Prefrontal Neuroplasticity and Emotional Control Following Psychodynamic and Cognitive Behavioral Interventions With Adjunctive Transcranial Direct Current Stimulation in Obsessive-Compulsive Disorder

Abstract

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder characterized by persistent intrusive thoughts, repetitive behaviors, impaired inhibitory control, and difficulties in regulating emotional responses. Although cognitive behavioral therapy (CBT), psychodynamic interventions, and neuromodulation have each demonstrated therapeutic potential, the neuroplastic mechanisms through which these approaches may influence prefrontal regulation and emotional control remain incompletely integrated. The present study examined the relationship between psychotherapeutic intervention, adjunctive transcranial direct current stimulation (tDCS), and neuroplastic changes within prefrontal-centered regulatory networks in OCD. Particular attention was given to the dorsolateral prefrontal cortex, orbitofrontal cortex, anterior cingulate cortex, supplementary motor area, and their functional interactions with limbic and striatal regions. A structured quantitative synthesis of recent clinical and neuroimaging evidence was undertaken to characterize changes in obsessive-compulsive symptom severity, executive regulation, emotional control, functional connectivity, and cortical activity following therapeutic intervention. Evidence from controlled intervention studies and systematic quantitative analyses was integrated to identify convergent and divergent neurobehavioral patterns associated with CBT, psychodynamic therapy, and tDCS. The synthesized findings indicate that psychotherapeutic interventions are associated with measurable alterations in prefrontal and frontostriatal functional organization, while adjunctive tDCS may further modulate cortical excitability and regulatory processes within targeted prefrontal and supplementary motor networks. Improvements in emotional regulation appear to be related not simply to reductions in obsessive-compulsive symptoms but also to changes in the functional coordination of prefrontal, limbic, and striatal systems involved in cognitive control and affective processing. The available evidence also suggests substantial heterogeneity in neuromodulation response, emphasizing the importance of stimulation parameters, target selection, baseline neurobiological characteristics, and individual treatment response. The findings support a neuroplastic framework in which psychotherapy and noninvasive neuromodulation may influence partially overlapping but not identical mechanisms of symptom regulation. This integrated perspective provides a basis for investigating personalized multimodal interventions aimed at strengthening prefrontal control over maladaptive emotional and behavioral responses in OCD.