title: Transcranial direct current stimulation in obsessive-compulsive disorder: emerging clinical evidence and considerations for optimal montage of electrodes.
abstract: BACKGROUND
  Neuromodulation techniques for obsessive-compulsive disorder (OCD) treatment have expanded with greater understanding of the brain circuits involved. Transcranial direct current stimulation (tDCS) might be a potential new treatment for OCD, although the optimal montage is unclear.
  
  
  OBJECTIVE
  To perform a systematic review on meta-analyses of repetitive transcranianal magnetic stimulation (rTMS) and deep brain stimulation (DBS) trials for OCD, aiming to identify brain stimulation targets for future tDCS trials and to support the empirical evidence with computer head modeling analysis.
  
  
  METHODS
  Systematic reviews of rTMS and DBS trials on OCD in Pubmed/MEDLINE were searched. For the tDCS computational analysis, we employed head models with the goal of optimally targeting current delivery to structures of interest.
  
  
  RESULTS
  Only three references matched our eligibility criteria. We simulated four different electrodes montages and analyzed current direction and intensity.
  
  
  CONCLUSIONS
  Although DBS, rTMS and tDCS are not directly comparable and our theoretical model, based on DBS and rTMS targets, needs empirical validation, we found that the tDCS montage with the cathode over the pre-supplementary motor area and extra-cephalic anode seems to activate most of the areas related to OCD.
authors.affiliation: Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Natasha M
authors.initials: NM
authors.lastname: Senço
authors.forename: Yu
authors.initials: Y
authors.lastname: Huang
authors.forename: Giordano
authors.initials: G
authors.lastname: D'Urso
authors.forename: Lucas C
authors.initials: LC
authors.lastname: Parra
authors.forename: Marom
authors.initials: M
authors.lastname: Bikson
authors.forename: Antonio
authors.initials: A
authors.lastname: Mantovani
authors.forename: Roseli G
authors.initials: RG
authors.lastname: Shavitt
authors.forename: Marcelo Q
authors.initials: MQ
authors.lastname: Hoexter
authors.forename: Eurípedes C
authors.initials: EC
authors.lastname: Miguel
authors.forename: André R
authors.initials: AR
authors.lastname: Brunoni
mesh_terms: D004566:Electrodes; D005260:Female; D006801:Humans; D016239:MEDLINE; D055909:Magnetic Field Therapy / Q000295:instrumentation* / Q000379:methods*; D008297:Male; D008954:Models, Biological; D009044:Motor Cortex / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology / Q000628:therapy*; D065908:Transcranial Direct Current Stimulation / Q000295:instrumentation* / Q000379:methods*
keywords: computer-based modeling; non-invasive brain stimulation; obsessive–compulsive disorder; repetitive transcranial magnetic stimulation; transcranial direct current stimulation