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Reduktion von Zwangssymptomen durch „nichtinvasive“ Hirnstimulation

Kritische Einordnung der Evidenz

Reduction of obsessive-compulsive symptoms by “noninvasive” brain stimulation

Critical classification of the evidence

  • Schwerpunkt: Neurowissenschaftlich fundierte Psychotherapie – Übersichten
  • Published:
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Zusammenfassung

Hintergrund

Die „nichtinvasiven“ Hirnstimulationstechniken transkranielle Gleichstromstimulation („transcranial direct current stimulation“, tDCS) und transkranielle Magnetstimulation (TMS) werden in letzter Zeit immer häufiger als unterstützende oder alternative therapeutische Intervention bei Zwangsstörungen angewendet. Während für die Wirksamkeit von TMS bei Zwangsstörungen inzwischen erste Metaanalysen vorliegen, ist die Studienlage bei tDCS noch sehr unübersichtlich.

Material und Methode

Im vorliegenden Übersichtsbeitrag werden die Studien zu tDCS bei Zwangsstörungen sowie die aktuellste Metaanalyse zu TMS vorgestellt.

Ergebnisse

Die Ergebnisse, sowohl zu tDCS wie auch zu TMS, zeigen derzeit in eine vielversprechende Richtung. So finden die publizierten Studien, dass aktive tDCS und TMS zu einer signifikanten Reduktion der Zwangssymptomatik führen.

Schlussfolgerung

Chancen ergeben sich hieraus insbesondere für therapieresistente Patienten mit Zwangsstörungen. Kritisch sind derzeit allerdings noch die unzureichende Zahl an publizierten Studien sowie die unzureichende Qualität der Studien einzuschätzen. Insbesondere für die Wirksamkeit von tDCS zur Reduktion von Zwangssymptomatik fehlen noch kontrollierte Studien, die mit Scheinstimulationsbedingung durchgeführt wurden.

Abstract

Background

The so-called noninvasive brain stimulation techniques of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) have recently been increasingly investigated as supportive or alternative therapeutic interventions for patients with therapy-resistant obsessive-compulsive disorders. While research into TMS for obsessive-compulsive disorders has meanwhile led to the first meta-analyses, the evidence for tDCS is still unclear.

Material and methods

In order to make an initial assessment of the evidence, this review briefly presents the studies on tDCS for obsessive-compulsive disorders as well as the most recent meta-analysis on TMS.

Results

Results for both active tDCS and TMS are currently pointing in a promising direction. Thus, the published studies found that both tDCS and TMS led to a significant reduction of obsessive-compulsive symptoms.

Conclusion

This provides opportunities in particular for therapy-resistant patients with obsessive-compulsive disorders; however, at present the insufficient number of published studies as well as the inadequate quality of studies, particularly in the case of tDCS, are still critical. There is specifically a lack of tDCS studies using sham stimulation conditions for control of effects.

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Authors and Affiliations

  1. Klinische Psychologie und Psychotherapie, Universität Leipzig, Neumarkt 9–19, 04109, Leipzig, Deutschland

    Jakob Fink &  Cornelia Exner

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  1. Jakob Fink
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  2. Cornelia Exner
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Correspondence to Jakob Fink.

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Interessenkonflikt

J. Fink und C. Exner geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Anja Hilbert, Leipzig

Ann-Christine Ehlis, Tübingen

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Fink, J., Exner, C. Reduktion von Zwangssymptomen durch „nichtinvasive“ Hirnstimulation. Psychotherapeut 64, 225–231 (2019). https://doi.org/10.1007/s00278-019-0347-z

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  • DOI: https://doi.org/10.1007/s00278-019-0347-z

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