Transcranial Current Stimulation Research Articles

The potential of fNIRS, EEG, and transcranial current stimulation to probe neural mechanisms of resistance training

The potential of fNIRS, EEG, and transcranial current stimulation to probe neural mechanisms of resistance training

Galvanic Vestibular Stimulation Activates the Parietal and Temporal Cortex in Humans: A functional near-infrared spectroscopy (fNIRS) Study.

Galvanic Vestibular Stimulation (GVS) helps stabilize subjects when balance and posture are compromised. This work aimed to define the cortical regions that GVS activates in normal subjects. We used Functional Near-Infrared Spectroscopy (fNIRS) to test the hypothesis that GVS activates similar cortical areas as a passive movement. We used transcranial current stimulation (cathode in the right mastoid process and anode in the FPz frontopolar point) of bipolar direct current (2 mA), false GVS (sham), vibration (neutral stimulus), and back and forth motion (positive control of vestibular movement) in 18 clinically healthy volunteers. Seventy-two brain scans were performed, applying a crossover-type experimental design. We measured the heart rate, blood pressure, body temperature, head capacitance, and resistance before and after the experiment. The hemodynamic changes of the cerebral cortex were recorded with an arrangement of 26 channels in four regions to perform an ROI-level analysis. The back-and-forth motion produced the most significant oxygenated Hemoglobin (HbO2 ) increase. The response was similar for the GVS stimulus on the anterior and posterior parietal and right temporal regions. Sham and vibrational conditions did not produce significant changes ROI-wise. The results indicate that GVS produces a cortical activation coherent with displacement percept.

N°291 – ERC Galvani – Pilot study 2: Impact of transcranial current stimulation on brain networks by simultaneous stereoelectroencephalography recordings in drug-resistant focal epilepsy patients

N°291 – ERC Galvani – Pilot study 2: Impact of transcranial current stimulation on brain networks by simultaneous stereoelectroencephalography recordings in drug-resistant focal epilepsy patients

Quasi-static approximation error of electric field analysis for transcranial current stimulation

Objective. Numerical modeling of electric fields induced by transcranial alternating current stimulation (tACS) is currently a part of the standard procedure to predict and understand neural response. Quasi-static approximation (QSA) for electric field calculations is generally applied to reduce the computational cost. Here, we aimed to analyze and quantify the validity of the approximation over a broad frequency range. Approach. We performed electromagnetic modeling studies using an anatomical head model and considered approximations assuming either a purely ohmic medium (i.e. static formulation) or a lossy dielectric medium (QS formulation). The results were compared with the solution of Maxwell’s equations in the cases of harmonic and pulsed signals. Finally, we analyzed the effect of electrode positioning on these errors. Main results. Our findings demonstrate that the QSA is valid and produces a relative error below 1% up to 1.43 MHz. The largest error is introduced in the static case, where the error is over 1% across the entire considered spectrum and as high as 20% in the brain at 10 Hz. We also highlight the special importance of considering the capacitive effect of tissues for pulsed waveforms, which prevents signal distortion induced by the purely ohmic approximation. At the neuron level, the results point a difference of sense electric field as high as 22% at focusing point, impacting pyramidal cells firing times. Significance. QSA remains valid in the frequency range currently used for tACS. However, neglecting permittivity (static formulation) introduces significant error for both harmonic and non-harmonic signals. It points out that reliable low frequency dielectric data are needed for accurate transcranial current stimulation numerical modeling.

Neuropathic Pain Management, Pharmacological Approaches, Neuromodulation and Quality of Life

Neuropathic pain, which affects 7%–10% of the general population, is caused by a lesion or disease of the somatosensory system, which includes peripheral fibers and central neurons. There are numerous known causes of neuropathic pain, and as the world's population ages, the prevalence of diabetes mellitus rises, and cancer patients are more likely to survive postchemotherapy. Its occurrence is projected to rise. The intricacy of neuropathic symptoms, adverse outcomes, and challenging treatment choices all appear to contribute to the burden of chronic neuropathic pain. Crucially, neuropathic pain patients have a lower quality of life due to a higher need for prescription drugs, more frequent visits to the physician, the morbidity from the pain itself, and the underlying disease. The most effective strategy to treat neuropathic pain would employ the right combination of pharmacological and nonpharmacologic therapy. As first-line treatments, gabapentinoids, tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors are advised while tramadol and opioids are regarded as second-line therapy. Because there are currently insufficient high-quality trials, cannabinoids are advised as third-line treatments, and methadone and some anticonvulsants are suggested as fourth-line therapies. In cases of failure of pharmacological therapy or other special considerations, neuromodulation therapy is suggested, which involves deep brain stimulation, spinal cord stimulation, transcranial magnetic stimulation, and transcranial current stimulation and is broadly categorized under invasive and non-invasive neuromodulation procedures. In this study, we aim to comprehensively review the existing management strategies for neuropathic pain, specifically in the context of pharmacological, neuromodulation, and quality of life domains.

Modulation of visuospatial working memory performance using dual-site transcranial current stimulation of bilateral intraparietal sulci with high-gamma alternating currents with different phases

Modulation of visuospatial working memory performance using dual-site transcranial current stimulation of bilateral intraparietal sulci with high-gamma alternating currents with different phases

Anodal high-definition transcranial direct current stimulation reduces heart rate and modulates heart-rate variability in healthy young people: A randomized cross-controlled trial.

To investigate whether anodal high-definition transcranial current stimulation (HD-tDCS) over the left dorsolateral pre-frontal cortex (DLPFC) could modulate the heart rate (HR) and heart-rate variability (HRV) in healthy young people. Forty healthy young people were enrolled in this randomized crossover trial. The participants were randomized to receive anodal HD-tDCS (n = 20) or sham HD-tDCS (n = 20) over the left DLPFC with a washout period of 1 week. Electrocardiogram (ECG) data were continuously recorded 20 min before the stimulation, during the session (20 min), and 20 min after the session. HR and the time- and frequency-domain indices of the HRV were measured to investigate the activity of the sympathetic and parasympathetic nervous systems. Anodal HD-tDCS over the left DLPFC induced a significant decrease in HR and a significant increase in the average of normal-to-normal intervals (AVG NN), low-frequency (LF) power, total power (TP), and LF/high-frequency (HF) ratio in comparison with the sham stimulation and the baseline. However, sham HD-tDCS over the left DLPFC had no significant effect on HR or HRV. Anodal HD-tDCS over the left DLPFC could reduce HR and modulate the HRV in healthy young people. HD-tDCS may show some potential for acutely modulating cardiovascular function.

Neurodynamic correlates for the cross-frequency coupled transcranial alternating current stimulation during working memory performance.

Transcranial current stimulation is a neuromodulation technique used to modulate brain oscillations and, in turn, to enhance human cognitive function in a non-invasive manner. This study investigated whether cross-frequency coupled transcranial alternating current stimulation (CFC-tACS) improved working memory performance. Participants in both the tACS-treated and sham groups were instructed to perform a modified Sternberg task, where a combination of letters and digits was presented. Theta-phase/high-gamma-amplitude CFC-tACS was administered over electrode F3 and its four surrounding return electrodes (Fp1, Fz, F7, and C3) for 20 min. To identify neurophysiological correlates for the tACS-mediated enhancement of working memory performance, we analyzed EEG alpha and theta power, cross-frequency coupling, functional connectivity, and nodal efficiency during the retention period of the working memory task. We observed significantly reduced reaction times in the tACS-treated group, with suppressed treatment-mediated differences in frontal alpha power and unidirectional Fz-delta-phase to Oz-high-gamma-amplitude modulation during the second half of the retention period when network analyses revealed tACS-mediated fronto-occipital dissociative neurodynamics between alpha suppression and delta/theta enhancement. These findings indicate that tACS modulated top-down control and functional connectivity across the fronto-occipital regions, resulting in improved working memory performance. Our observations are indicative of the feasibility of enhancing cognitive performance by the CFC-formed tACS.

Cerebellar transcranial current stimulation - An intraindividual comparison of different techniques.

Transcranial current stimulation (tCS) techniques have been shown to induce cortical plasticity. As an important relay in the motor system, the cerebellum is an interesting target for plasticity induction using tCS, aiming to modulate its excitability and connectivity. However, until now it remains unclear, which is the most effective tCS method for inducing plasticity in the cerebellum. Thus, in this study, the effects of anodal transcranial direct current stimulation (tDCS), 50 Hz transcranial alternating current stimulation (50 Hz tACS), and high frequency transcranial random noise stimulation (tRNS) were compared with sham stimulation in 20 healthy subjects in a within-subject design. tCS was applied targeting the cerebellar lobe VIIIA using neuronavigation. We measured corticospinal excitability, short-interval intracortical inhibition (SICI), short-latency afferent inhibition (SAI), and cerebellar brain inhibition (CBI) and performed a sensor-based movement analysis at baseline and three times after the intervention (post1 = 15 min; post2 = 55 min; post3 = 95 min). Corticospinal excitability increased following cerebellar tACS and tRNS compared to sham stimulation. This effect was most pronounced directly after stimulation but lasted for at least 55 min after tACS. Cortico-cortical and cerebello-cortical conditioning protocols, as well as sensor-based movement analyses, did not change. Our findings suggest that cerebellar 50 Hz tACS is the most effective protocol to change corticospinal excitability.

Focal non-invasive deep-brain stimulation with temporal interference for the suppression of epileptic biomarkers.

IntroductionNeurostimulation applied from deep brain stimulation (DBS) electrodes is an effective therapeutic intervention in patients suffering from intractable drug-resistant epilepsy when resective surgery is contraindicated or failed. Inhibitory DBS to suppress seizures and associated epileptogenic biomarkers could be performed with high-frequency stimulation (HFS), typically between 100 and 165 Hz, to various deep-seated targets, such as the Mesio-temporal lobe (MTL), which leads to changes in brain rhythms, specifically in the hippocampus. The most prominent alterations concern high-frequency oscillations (HFOs), namely an increase in ripples, a reduction in pathological Fast Ripples (FRs), and a decrease in pathological interictal epileptiform discharges (IEDs).Materials and methodsIn the current study, we use Temporal Interference (TI) stimulation to provide a non-invasive DBS (130 Hz) of the MTL, specifically the hippocampus, in both mouse models of epilepsy, and scale the method using human cadavers to demonstrate the potential efficacy in human patients. Simulations for both mice and human heads were performed to calculate the best coordinates to reach the hippocampus.ResultsThis non-invasive DBS increases physiological ripples, and decreases the number of FRs and IEDs in a mouse model of epilepsy. Similarly, we show the inability of 130 Hz transcranial current stimulation (TCS) to achieve similar results. We therefore further demonstrate the translatability to human subjects via measurements of the TI stimulation vs. TCS in human cadavers. Results show a better penetration of TI fields into the human hippocampus as compared with TCS.SignificanceThese results constitute the first proof of the feasibility and efficiency of TI to stimulate at depth an area without impacting the surrounding tissue. The data tend to show the sufficiently focal character of the induced effects and suggest promising therapeutic applications in epilepsy.

Transcranial Current Stimulation as a Tool of Neuromodulation of Cognitive Functions in Parkinson's Disease.

Decrease in cognitive function is one of the most common causes of poor life quality and early disability in patients with Parkinson’s disease (PD). Existing methods of treatment are aimed at both correction of motor and non-motor symptoms. Methods of adjuvant therapy (or complementary therapy) for maintaining cognitive functions in patients with PD are of interest. A promising subject of research in this regard is the method of transcranial electric current stimulation (tES). Here we reviewed the current understanding of the pathogenesis of cognitive impairment in PD and of the effects of transcranial direct current stimulation and transcranial alternating current stimulation on the cognitive function of patients with PD-MCI (Parkinson’s Disease–Mild Cognitive Impairment).

Study on the Effect of Different Transcranial Pulse Current Stimulation Intervention Programs for Eliminating Physical Fatigue

Previous studies have reported the effect of transcranial pulsed current stimulation (tPCS) on eliminating cognitive fatigue, but there is little research on optimizing the intervention program of tPCS. The purpose of this study was to explore the effect of different tPCS intervention programs on the elimination of physical fatigue in college athletes. Accordingly, 40 healthy college athletes were randomly divided into two groups of 20, denoted as A and B. Both groups exercised on treadmills. There were 15 subjects in group A who met the criteria of moderate physical fatigue, and 15 subjects in group B who met the criteria of severe physical fatigue. The subjects in each group were intervened with five different intervention programs of tPCS (intervention programs I, II, III, IV and V). The heart rate variability (HRV) and concentrations of oxygenated hemoglobin (HbO2) were measured before and after each intervention to judge the elimination effects of different intervention programs on different degrees of physical fatigue; the measurement indicators of the HRV include RMSSD, SDNN, HF and LF. The results indicated that tPCS intervention can eliminate both moderate and severe physical fatigue. Programs II, III, and IV had a significant effect on eliminating the moderate physical fatigue of athletes (p < 0.05), among which program II, with a stimulation time of 30 min and a stimulation intensity of sensory intensity, had the best effect. Programs I, II, III, and IV all had significant effects on eliminating the severe physical fatigue of athletes (p < 0.05), among which program I, with a stimulation time of 30 min and a stimulation intensity of sensory intensity + 0.2 mA, had the best effect. We conclude that different tPCS intervention programs can have different effects on the elimination of physical fatigue. The effects of the five intervention programs on the elimination of physical fatigue in athletes are as follows: program II is most suitable for moderate physical fatigue, and program I is most suitable for severe physical fatigue.

P 39 MRI-based geometric modeling for transcranial current stimulation in mild cognitive impairment converters

Question: Transcranial direct current stimulation (tDCS) is a fast-growing field in rehabilitation medicine. However, the stimulation-induced E-field may be uneven on the highly folded cortical surface and thus leads to heterogeneous results in clinical trials. This challenge has been addressed by the analytical methods applicable to quantitatively measure the geometric features derived from the high-resolution structural magnetic resonance imaging (MRI). As a set of novel geometric measures, the geometric features of the folded cortex could be decomposed into scalp-to-cortex distance (SCD), cortical thickness and gyrification. Beyond MRI-based measures, learnings from computational geometric models will be beneficial as this field embraces biophysics and engineering. This study aimed to examine and quantify the cortical morphometry of bilateral dorsolateral prefrontal cortex (DLPFC) and its impact on the E-field during pathological ageing. Methods: Baseline, 1-year and 3-year follow-up structural magnetic resonance imaging scans from normal ageing (NA) adults (n = 32), and mild cognitive impairment (MCI) converters (n = 22) were drawn from the Open Access Series of Imaging Studies (OASIS-2). The quantitative measures of region-specific morphometry included gyrification, cortical thickness (mm), surface area (mm2) and volume (mm3). Head model was developed to simulate the impact of morphometric changes on the E-field induced by tDCS. Results: Ageing had a nonlinear effect on the changes of volume and cortical thickness in the bilateral DLPFC. A pronounced ageing-related reduction was found in the gyrification of left DLPFC in MCI converters, which could predict the global cognition decline at the 3-year follow-up. Along with the reduced gyrification in left DLPFC, the E-field intensity of tDCS model was consequently decreased in MCI converters. Conclusions: Ageing has a prominent effect on region-specific cortical morphometry that leads to decreased E-field intensity in old adults with cognitive impairments. Our findings have important implications for conducting the transcranial brain stimulation in individuals with brain atrophy, such as Alzheimer’s Disease.

Old and New Hypothesis to The Mechanism Underlying Opioid Addiction and A Novel Treatment – A Review

Previously we presented experimental evidence that the severity of drugs of abuse withdrawal behaviors is correlated with drug-related changes in baseline neuronal firing patterns in 14 regions of the brain that we studied. These 14 areas of the brain participate in reward and pain sensations as well in response to drugs of abuse. Based on these experiments we came to the following hypothesis: Repeated morphine exposure elicits a chain of molecular and cellular events that results in the modulation (disruption) of the baseline (spontaneous) neuronal activities from the initial state to the opioid-induced state which requires continuous morphine use to keep this new baseline (BL). Cessation of morphine consumption disrupts this new morphine modified BL. This BL neuronal activity disruption leads to the expression of the withdrawal. Activation of these brain areas by noninvasive transcranial current stimulation (NTCS) will provide a novel efficacious intervention to diminish the development of opioid tolerance and the severe symptoms of opioid withdrawal. NTCS, when applied to addicted animals when the morphine consumption is discontinued rewires the disrupted neuronal circuits activities and facilitates a return to the initial BL. This will lessen or eliminate the behavioral expression of the withdrawal symptoms. NTCS have the potential to obviate and/or supplement significantly the common treatments of addiction that employ medications with drugs in the opioid family and prolonged behavioral therapies. New approaches to the opioid crisis are badly needed since the current drug treatments require lengthy investments of times.

Efficacy of cathodal transcranial direct current stimulation on electroencephalographic functional networks in patients with focal epilepsy: Preliminary findings

BackgroundNeuromodulation is a promising therapeutic alternative for epilepsy. We aimed to explore the efficacy and safety of cathodal transcranial current direct stimulation (ctDCS) on electroencephalographic functional networks in focal epilepsy. MethodsA sham-controlled, double-blinded, randomized study was conducted on 25 participants with focal epilepsy who underwent a 5-day, −1.0 mA, 20 min ctDCS, which targeted at the most active interictal epileptiform discharge (IED) region. We examined the electroencephalograms (EEGs) at baseline, immediately and at 4 weeks following ctDCS. The graph theory-based brain networks were established through time-variant partial directed coherence (TVPDC), and were calculated between each pair of EEG signals. The functional networks were characterized using average clustering coefficient, characteristic path length, and small-worldness index. The seizure frequencies, IEDs, graph-theory metrics and cognitive tests were compared. ResultsPreliminary findings indicated an IED reduction of 30.2% at the end of 5-day active ctDCS compared to baseline (p < 0.10) and a significant IED reduction of 33.4% 4 weeks later (p < 0.05). In terms of the EEG functional network, the small-worldness index significantly reduced by 3.5% (p < 0.05) and the characteristic path length increased by 1.8% (p < 0.10) at the end of the session compared to the baseline. No obvious change was found in the seizure frequency during follow-up (p > 0.05). The Mini-Mental State Examination (MMSE) showed no difference between the active and sham groups (p > 0.05). No severe adverse reactions were observed. ConclusionsIn focal epilepsy, the 5-day consecutive ctDCS may potentially decrease the IEDs and ameliorate the EEG functional network, proposing a novel personalized therapeutic scenario for epilepsy.

Comb filters for the removal of transcranial current stimulation artifacts from single channel EEG recordings

Abstract The combination of transcranial alternating current stimulation (tACS) and electroencephalogram (EEG) for mobile and home-based interventions offers the potential for control and adaptation of stimulation parameters. Yet, during stimulation, the EEG is heavily affected by stimulation artifacts. Spatial filters are often unsuited because too few channels are recorded and hardware capabilities are limited. Due to their speed and as they can be used for single channels, we explore the performance of single-channel weighted comb filters on artifact removal. At any given time point t, the recording r(t) is a superposition of a neurophysiological signal n(t), the stimulation artifact a(t) and noise e(t). Now, we can estimate the artifact a(t) based on the recording from an earlier (or later) time-point shifted by the artifacts period. A weighted estimate based on multiple time points has the potential to improve the signal recovery. Therefore, we explored several approaches and evaluated their performance on simulated and real data. The comb kernel filters were implemented in Matlab (https://github.com/agricolab/ARtACS) and Python (https://github.com/agricolab/pyARtACS), and the code is open access under an X11-license. We found that independent of the weighting function, all comb filters exhibit similarity in their suppression of the DC component, the artifacts frequency, and its harmonics. Yet, different weighting functions exhibit different pass-band performance, evident as ringing and amplification, and their induction of time-domain echoes. Interestingly, we note that a causal uniform filter is comparable to more complex approaches, while offering the option for real-time filtering. Comb filters are able to remove tACS artifacts even if only a single channel is available. As comb filters require no assumptions about the shape of the artifact, they might also be useful for filtering of non-sinusoidal, e.g. pulsed or saw-tooth, transcranial current stimulation.

Using Probabilistic Movement Primitives in Analyzing Human Motion Differences Under Transcranial Current Stimulation.

In medical tasks such as human motion analysis, computer-aided auxiliary systems have become the preferred choice for human experts for their high efficiency. However, conventional approaches are typically based on user-defined features such as movement onset times, peak velocities, motion vectors, or frequency domain analyses. Such approaches entail careful data post-processing or specific domain knowledge to achieve a meaningful feature extraction. Besides, they are prone to noise and the manual-defined features could hardly be re-used for other analyses. In this paper, we proposed probabilistic movement primitives (ProMPs), a widely-used approach in robot skill learning, to model human motions. The benefit of ProMPs is that the features are directly learned from the data and ProMPs can capture important features describing the trajectory shape, which can easily be extended to other tasks. Distinct from previous research, where classification tasks are mostly investigated, we applied ProMPs together with a variant of Kullback-Leibler (KL) divergence to quantify the effect of different transcranial current stimulation methods on human motions. We presented an initial result with 10 participants. The results validate ProMPs as a robust and effective feature extractor for human motions.

Anodal Transcranial Direct Current Stimulation Reduces Secondary Hyperalgesia Induced by low Frequency Electrical Stimulation in Healthy Volunteers

The aim of the study was to determine whether transcranial direct current stimulation (tDCS) reduced pain and signs of central sensitization induced by low frequency electrical stimulation in healthy volunteers. Thirty-nine participants received tDCS stimulation under 4 different conditions: anodal tDCS of the primary motor cortex (M1), anodal tDCS of the dorsolateral prefrontal cortex (DLPFC), anodal tDCS over M1 and DLPFC concurrently, and sham tDCS. Participants were blind to the tDCS condition. The order of the conditions was randomized among participants. Pain ratings to pinpricks, the current level that evoked moderate pain, and pain induced by low frequency electrical stimulation were assessed in the forearm by an experimenter who was blind to the tDCS conditions. Anodal tDCS at M1 increased the current level that evoked moderate pain compared to sham and other conditions. Anodal tDCS of DLPFC completely abolished secondary hyperalgesia. Unexpectedly, however, concurrent anodal tDCS over M1 and DLPFC did not reduce pain or hyperalgesia more than M1 alone or DLPFC alone. Overall, these findings suggest that anodal tDCS over M1 suppresses pain, and that anodal tDCS over DLPFC modulates secondary hyperalgesia (a sign of central sensitization) in healthy participants. PerspectiveAnodal transcranial current stimulation (atDCS) at the left motor cortex and the dorsolateral prefrontal cortex increased the electrically-evoked pain threshold and reduced secondary hyperalgesia in healthy participants. Replication of this study in chronic pain populations may open more avenues for chronic pain treatment.

Influence of layered skull modeling on the frequency sensitivity and target accuracy in simulations of transcranial current stimulation.

With the development of electrical stimulation technology, especially the emergence of temporally interfering (TI) stimulation, it is necessary to discuss the influence of current frequency on stimulation intensity. Accurate skull modeling is important for transcranial current stimulation (tCS) simulation prediction because of its large role in dispersing current. In this study, we simulated different frequencies of transcranial alternating current stimulation (tACS) and TI stimulation in single‐layer and layered skull model, compared the electric field via error parameters such as the relative difference measure and relative magnification factor. Pearson correlation analysis and t‐test were used to measure the differences in envelope amplitude. The results showed that the intensity of electric field in the brain generated by per unit of stimulation current will increase with current frequency, and the layered skull model had a better response to frequency. An obvious pattern difference was found between the electric fields of the layered and single‐layer skull individualized models. For TI stimulation, the Pearson correlation coefficient between the envelope distribution of the layered skull model and the single‐layer skull was only 0.746 in the individualized model, which is clearly lower than the correlation coefficient of 0.999 determined from the spherical model. Higher carrier frequencies seemed to be easier to generate a large enough brain electric field envelope in TI stimulation. In conclusion, we recommend using layered skull models instead of single‐layer skull models in tCS (particularly TI stimulation) simulation studies in order to improve the accuracy of the prediction of stimulus intensity and stimulus target.

Effect of skull thickness and conductivity on current propagation for noninvasively injected currents

Objective. When currents are injected into the scalp, e.g. during transcranial current stimulation, the resulting currents generated in the brain are substantially affected by the changes in conductivity and geometry of intermediate tissue. In this work, we introduce the concept of ‘skull-transparent’ currents, for which the changing conductivity does not significantly alter the field while propagating through the head. Approach. We establish transfer functions relating scalp currents to head potentials in accepted simplified models of the head, and find approximations for which skull-transparency holds. The current fields resulting from specified current patterns are calculated in multiple head models, including MRI heads and compared with homogeneous heads to characterize the transparency. Experimental validation is performed by measuring the current field in head phantoms. Main results. The main theoretical result is derived from observing that at high spatial frequencies, in the transfer function relating currents injected into the scalp to potential generated inside the head, the conductivity terms form a multiplicative factor and do not otherwise influence the transfer function. This observation is utilized to design injected current waveforms that maintain nearly identical focusing patterns independently of the changes in skull conductivity and thickness for a wide range of conductivity and thickness values in an idealized spherical head model as well as in a realistic MRI-based head model. Experimental measurements of the current field in an agar-based head phantom confirm the transparency of these patterns. Significance. Our results suggest the possibility that well-chosen patterns of current injection result in precise focusing inside the brain even without a priori knowledge of exact conductivities of intermediate layers.