Integrating EMDR with tDCS in Obsessive–Compulsive Disorder: An Opinion Paper

Current evidence indicates that approximately 25% of patients with obsessive–compulsive disorder (OCD) fail to respond to conventional therapies. Although trauma exerts a substantial role in the etiology of OCD, eye movement desensitization and reprocessing (EMDR) has shown limited evidence in treating such condition, highlighting the need for novel interventions. As a result, recent clinical advances suggest that combined approaches integrating multiple psychological interventions could be effective in yielding positive therapeutic outcomes. Concurrently, neuroimaging studies indicate that EMDR modulates neuronal activity within the anterior cingulate cortex (ACC) and orbitofrontal cortex (OFC), both implicated in OCD pathophysiology. Building on this evidence, noninvasive brain stimulation techniques, including transcranial direct current stimulation (tDCS), have demonstrated promise for OCD treatment by modulating OFC neuroplasticity. Hence, this opinion paper proposes a therapeutic strategy combining EMDR with tDCS to concomitantly target trauma-related psychological processes and rehabilitate neural dysfunction in the OFC and ACC. Such a novel therapeutic approach may enhance treatment effectiveness and offer an option for treatment-resistant OCD.