{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:34:28Z","timestamp":1787027668095,"version":"build-2736575974"},"reference-count":250,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1154651"],"award-info":[{"award-number":["GNT1154651"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"IMPACT philanthropy grant","award":["IPAP2017\/1439"],"award-info":[{"award-number":["IPAP2017\/1439"]}]},{"name":"Australian Government Research Training Program Scholarship","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Invasive and noninvasive neurostimulation therapies for obsessive-compulsive and related disorders (OCRD) were systematically reviewed with the aim of assessing clinical characteristics, methodologies, neuroanatomical substrates, and varied stimulation parameters. Previous reviews have focused on a narrow scope, statistical rather than clinical significance, grouped together heterogenous protocols, and proposed inconclusive outcomes and directions. Herein, a comprehensive and transdiagnostic evaluation of all clinically relevant determinants is presented with translational clinical recommendations and novel response rates. Electroconvulsive therapy (ECT) studies were limited in number and quality but demonstrated greater efficacy than previously identified. Targeting the pre-SMA\/SMA is recommended for transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS). TMS yielded superior outcomes, although polarity findings were conflicting, and refinement of frontal\/cognitive control protocols may optimize outcomes. For both techniques, standardization of polarity, more treatment sessions (&gt;20), and targeting multiple structures are encouraged. A deep brain stimulation (DBS) \u2018sweet spot\u2019 of the striatum for OCD was proposed, and CBT is strongly encouraged. Tourette\u2019s patients showed less variance and reliance on treatment optimization. Several DBS targets achieved consistent, rapid, and sustained clinical response. Analysis of fiber connectivity, as opposed to precise neural regions, should be implemented for target selection. Standardization of protocols is necessary to achieve translational outcomes.<\/jats:p>","DOI":"10.3390\/brainsci11070948","type":"journal-article","created":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T10:07:37Z","timestamp":1626689257000},"page":"948","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["Therapeutic Neurostimulation in Obsessive-Compulsive and Related Disorders: A Systematic Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3059-3620","authenticated-orcid":false,"given":"Nicola","family":"Acevedo","sequence":"first","affiliation":[{"name":"Centre for Mental Health, Swinburne University of Technology, John Street, Melbourne, VIC 3122, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bosanac","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne, 41 Victoria Parade, Melbourne, VIC 3065, Australia"},{"name":"Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7953-9030","authenticated-orcid":false,"given":"Toni","family":"Pikoos","sequence":"additional","affiliation":[{"name":"Centre for Mental Health, Swinburne University of Technology, John Street, Melbourne, VIC 3122, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Rossell","sequence":"additional","affiliation":[{"name":"Centre for Mental Health, Swinburne University of Technology, John Street, Melbourne, VIC 3122, Australia"},{"name":"St. Vincent\u2019s Hospital Melbourne, 41 Victoria Parade, Melbourne, VIC 3065, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Castle","sequence":"additional","affiliation":[{"name":"St. Vincent\u2019s Hospital Melbourne, 41 Victoria Parade, Melbourne, VIC 3065, Australia"},{"name":"Department of Psychiatry, University of Melbourne, Melbourne, VIC 3010, Australia"},{"name":"Centre for Addiction and Mental Health, 252 College Street, Toronto, ON M5T 1R7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,19]]},"reference":[{"key":"ref_1","unstructured":"(2013). 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