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Insula is considered an important region of the brain in the generation and maintenance of a wide range of psychiatric symptoms, possibly due to being key in fundamental functions such as interoception and cognition in general. Investigating the possibility of targeting this area using non-invasive brain stimulation techniques can open new possibilities to probe the normal and abnormal functioning of the brain and potentially new treatment protocols to alleviate symptoms of different psychiatric disorders. In the current study, COMETS2, a MATLAB based toolbox was used to simulate the magnitude of the current density and electric field in the brain caused by different transcranial direct current stimulation (tDCS) protocols to find an optimum montage to target the insula and its 6 subregions for three different current intensities, namely 2, 3, and 4 mA. Frontal and occipital regions were found to be optimal candidate regions.. The results of the current study showed that it is viable to reach the insula and its individual subregions using tDCS., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Transcranial direct current stimulation (tDCS) is a promising tool to enhance therapeutic efforts, for instance, after a stroke. The achieved stimulation effects exhibit high inter-subject variability, primarily driven by perturbations of the induced electric field (EF). Differences are further elevated in the aging brain due to anatomical changes such as atrophy or lesions. Informing tDCS protocols by computer-based, individualized EF simulations is a suggested measure to mitigate this variability., Objective: While brain anatomy in general and specifically atrophy as well as stroke lesions are deemed influential on the EF in simulation studies, the influence of the uncertainty in the change of the electrical properties of the white matter due to white matter lesions (WMLs) has not been quantified yet., Methods: A group simulation study with 88 subjects assigned into four groups of increasing lesion load was conducted. Due to the lack of information about the electrical conductivity of WMLs, an uncertainty analysis was employed to quantify the variability in the simulation when choosing an arbitrary conductivity value for the lesioned tissue., Results: The contribution of WMLs to the EF variance was on average only one tenth to one thousandth of the contribution of the other modeled tissues. While the contribution of the WMLs significantly increased (p≪.01) in subjects exhibiting a high lesion load compared to low lesion load subjects, typically by a factor of 10 and above, the total variance of the EF didnot change with the lesion load., Conclusion: Our results suggest that WMLs do not perturb the EF globally and can thus be omitted when modeling subjects with low to medium lesion load. However, for high lesion load subjects, the omission of WMLs may yield less robust local EF estimations in the vicinity of the lesioned tissue. Our results contribute to the efforts of accurate modeling of tDCS for treatment planning., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)