AbstractBackgroundNon‐invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) can potentially counteract disrupted local and distributed brain network activity in Alzheimer’s disease (AD) with a beneficial effect on cognition. However, results of tDCS studies in AD up till now are inconsistent, probably partly due to different methodological choices such as electrode placement. We therefore explored tDCS optimization using a virtual brain network model of AD. Our aim was to compare a large, representative set of virtual tDCS intervention setups, to identify and potentially explain the optimal theoretical tDCS electrode positions for reducing or restoring functional network disruption.MethodWe simulated 20 tDCS setups in a computational macroscopic dynamic network model of 78 neural masses, coupled according to human structural topology. AD network damage was simulated using an activity‐dependent degeneration algorithm, which produces typical gradual oscillatory slowing and loss of connectivity. Current flow modeling was used to estimate tDCS‐targeted cortical regions for different electrode positions, and excitability of the pyramidal neurons of the corresponding neural masses was modulated to simulate tDCS. Outcome measures were relative power spectral density in the lower (8‐10 Hz) and upper (8‐13 Hz) alpha bands, total spectral power, posterior alpha peak frequency, and connectivity measures phase lag index (PLI) and amplitude envelope correlation (AEC).ResultThe performance of different tDCS strategies varied considerably, with best setups temporarily improving all spectral and connectivity outcome measures, while other setups had little to no effect, or even caused network deterioration. The best performing setup involved right parietal anodal stimulation, with a contralateral supraorbital cathode. A clear correlation between the network role of a region (e.g. hub) and its involvement in successful tDCS was not observed.ConclusionModeling tDCS produces specific, falsifiable predictions on how to counter disrupted brain dynamics in AD. In follow‐up studies, our general predictions will be compared to those of personalized virtual models, and then validated with tDCS‐magnetoencephalography (MEG) in a clinical AD patient cohort. This modeling‐informed approach can guide and perhaps accelerate tDCS therapy development, as well as enhance our understanding of tDCS effects.
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