 331-346   ,  Special Notes: doi: 10.1007/978-981-32-9705-0_18.   ,  Word Count: 243  
    Many pharmacological treatments were proved effective in the treatment of panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD); still many patients do not achieve remission with these treatments. Neurostimulation techniques have been studied as promising alternatives or augmentation treatments to pharmacological and psychological therapies. The most studied neurostimulation method for anxiety disorders, PTSD, and OCD was repetitive transcranial magnetic stimulation (rTMS). This neurostimulation technique had the highest level of evidence for GAD. There were also randomized sham-controlled trials indicating that rTMS may be effective in the treatment of PTSD and OCD, but there were conflicting findings regarding these two disorders. There is indication that rTMS may be effective in the treatment of panic disorder, but the level of evidence is low. Deep brain stimulation (DBS) was most studied for treatment of OCD, but the randomized sham-controlled trials had mixed findings. Preliminary findings indicate that DBS could be affective for PTSD. There is weak evidence indicating that electroconvulsive therapy, transcranial direct current stimulation, vagus nerve stimulation, and trigeminal nerve stimulation could be effective in the treatment of anxiety disorders, PTSD, and OCD. Regarding these disorders, there is no support in the current literature for the use of neurostimulation in clinical practice. Large high-quality studies are warranted.



KEYWORDS: Deep brain stimulation; Generalized anxiety disorder; Obsessive-compulsive disorder; Panic disorder; Post-traumatic stress disorder; Repetitive transcranial magnetic resonance; Social anxiety disorder



PMID: 32002936  DOI: 10.1007/978-981-32-9705-0_18