Differences in electric field strength between clinical and non-clinical 
populations induced by prefrontal tDCS: A cross-diagnostic, individual 
MRI-based modeling study

Mizutani-Tiebel, Yuki; Takahashi, Shun; Karali, Temmuz; Mezger, Eva; Bulubas, Lucia; Papazova, Irina; Dechantsreiter, Esther; Stoecklein, Sophia; Papazov, Boris; Thielscher, Axel; Padberg, Frank; Keeser, Daniel

doi:10.1016/j.nicl.2022.103011

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Differences in electric field strength between clinical and non-clinical populations induced by prefrontal tDCS: A cross-diagnostic, individual MRI-based modeling study

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Bulubas, Lucia
IMPRS Translational Psychiatry, Max Planck Institute of Psychiatry, Max Planck Society;

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Citation

Mizutani-Tiebel, Y., Takahashi, S., Karali, T., Mezger, E., Bulubas, L., Papazova, I., et al. (2022). Differences in electric field strength between clinical and non-clinical populations induced by prefrontal tDCS: A cross-diagnostic, individual MRI-based modeling study. NEUROIMAGE-CLINICAL, 34: 103011. doi:10.1016/j.nicl.2022.103011.

Cite as: https://hdl.handle.net/21.11116/0000-000A-A9E4-6

Abstract

Introduction: Prefrontal cortex (PFC) regions are promising targets for therapeutic applications of non-invasive brain stimulation, e.g. transcranial direct current stimulation (tDCS), which has been proposed as a novel intervention for major depressive disorder (MDD) and negative symptoms of schizophrenia (SCZ). However, the effects of tDCS vary inter-individually, and dose-response relationships have not been established. Stimulation parameters are often tested in healthy subjects and transferred to clinical populations. The current study investigates the variability of individual MRI-based electric fields (e-fields) of standard bifrontal tDCS across individual subjects and diagnoses.Method: The study included 74 subjects, i.e. 25 patients with MDD, 24 patients with SCZ, and 25 healthy controls (HC). Individual e-fields of a common tDCS protocol (i.e. 2 mA stimulation intensity, bifrontal anode-F3/ cathode-F4 montage) were modeled by two investigators using SimNIBS (2.0.1) based on structural MRI scans.Result: On a whole-brain level, the average e-field strength was significantly reduced in MDD and SCZ compared to HC, but MDD and SCZ did not differ significantly. Regions of interest (ROI) analysis for PFC subregions showed reduced e-fields in Sallet areas 8B and 9 for MDD and SCZ compared to HC, whereas there was again no difference between MDD and SCZ. Within groups, we generally observed high inter-individual variability of e-field intensities at a higher percentile of voxels.Conclusion: MRI-based e-field modeling revealed significant differences in e-field strengths between clinical and non-clinical populations in addition to a general inter-individual variability. These findings support the notion that dose-response relationships for tDCS cannot be simply transferred from healthy to clinical cohorts and need to be individually established for clinical groups. In this respect, MRI-based e-field modeling may serve as a proxy for individualized dosing.