Fig. 6: tES interventions with therapeutic potential.
OCD features a complex pathophysiology involving various cortical and subcortical regions that influence disease severity. Neuropsychological and cognitive deficits are integral to OCD psychopathology and closely linked to its pathophysiology. According to the latest framework about OCD psychopathology and pathophysiology92, several regions can be targeted by tES and other NIBS interventions. a, The VLPFC, an important region for the executive control system, is often hypoactive in OCD. This diminishes influence over the dorsal striatum and habit system, which can lead to compulsive behaviors. Enhancing VLPFC activity (for example, with atDCS) may benefit OCD by strengthening goal-directed behavior. b, The vmPFC is typically hyperactive in OCD. A downregulatory tES intervention targeting the medial PFC could alleviate negative feelings and urges to act by modulating the insula and caudate. c, The dorsal ACC, which is involved in action monitoring and interoceptive feelings through its connections to the insula, is also hyperactive in OCD. This hyperactivity can hinder action monitoring and amplify interoceptive urges, leading to compulsions. A downregulatory tES intervention on the dorsal ACC may help regulate these urges and improve action monitoring, potentially reducing compulsions. vmPFC, ventromedial prefrontal cortex; vlPFC, ventrolateral prefrontal cortex; ACC, anterior cingulate cortex; DLPFC, dorsolateral prefrontal cortex. Brain surface renderings are based on the MNI152 nonlinear 2009 (ICBM152) standard template.
