RNS for Treatment-resistant Obsessive-compulsive Disorder

Inclusion Criteria:

1. aged 18-65;

2. able to provide written informed consent;

3. have a diagnosis of OCD according to the Statistical Manual of MentalDisorders-Fourth Edition-Text Revised (DSM-IV-TR) criteria and confirmed by theMini-International Neuropsychiatric Interview Chinese version 5.0;

4. have failed to improve despite undergoing two distinct courses of selectiveserotonin reuptake inhibitors (SSRIs), each lasting a minimum of 3-6 months; havefailed to yield therapeutic efficacy after the administration of the maximum dose ofclomipramine for 3-6 months in a single trial; without achieving effectiveness undercognitive behaviour therapy for six months; have failed to achieve therapeuticefficacy after three months of atypical antipsychotic medications, singularly or incombination with SSRIs or clomipramine.

Exclusion Criteria:

1. presence of other psychotic disorders;

2. have a treatment history that includes electroconvulsive therapy (ECT), modifiedelectroconvulsive therapy (MECT), transcranial direct current stimulation (tDCS),transcranial alternating current stimulation (tACS), DBS, and transcranial magneticstimulation (TMS);

3. presents a suicide risk (defined as a HAMD-17 score of ≥3 on suicide-related items);

4. experience difficulty in effectively communicating with investigators;

5. with a history of traumatic brain injury (TBI);

6. with intracranial or cardiovascular stents;

7. substance abuse within the past six months;

8. unstable neurological or coagulation disorders;

9. women who are pregnant, lactating, or of childbearing potential who refuse the useof reliable contraception during the study;

10. have been involved in other clinical studies within three months before enrollmentin this study;

11. any conditions unsuitable for conducting this study program considered by the studygroup.