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Gyri-precise head model of transcranial direct current stimulation: improved spatial focality using a ring electrode versus conventional rectangular pad.

ABSTRACT: The spatial resolution of conventional transcranial direct current stimulation (tDCS) is considered to be relatively diffuse owing to skull dispersion. However, we show that electric fields may be clustered at distinct gyri/sulci sites because of details in tissue architecture/conductivity, notably cerebrospinal fluid (CSF). We calculated the cortical electric field/current density magnitude induced during tDCS using a high spatial resolution (1 mm3) magnetic resonance imaging (MRI)-derived finite element human head model; cortical gyri/sulci were resolved. The spatial focality of conventional rectangular-pad (7 x 5 cm2) and the ring (4 x 1) electrode configurations were compared. The rectangular-pad configuration resulted in diffuse (unfocal) modulation, with discrete clusters of electric field magnitude maxima. Peak-induced electric field magnitude was not observed directly underneath the pads, but at an intermediate lobe. The 4 x 1 ring resulted in enhanced spatial focality, with peak-induced electric field magnitude at the sulcus and adjacent gyri directly underneath the active electrode. Cortical structures may be focally targeted by using ring configurations. Anatomically accurate high-resolution MRI-based forward-models may guide the "rational" clinical design and optimization of tDCS.

SUBMITTER: Datta A

PROVIDER: S-EPMC2790295 | biostudies-literature | 2009 Oct

REPOSITORIES: biostudies-literature

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Gyri-precise head model of transcranial direct current stimulation: improved spatial focality using a ring electrode versus conventional rectangular pad.

Datta Abhishek A Bansal Varun V Diaz Julian J Patel Jinal J Reato Davide D Bikson Marom M

Brain stimulation 20091001 4

The spatial resolution of conventional transcranial direct current stimulation (tDCS) is considered to be relatively diffuse owing to skull dispersion. However, we show that electric fields may be clustered at distinct gyri/sulci sites because of details in tissue architecture/conductivity, notably cerebrospinal fluid (CSF). We calculated the cortical electric field/current density magnitude induced during tDCS using a high spatial resolution (1 mm3) magnetic resonance imaging (MRI)-derived fini ...[more]

PMID: 20648973

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Project description:Background: In transcranial direct current stimulation (tDCS), the injected current becomes distributed across the brain areas. The objective is to stimulate the target region of interest (ROI) while minimizing the current in non-target ROIs (the 'focality' of tDCS). For this purpose, determining the appropriate current dose for an individual is difficult. Aim: To introduce a dose-target determination index (DTDI) to quantify the focality of tDCS and examine the dose-focality relationship in three different populations. Method: Here, we extended our previous toolbox i-SATA to the MNI reference space. After a tDCS montage is simulated for a current dose, the i-SATA(MNI) computes the average (over voxels) current density for every region in the brain. DTDI is the ratio of the average current density at the target ROI to the ROI with a maximum value (the peak region). Ideally, target ROI should be the peak region, so DTDI shall range from 0 to 1. The higher the value, the better the dose. We estimated the variation of DTDI within and across individuals using T1-weighted brain images of 45 males and females distributed equally across three age groups: (a) young adults (20 ≤ x ˂ 40 years), (b) mid adults (40 ≤ x ˂ 60 years), and (c) older adults (60 ≤ x ˂ 80 years). DTDI's were evaluated for the frontal montage with electrodes at F3 and the right supraorbital for three current doses of 1 mA, 2 mA, and 3 mA, with the target ROI at the left middle frontal gyrus. Result: As the dose is incremented, DTDI may show (a) increase, (b) decrease, and (c) no change across the individuals depending on the relationship (nonlinear or linear) between the injected tDCS current and the distribution of current density in the target ROI. The nonlinearity is predominant in older adults with a decrease in focality. The decline is stronger in males. Higher current dose at older age can enhance the focality of stimulation. Conclusion: DTDI provides information on which tDCS current dose will optimize the focality of stimulation. The recommended DTDI dose should be prioritized based on the age (>40 years) and sex (especially for males) of an individual. The toolbox i-SATA(MNI) is freely available.

Project description:Functional electrical stimulation (FES) can be applied as an assistive and therapeutic aid in the rehabilitation of foot drop. Transcutaneous multi-pad electrodes can increase the selectivity of stimulation; however, shaping the stimulation electrode becomes increasingly complex with an increasing number of possible stimulation sites. We described and tested a novel decision support system (DSS) to facilitate the process of multi-pad stimulation electrode shaping. The DSS is part of a system for drop foot treatment that comprises a custom-designed multi-pad electrode, an electrical stimulator, and an inertial measurement unit.The system was tested in ten stroke survivors (3-96 months post stroke) with foot drop over 20 daily sessions. The DSS output suggested stimulation pads and parameters based on muscle twitch responses to short stimulus trains. The DSS ranked combinations of pads and current amplitudes based on a novel measurement of the quality of the induced movement and classified them based on the movement direction (dorsiflexion, plantar flexion, eversion and inversion) of the paretic foot. The efficacy of the DSS in providing satisfactory pad-current amplitude choices for shaping the stimulation electrode was evaluated by trained clinicians. The range of paretic foot motion was used as a quality indicator for the chosen patterns.The results suggest that the DSS output was highly effective in creating optimized FES patterns. The position and number of pads included showed pronounced inter-patient and inter-session variability; however, zones for inducing dorsiflexion and plantar flexion within the multi-pad electrode were clearly separated. The range of motion achieved with FES was significantly greater than the corresponding active range of motion (p < 0.05) during the first three weeks of therapy.The proposed DSS in combination with a custom multi-pad electrode design covering the branches of peroneal and tibial nerves proved to be an effective tool for producing both the dorsiflexion and plantar flexion of a paretic foot. The results support the use of multi-pad electrode technology in combination with automatic electrode shaping algorithms for the rehabilitation of foot drop.This study was registered at the Current Controlled Trials website with ClinicalTrials.gov ID NCT02729636 on March 29, 2016.

Dataset Information

Gyri-precise head model of transcranial direct current stimulation: improved spatial focality using a ring electrode versus conventional rectangular pad.

Publications

Gyri-precise head model of transcranial direct current stimulation: improved spatial focality using a ring electrode versus conventional rectangular pad.

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