Transcranial direct current stimulation in the management of obsessive-compulsive disorder with comorbid bipolar affective disorder: A case study

Obsessive-compulsive disorder (OCD) frequently coexists with bipolar affective disorder (BPAD), and having both conditions can complicate treatment. Recently, various neuromodulation techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), have been utilized for OCD treatment, showing varying degrees of success with minimal risk. tDCS offers the benefit of simultaneous dual-site neuromodulation. Since various psychiatric disorders cause changes in neuronal activity across different brain areas, multisite neuromodulation might be necessary for patients with multiple concurrent psychiatric disorders. Precise targeting of the brain for a particular psychiatric disorder will probably minimize the risk of worsening of the comorbid psychiatric disorder. Here, we present the case of a young female with BPAD and OCD who received effective treatment with adjunctive multi-site tDCS. The treatment challenges in the case and the multisite neuromodulation strategies used are elaborated with a review of the literature.