Randomized Controlled Trial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Jun 9, 2024; 13(2): 93138
Published online Jun 9, 2024. doi: 10.5409/wjcp.v13.i2.93138
Transcranial direct current stimulation as early augmentation in adolescent obsessive compulsive disorder: A pilot proof-of-concept randomized control trial
Aditya Agrawal, Vivek Agarwal, Sujita Kumar Kar, Amit Arya
Aditya Agrawal, Vivek Agarwal, Sujita Kumar Kar, Amit Arya, Department of Psychiatry, King George Medical University, Uttar Pradesh, Lucknow 226003, India
Author contributions: Agrawal A, Agarwal V, Kar SK, and Arya A designed the research study; Agrawal A conducted the research; Agarwal V, Kar SK, and Arya A have supervised the research; Agrawal A, Agarwal V, Kar SK did the analysis and wrote the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: Ethical approval was obtained from the Institutional ethics committee (107th ECM II B-Thesis/P16).
Clinical trial registration statement: The study was registered with Clinical Trials Registry of India (CTRI/2021/12/039002)
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: Data will be shared on reasonable request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sujita Kumar Kar, MD, Additional Professor, Department of Psychiatry, King George Medical University, Shahmina Road, Uttar Pradesh, Lucknow 226003, India. drsujita@gmail.com
Received: February 20, 2024
Revised: April 9, 2024
Accepted: April 24, 2024
Published online: June 9, 2024
Processing time: 108 Days and 0.8 Hours
Abstract
BACKGROUND

Transcranial direct current stimulation (tDCS) is proven to be safe in treating various neurological conditions in children and adolescents. It is also an effective method in the treatment of OCD in adults.

AIM

To assess the safety and efficacy of tDCS as an add-on therapy in drug-naive adolescents with OCD.

METHODS

We studied drug-naïve adolescents with OCD, using a Children’s Yale-Brown obsessive-compulsive scale (CY-BOCS) scale to assess their condition. Both active and sham groups were given fluoxetine, and we applied cathode and anode over the supplementary motor area and deltoid for 20 min in 10 sessions. Reassessment occurred at 2, 6, and 12 wk using CY-BOCS.

RESULTS

Eighteen adolescents completed the study (10-active, 8-sham group). CY-BOCS scores from baseline to 12 wk reduced significantly in both groups but change at baseline to 2 wk was significant in the active group only. The mean change at 2 wk was more in the active group (11.8 ± 7.77 vs 5.25 ± 2.22, P = 0.056). Adverse effects between the groups were comparable.

CONCLUSION

tDCS is safe and well tolerated for the treatment of OCD in adolescents. However, there is a need for further studies with a larger sample population to confirm the effectiveness of tDCS as early augmentation in OCD in this population.

Keywords: Adolescents, Early augmentation, Obsessive compulsive disorder, Safety, Transcranial direct current stimulation

Core Tip: Transcranial direct current stimulation (tDCS) is a safe treatment modality in the management of obsessive compulsive disorder (OCD) in adolescents. Cathodal stimulation over the supplementary motor area produces insignificant improvement in severity of OCD than sham controls. The improvement following 10 sessions of tDCS is mostly short-lasting and usually goes off by 6 wk.