tDCS Stimulation to Treat Patients With Severe and Resistant Obsessive Compulsive Disorder-Pilot Study

• bifocal stimulation with tDCS (Other): Patients will receive an active Treatment with tDCS (10 sessions of 30 mn with an intensity of 2 mA)

Primary outcomes

• The primary outcome measure is used to show that bifocal tDCS with anodal stimulation on OFC and cathodic stimulation on the SMA is an effective treatment [Day 14]: Score improvement on the Y-BOCS after 14 days compared to the baseline

Secondary outcomes

• Evaluate the persistence of therapeutic response at 45 days [Day 45]: Score improvement on the Y-BOCS after 45 days compared to the baseline
• Evaluate the persistence of therapeutic response at 105 days [Day 105]: Score improvement on the Y-BOCS after 105 days compared to the baseline
• Evaluate the therapeutic effect of tDCS on the depressive and anxious symptoms associated with Obsessive compulsive disorder at 14 days [Day 14]: Score improvement of Hamilton and HDRS scales between the baseline and day 14
• Evaluate the therapeutic effect of tDCS on the depressive and anxious symptoms associated with Obsessive compulsive disorder at 45 days [Day 45]: Score improvement of Hamilton and HDRS scales between the baseline and day 45
• Evaluate the therapeutic effect of tDCS on the depressive and anxious symptoms associated with Obsessive compulsive disorder at 105 days [Day 105]: Score improvement of Hamilton and HDRS scales between the baseline and day 105
• Evaluate the effect of tDCS on the quality of life at day 14 [Day 14]: Improvement of MOS SF-36 scale (Medical Outcome Study, Short Form) between baseline and day 14
• Evaluate the effect of tDCS on the quality of life at day 45 [Day 45]: Improvement of MOS SF-36 scale (Medical Outcome Study, Short Form) between baseline and day 45
• Evaluate the effect of tDCS on global functioning at day 14 [Day 14]: Improvement of GAF (Global Assessment of Functioning) scale between baseline and day 14
• Evaluate the effect of tDCS on global functioning at day 45 [Day 45]: Improvement of GAF (Global Assessment of Functioning) scale between baseline and day 45
• Evaluate the effect of tDCS on social adjustment at day 14 [Day 14]: Improvement of SAS (Social Adjustment Scale) scale between baseline and day 14
• Evaluate the effect of tDCS on social adjustement at day 45 [Day 45]: Improvement of SAS (Social Adjustment Scale) scale between baseline and day 45

Sex: All, ages: 18 Years to 70 Years

Patients must present all of the following criteria in order to be eligible:

Inclusion Criteria:

* Meets criteria for obsessive compulsive disorder according to DSM-IV with a "good insight" (BABS),
* Age: Participants will be both males and females, 18-70 years of age included.
* No current depressive and suicidal risks,
* No epileptic pathology,
* Chronic evolution ( Total Y-BOCS>20 ),
* Obsessive compulsive disorder resistant to pharmacology treatment, at least 2 antidepressants (type IRS) or cognitive and comportment therapy since at least one year,
* Stability treatment (antidepressants) for more than 12 weeks without significant improvement,
* Affiliation to a social security system (recipient or assignee),
* Signed written inform consent form.

Exclusion Criteria:

* Female subject who is pregnant, or of child-bearing age, sexually active and not using reliable contraception or who is nursing,
* Patient under curators
* Meets another diagnosis of axe 1 of DSM-IV,
* Current depressive or suicidal risks,
* Patient with a benzodiazepine treatment,
* Patient with any form of metal in the cranium, a pacemaker, skull defects, or skin lesions to the scalp (cuts, abrasions, rash) ,
* Epileptic patient,
* Patient with a medical history of cranial trauma,
* Patient unable to give his or hers informed consent.

• Results publication: Harika-Germaneau G, Heit D, Chatard A, Thirioux B, Langbour N, Jaafari N. Treating refractory obsessive-compulsive disorder with transcranial direct current stimulation: An open label study. Brain Behav. 2020 Jul;10(7):e01648. doi: 10.1002/brb3.1648. Epub 2020 May 14. PMID 32406608

• Nematollah JAAFARI, Professor, Study director, Centre Hospitalier Henri Laborit