{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T22:38:14Z","timestamp":1769553494714,"version":"3.49.0"},"reference-count":34,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:00:00Z","timestamp":1608249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Obsessive-compulsive disorder (OCD) is a debilitating disorder with an approximate lifetime prevalence of 1\u20133%. Despite advances in leading treatment modalities, including pharmacotherapy and psychotherapy, some cases remain treatment resistant. Non-invasive brain stimulation has been explored in this treatment-resistant population with some promising findings; however, a lack of methodological rigor has reduced the quality of the findings. The current paper presents the protocol for conducting research into the efficacy of transcranial direct current stimulation (tDCS) in the treatment of OCD. A double-blind randomised controlled trial (RCT) will be conducted involving active tDCS vs. sham tDCS on 40 general OCD patients. The intervention consists of 2 mA anodal stimulation over the pre-supplementary motor area (pre-SMA) with the cathode positioned over the orbitofrontal cortex (OFC). Participants will receive 10 sessions of 20 min of either sham- or active-tDCS over 4 weeks. Outcomes will be categorical and dimensional measures of OCD, as well as related secondary clinical measures (depression, anxiety, quality of life), and neurocognitive functions (inhibitory control, cognitive flexibility).<\/jats:p>","DOI":"10.3390\/brainsci10121008","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T11:42:09Z","timestamp":1608291729000},"page":"1008","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Protocol for Transcranial Direct Current Stimulation for Obsessive-Compulsive Disorder"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0039-118X","authenticated-orcid":false,"given":"Peta","family":"Green","sequence":"first","affiliation":[{"name":"School of Psychology in Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Loftus","sequence":"additional","affiliation":[{"name":"School of Psychology in Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Anderson","sequence":"additional","affiliation":[{"name":"School of Psychology in Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S0022-3956(00)00022-4","article-title":"fMRI of neuronal activation with symptom provocation in unmedicated patients with obsessive compulsive disorder","volume":"34","author":"Adler","year":"2000","journal-title":"J. Psychiatr. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1001\/archgenpsychiatry.2009.152","article-title":"Altered corticostriatal functional connectivity in obsessive-compulsive disorder","volume":"66","author":"Harrison","year":"2009","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"226","DOI":"10.4088\/PCC.08m00663","article-title":"Augmentation effect of repetitive transcranial magnetic stimulation over the orbitofrontal cortex in drug-resistant obsessive-compulsive disorder patients: A controlled investigation","volume":"11","author":"Ruffini","year":"2009","journal-title":"Prim. Care Companion J. Clin. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1176\/appi.ajp.2012.12010073","article-title":"Presupplementary motor area hyperactivity during response inhibition: A candidate endophenotype of obsessive-compulsive disorder","volume":"169","author":"Cath","year":"2012","journal-title":"Am. J. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000343912","article-title":"A similar but distinctive pattern of impaired cortical excitability in first-episode schizophrenia and ADHD","volume":"67","author":"Hasan","year":"2013","journal-title":"Neuropsychobiology"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Brunelin, J., Mondino, M., Bation, R., Palm, U., Saoud, M., and Poulet, E. (2018). Transcranial direct current stimulation for obsessive-compulsive disorder: A systematic review. Brain Sci., 8.","DOI":"10.3390\/brainsci8020037"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/YCT.0000000000000309","article-title":"Response to transcranial direct current stimulation in a case of episodic obsessive compulsive disorder","volume":"32","author":"Hazari","year":"2016","journal-title":"J. ECT"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.brs.2014.12.003","article-title":"Successful application of add-on transcranial direct current stimulation (tDCS) for treatment of SSRI resistant OCD","volume":"8","author":"Narayanaswamy","year":"2015","journal-title":"Brain Stimul."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/687909","article-title":"Effect of transcranial brain stimulation for the treatment of Alzheimer disease: A review","volume":"2012","author":"Nardone","year":"2012","journal-title":"Int. J. Alzheimer\u2019s Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.brs.2008.06.004","article-title":"Transcranial direct current stimulation: State of the art 2008","volume":"1","author":"Nitsche","year":"2008","journal-title":"Brain Stimul."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.neuroimage.2013.07.083","article-title":"Battery powered thought: Enhancement of attention, learning, and memory in healthy adults using transcranial direct current stimulation","volume":"85","author":"Coffman","year":"2014","journal-title":"Neuroimage"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"48","DOI":"10.3389\/fpsyt.2012.00048","article-title":"Action mechanisms of transcranial direct current stimulation in Alzheimer\u2019s disease and memory loss","volume":"3","author":"Hansen","year":"2012","journal-title":"Front. Psychiatry"},{"key":"ref_13","first-page":"1","article-title":"Cognitive training and transcranial direct current stimulation for mild cognitive impairment in parkinson\u2019s disease: A randomized controlled trial","volume":"1","author":"Lawrence","year":"2018","journal-title":"Parkinson\u2019s Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1038\/nrn2478","article-title":"Functional role of the supplementary and pre-supplementary motor areas","volume":"9","author":"Nachev","year":"2008","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1002\/da.22578","article-title":"Transcranial direct current stimulation for obsessive\u2013compulsive disorder: A randomized, controlled, partial crossover trial","volume":"33","author":"Brunoni","year":"2016","journal-title":"Depress. Anxiety"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"573","DOI":"10.4103\/IJPSYM.IJPSYM_388_16","article-title":"Efficacy of transcranial direct current stimulation in the treatment: Resistant patients who suffer from severe obsessive-compulsive disorder","volume":"39","author":"Najafi","year":"2017","journal-title":"Indian J. Psychol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"American Psychological Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_18","first-page":"22","article-title":"The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10","volume":"59","author":"Sheehan","year":"1998","journal-title":"J. Clin. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1177\/0004867418799453","article-title":"Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of panic disorder, social anxiety disorder and generalised anxiety disorder","volume":"52","author":"Andrews","year":"2018","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/S0140-6736(02)07683-3","article-title":"Generation of allocation sequences in randomised trials: Chance, not choice","volume":"359","author":"Schulz","year":"2002","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jpsychires.2015.12.018","article-title":"A systematic review of the clinical efficacy of transcranial direct current stimulation (tDCS) in psychiatric disorders","volume":"74","author":"Kekic","year":"2016","journal-title":"J. Psychiatr. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.clinph.2005.12.003","article-title":"Transcranial DC stimulation (tDCS): A tool for double-blind sham-controlled clinical studies in brain stimulation","volume":"117","author":"Gandiga","year":"2006","journal-title":"Clin. Neurophysiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1001\/archpsyc.1989.01810110048007","article-title":"The Yale-Brown obsessive compulsive scale: I. Development, use, and reliability","volume":"46","author":"Goodman","year":"1989","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-U","article-title":"The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories","volume":"33","author":"Lovibond","year":"1995","journal-title":"Behav. Res. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1111\/j.1365-2850.2011.01735.x","article-title":"Quality of Life Enjoyment and Satisfaction Questionnaire\u2013short form for quality of life assessments in clinical practice: A psychometric study","volume":"18","author":"Stevanovic","year":"2011","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.janxdis.2007.03.012","article-title":"Belief domains of the Obsessive Beliefs Questionnaire-44 (OBQ-44) and their specific relationship with obsessive\u2013compulsive symptoms","volume":"22","author":"Myers","year":"2008","journal-title":"J. Anxiety Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e46323","DOI":"10.7554\/eLife.46323","article-title":"A consensus guide to capturing the ability to inhibit actions and impulsive behaviors in the stop-signal task","volume":"8","author":"Verbruggen","year":"2019","journal-title":"eLife"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.neubiorev.2004.11.006","article-title":"The neuropsychology of obsessive compulsive disorder: The importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers","volume":"29","author":"Chamberlain","year":"2005","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1080\/1357650X.2013.783045","article-title":"Edinburgh Handedness Inventory\u2013Short Form: A revised version based on confirmatory factor analysis","volume":"19","author":"Veale","year":"2014","journal-title":"Laterality Asymmetries Body Brain Cogn."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.brainresbull.2007.01.004","article-title":"Safety aspects of transcranial direct current stimulation concerning healthy subjects and patients","volume":"72","author":"Poreisz","year":"2007","journal-title":"Brain Res. Bull."},{"key":"ref_31","first-page":"1049","article-title":"Generalized linear mixed models","volume":"4","author":"McCulloch","year":"2005","journal-title":"Encycl. Biostat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/1099800404267682","article-title":"A comparison of the general linear mixed model and repeated measures ANOVA using a dataset with multiple missing data points","volume":"6","author":"Krueger","year":"2004","journal-title":"Biol. Res. Nurs."},{"key":"ref_33","unstructured":"National Health and Medical Research Council (2007). National Statement on Ethical Conduct in Human Research."},{"key":"ref_34","unstructured":"Australian Psychological Society (APS) (2007). Code of Ethics, The Australian Breastfeeding Association."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/10\/12\/1008\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:46:52Z","timestamp":1760179612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/10\/12\/1008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,18]]},"references-count":34,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["brainsci10121008"],"URL":"https:\/\/doi.org\/10.3390\/brainsci10121008","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,18]]}}}