Transcranial Current Stimulation Research Articles

Regional Personalized Electrodes to Select Transcranial Current Stimulation Target

Rationale: Personalizing transcranial stimulations promises to enhance beneficial effects for individual patients.Objective: To stimulate specific cortical regions by developing a procedure to bend and position custom shaped electrodes; to probe the effects on cortical excitability produced when the properly customized electrode is targeting different cortical areas.Method: An ad hoc neuronavigation procedure was developed to accurately shape and place the personalized electrodes on the basis of individual brain magnetic resonance images (MRI) on bilateral primary motor (M1) and somatosensory (S1) cortices. The transcranial alternating current stimulation (tACS) protocol published by Feurra et al. (2011b) was used to test the effects on cortical excitability of the personalized electrode when targeting S1 or M1.Results: Neuronal excitability as evaluated by tACS was different when targeting M1 or S1, with the General Estimating Equation model indicating a clear tCS Effect (p < 0.001), and post hoc comparisons showing solely M1 20 Hz tACS to reduce M1 excitability with respect to baseline and other tACS conditions.Conclusions: The present work indicates that specific cortical regions can be targeted by tCS properly shaping and positioning the stimulating electrode.Significance: Through multimodal brain investigations continuous efforts in understanding the neuronal changes related to specific neurological or psychiatric diseases become more relevant as our ability to build the compensating interventions improves. An important step forward on this path is the ability to target the specific cortical area of interest, as shown in the present pilot work.

Predicting the behavioral impact of transcranial direct current stimulation: issues and limitations

The transcranial application of weak currents to the human brain has enjoyed a decade of widespread use, providing a simple and powerful tool for non-invasively altering human brain function. However, our understanding of current delivery and its impact upon neural circuitry leaves much to be desired. We argue that the credibility of conclusions drawn with transcranial direct current stimulation (tDCS) is contingent upon realistic explanations of how tDCS works, and that our present understanding of tDCS limits the technique’s use to localize function in the human brain. We outline two central issues where progress is required: the localization of currents, and predicting their functional consequence. We encourage experimenters to eschew simplistic explanations of mechanisms of transcranial current stimulation. We suggest the use of individualized current modeling, together with computational neurostimulation to inform mechanistic frameworks in which to interpret the physiological impact of tDCS. We hope that through mechanistically richer descriptions of current flow and action, insight into the biological processes by which transcranial currents influence behavior can be gained, leading to more effective stimulation protocols and empowering conclusions drawn with tDCS.

The electric field in the cortex during transcranial current stimulation

The electric field in the cortex during transcranial current stimulation was calculated based on a realistic head model derived from structural MR images. The aim of this study was to investigate the effect of tissue heterogeneity and of the complex cortical geometry on the electric field distribution. To this end, the surfaces separating the different tissues were represented as accurately as possible, particularly the cortical surfaces. Our main finding was that the complex cortical geometry combined with the high conductivity of the CSF which covers the cortex and fills its sulci gives rise to a very distinctive electric field distribution in the cortex, with a strong normal component confined to the bottom of sulci under or near the electrodes and a weaker tangential component that covers large areas of the gyri that lie near each electrode in the direction of the other electrode. These general features are shaped by the details of the sulcal and gyral geometry under and between the electrodes. Smaller electrodes resulted in a significant improvement in the focality of the tangential component but not of the normal component, when focality is defined in terms of percentages of the maximum values in the cortex. Experimental validation of these predictions could provide a better understanding of the mechanisms underlying the acute effects of tCS.

The point spread function of the human head and its implications for transcranial current stimulation

Rational development of transcranial current stimulation (tCS) requires solving the ‘forward problem’: the computation of the electric field distribution in the head resulting from the application of scalp currents. Derivation of forward models has represented a major effort in brain stimulation research, with model complexity ranging from spherical shells to individualized head models based on magnetic resonance imagery. Despite such effort, an easily accessible benchmark head model is greatly needed when individualized modeling is either undesired (to observe general population trends as opposed to individual differences) or unfeasible. Here, we derive a closed-form linear system which relates the applied current to the induced electric potential. It is shown that in the spherical harmonic (Fourier) domain, a simple scalar multiplication relates the current density on the scalp to the electric potential in the brain. Equivalently, the current density in the head follows as the spherical convolution between the scalp current distribution and the point spread function of the head, which we derive. Thus, if one knows the spherical harmonic representation of the scalp current (i.e. the electrode locations and current intensity to be employed), one can easily compute the resulting electric field at any point inside the head. Conversely, one may also readily determine the scalp current distribution required to generate an arbitrary electric field in the brain (the ‘backward problem’ in tCS). We demonstrate the simplicity and utility of the model with a series of characteristic curves which sweep across a variety of stimulation parameters: electrode size, depth of stimulation, head size and anode–cathode separation. Finally, theoretically optimal montages for targeting an infinitesimal point in the brain are shown.

Transcranial Electrical Stimulation: Methodology and Applications

Low-intensity transcranial current stimulation is a rapidly growing field of research. Transcranial direct current stimulation (tDCS) is the dominant paradigm of this new field, with transcranial alternating current stimulation (tACS) just emerging. Anodal stimulation with tDCS has excitatory effects on the underlying cortex, whereas cathodal stimulation has inhibitory effects. Because both electrodes have significant brain effects when placed at cephalic areas, the term “reference” electrode should be avoided. Most studies have applied tDCS to the motor cortex, the prefrontal cortex, and the occipital cortex. Applications of tDCS include modulation of electrophysiological and hemodynamic brain activity, symptom reduction in neurological and psychiatric pathology, and cognitive improvement in healthy volunteers or clinical populations. There is evidence of motor improvement in patients with stroke, pain reduction in fibromyalgia, improved mood in patients with unipolar or bipolar depression, and reduced c...

S13.4 Effect of electrode size on focality of transcranial current stimulation: a modeling study using realistic electrode and head models

S13.4 Effect of electrode size on focality of transcranial current stimulation: a modeling study using realistic electrode and head models

Transcranial direct current stimulation for major depression: A general system for quantifying transcranial electrotherapy dosage

There has been a recent resurgence of interest in therapeutic modalities using transcranial weak electrical stimulation through scalp electrodes, such as trans-cranial direct current stimulation (tDCS), as a means of experimentally modifying and studying brain function and possibly treating psychiatric conditions. A range of electrotherapy paradigms have been investigated, but no consistent method has been indicated for reporting reproducible stimulation "dosage." Anecdotal reports, case studies, and limited clinical trials with small numbers suggest that tDCS may be effective in treating some patients with depression, but methods for selecting the optimal stimulation parameters ("dosage") are not clear, and there is no conclusive indication that tDCS is an effective treatment for depression. Larger, controlled studies are necessary to determine its safety and efficacy in a clinical setting. If tDCS can be established as an effective treatment for depression, it would represent a particularly attractive electrotherapy option, as it is a relatively benign and affordable treatment modality. An accurate system for describing reproducible treatment parameters is essential so that further studies can yield evidence-based guidelines for the clinical use of transcranial current stimulation. Development of appropriate parameters requires a biophysical understanding of how electrotherapy affects brain function and should include different paradigms for different clinical applications. As with any dosage guidelines, such a system does not supersede physician judgment on safety.

Role of cortical cell type and neuronal morphology in electric field stimulation

Clinical application of transcranial magnetic stimulation (TMS) and transcranial current stimulation (TCS, encompassing transcranial direct current stimulation, cranial electrotherapy stimulation, transcranial electric stimulation, and electroconvulsive therapy) are promising non-invasive approaches for the treatment of a number of psychiatric disorders and pain. The cortex is the most common target of these non-invasive brain stimulation modalities. Cellular level studies of the electric fields, imposed by these brain stimulation modalities, state that cellular morphology predict the induced transmembrane polarization along a neuron.

Transcranial current stimulation focality using disc and ring electrode configurations: FEM analysis

We calculated the electric fields induced in the brain during transcranial current stimulation (TCS) using a finite-element concentric spheres human head model. A range of disc electrode configurations were simulated: (1) distant-bipolar; (2) adjacent-bipolar; (3) tripolar; and three ring designs, (4) belt, (5) concentric ring, and (6) double concentric ring. We compared the focality of each configuration targeting cortical structures oriented normal to the surface (‘surface-radial’ and ‘cross-section radial’), cortical structures oriented along the brain surface (‘surface-tangential’ and ‘cross-section tangential’) and non-oriented cortical surface structures (‘surface-magnitude’ and ‘cross-section magnitude’). For surface-radial fields, we further considered the ‘polarity’ of modulation (e.g. superficial cortical neuron soma hyper/depolarizing). The distant-bipolar configuration, which is comparable with commonly used TCS protocols, resulted in diffuse (un-focal) modulation with bi-directional radial modulation under each electrode and tangential modulation between electrodes. Increasing the proximity of the two electrodes (adjacent-bipolar electrode configuration) increased focality, at the cost of more surface current. At similar electrode distances, the tripolar-electrodes configuration produced comparable peak focality, but reduced radial bi-directionality. The concentric-ring configuration resulted in the highest spatial focality and uni-directional radial modulation, at the expense of increased total surface current. Changing ring dimensions, or use of two concentric rings, allow titration of this balance. The concentric-ring design may thus provide an optimized configuration for targeted modulation of superficial cortical neurons.