Dataset Information

Modeling Transcranial Direct-Current Stimulation-Induced Electric Fields in Children and Adults.

ABSTRACT: Transcranial direct-current stimulation (tDCS) is a form of non-invasive brain stimulation that induces electric fields in neuronal tissue, modulating cortical excitability. Therapeutic applications of tDCS are rapidly expanding, and are being investigated in pediatrics for various clinical conditions. Anatomical variations are among a host of factors that influence the effects of tDCS, and pronounced anatomical differences between children and adults suggest that induced electric fields may be substantially different across development. The aim of this study was to determine the strength and distribution of tDCS-induced electric fields across development. Typically developing children, adolescents, and adults were recruited. Individualized finite-element method modeling of primary motor cortex (M1) targeting tDCS was performed. In the largest pediatric sample to date, we found significantly higher peak and mean M1 electric field strength, and more expansive electric field spread for children compared to adults. Electric fields were often comparable between adolescents and adults. Our results suggest that these differences may be associated with age-related differences in skull and extra-axial space thickness, as well as developmental changes occurring in gray and white matter. Individualized current modeling may be a valuable tool for personalizing effective doses of tDCS in future pediatric clinical trials.

SUBMITTER: Ciechanski P

PROVIDER: S-EPMC6037769 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Modeling Transcranial Direct-Current Stimulation-Induced Electric Fields in Children and Adults.

Ciechanski Patrick P Carlson Helen L HL Yu Sabrina S SS Kirton Adam A

Frontiers in human neuroscience 20180703

Transcranial direct-current stimulation (tDCS) is a form of non-invasive brain stimulation that induces electric fields in neuronal tissue, modulating cortical excitability. Therapeutic applications of tDCS are rapidly expanding, and are being investigated in pediatrics for various clinical conditions. Anatomical variations are among a host of factors that influence the effects of tDCS, and pronounced anatomical differences between children and adults suggest that induced electric fields may be ...[more]

PMID: 30018543

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Project description:Introduction: Conventional transcranial direct current stimulation (tDCS) and high-definition tDCS (HD-tDCS) may improve motor learning in children. Mechanisms are not understood. Neuronavigated robotic transcranial magnetic stimulation (TMS) can produce individualised maps of primary motor cortex (M1) topography. We aimed to determine the effects of tDCS- and HD-tDCS-enhanced motor learning on motor maps. Methods: Typically developing children aged 12-18 years were randomised to right M1 anodal tDCS, HD-tDCS, or Sham during training of their left-hand on the Purdue Pegboard Task (PPT) over 5 days. Bilateral motor mapping was performed at baseline (pre), day 5 (post), and 6-weeks retention time (RT). Primary muscle was the first dorsal interosseous (FDI) with secondary muscles of abductor pollicis brevis (APB) and adductor digiti minimi (ADM). Primary mapping outcomes were volume (mm2/mV) and area (mm2). Secondary outcomes were centre of gravity (COG, mm) and hotspot magnitude (mV). Linear mixed-effects modelling was employed to investigate effects of time and stimulation type (tDCS, HD-tDCS, Sham) on motor map characteristics. Results: Twenty-four right-handed participants (median age 15.5 years, 52% female) completed the study with no serious adverse events or dropouts. Quality maps could not be obtained in two participants. No effect of time or group were observed on map area or volume. LFDI COG (mm) differed in the medial-lateral plane (x-axis) between tDCS and Sham (p = 0.038) from pre-to-post mapping sessions. Shifts in map COG were also observed for secondary left-hand muscles. Map metrics did not correlate with behavioural changes. Conclusion: Robotic TMS mapping can safely assess motor cortex neurophysiology in children undergoing motor learning and neuromodulation interventions. Large effects on map area and volume were not observed while changes in COG may occur. Larger controlled studies are required to understand the role of motor maps in interventional neuroplasticity in children.

Project description:Perinatal stroke occurs in more than 1 in 2,500 live births and resultant congenital hemiparesis necessitates investigation into interventions which may improve long-term function and decreased burden of care beyond current therapies ( http://www.cdc.gov/ncbddd/cp/data.html ). Constraint-Induced Movement Therapy (CIMT) is recognized as an effective hemiparesis rehabilitation intervention. Transcranial direct current stimulation as an adjunct treatment to CIMT may potentiate neuroplastic responses and improve motor function. The methodology of a clinical trial in children designed as a placebo-controlled, serial -session, non-invasive brain stimulation trial incorporating CIMT is described here. The primary hypotheses are 1) that no serious adverse events will occur in children receiving non-invasive brain stimulation and 2) that children in the stimulation intervention group will show significant improvements in hand motor function compared to children in the placebo stimulation control group.A randomized, controlled, double-blinded clinical trial. Twenty children and/or young adults (ages 8-21) with congenital hemiparesis, will be enrolled. The intervention group will receive ten 2-hour sessions of transcranial direct current stimulation combined with constraint-induced movement therapy and the control group will receive sham stimulation with CIMT. The primary outcome measure is safety assessment of transcranial direct current stimulation by physician evaluation, vital sign monitoring and symptom reports. Additionally, hand function will be evaluated using the Assisting Hand Assessment, grip strength and assessment of goals using the Canadian Occupational Performance Measure. Neuroimaging will confirm diagnoses, corticospinal tract integrity and cortical activation. Motor cortical excitability will also be examined using transcranial magnetic stimulation techniques.Combining non-invasive brain stimulation and CIMT interventions has the potential to improve motor function in children with congenital hemiparesis beyond each intervention independently. Such a combined intervention has the potential to benefit an individual throughout their lifetime.Clinicaltrials.gov, NCT02250092 Registered 18 September 2014.

Dataset Information

Modeling Transcranial Direct-Current Stimulation-Induced Electric Fields in Children and Adults.

Publications

Modeling Transcranial Direct-Current Stimulation-Induced Electric Fields in Children and Adults.

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