Patient description: The patient is a 60 year old man complaining of frequent headaches, generalized bone pain and difficulty chewing that started 6 years ago and is worsening. Examination shows bilateral swellings around the molars. The swellings have increased since his last examination. Several extraoral lesions are detected in the head and face. The swellings are non-tender and attached to the underlying bone. Further evaluation shows increased uptake of radioactive substance as well as an increase in urinary pyridinoline. His serum alkaline phosphatase is 300 IU/L (the normal range is 44- 147 IU/L). His family history is only significant for hypertension in his mother and DM type 2 in his father. The diagnosis of Paget's Disease of Bone was confirmed and Bisphosphonate will be started as first-line therapy.

Clinical trial eligibility criteria: eligible ages (years): 19.0-999.0,  Depression Parkinson's are outpatients, 2. are voluntary and competent to consent to treatment, 3. have a Mini-International Neuropsychiatric Interview (MINI) confirmed diagnosis of major depressive disorder (MDD), 4. have a diagnosis of PD according to the UK PD brain bank 5. are 19 years of age or more, 6. have a score > 13 on the Beck Depression Inventory-II (BDI-II), 7. still have depressive symptoms after 6 weeks or more of antidepressant (SSRI) medication treatment (and on a stabilized dose of at least 4 weeks), 8. are able to adhere to the treatment schedule, 9. are proficient in written and verbal English  have a history of substance dependence or abuse within the last 6 months, 2. have a concomitant significant unstable medical illness, 3. have active suicidal intent, 4. have any history of seizure or medication-resistant epilepsy in the family, 5. have a lifetime Mini-International Neuropsychiatric Interview (MINI) diagnosis of bipolar I or II disorder, schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, or current psychotic symptoms 6. have a MINI diagnosis of obsessive compulsive disorder, post-traumatic stress disorder (current or within the last year), anxiety disorder (generalized anxiety disorder, social anxiety disorder, panic disorder), or dysthymia, assessed by a study investigator to be primary and causing greater impairment than MDD, 7. have failed a course of ECT in the current episode or previous episode, 8. have received tDCS or other neurostimulation therapy for any previous indication due to the potential compromise of expectancy effects, 9. have any significant neurological disorder or insult including, but not limited to: any condition likely to be associated with increased intracranial pressure, space occupying brain lesion, any history of seizure except those therapeutically induced by ECT, cerebral aneurysm, Huntington's chorea, multiple sclerosis, significant head trauma with loss of consciousness for greater than or equal to 5 minutes, or developmental disorder, 10. have an intracranial implant (e.g., aneurysm clips, shunts, stimulators, cochlear implants, or electrodes) or any other metal object within or near the head, excluding the mouth, that cannot be safely removed, 11. are taking a non-SSRI antidepressant medication, 12. are pregnant (women of childbearing age only) for PET: 1. unable to tolerate staying off anti-parkinsonian medication for 12-18 hours pre-PET scan, 2. have a history of radiation therapy treatment or other high amounts of radiation for MRI Artificial heart valve Brain aneurysm clip Electrical stimulator for nerves or bones Ear or eye implant Implanted drug infusion pump Coil, catheter, or filter in any blood vessel Orthopedic hardware (artificial joint, plate, screws)