Paula Faria

What does the ratio of injected current to electrode area tell us about current density in the brain during tDCS

OBJECTIVE To examine the relationship between the ratio of injected current to electrode area (I/A) and the current density at a fixed target point in the brain under the electrode during transcranial direct current stimulation (tDCS). METHODS Numerical methods were used to calculate the current density distribution in a standard spherical head model as well as in a homogeneous cylindrical conductor. RESULTS The calculations using the cylindrical model showed that, for the same I/A ratio, the current density at a fixed depth under the electrode was lower for the smaller of the two electrodes. Using the spherical model, the current density at a fixed target point in the brain under the electrode was found to be a non-linear function of the I/A ratio. For smaller electrodes, more current than predicted by the I/A ratio was required to achieve a predetermined current density in the brain. CONCLUSIONS A non-linear relationship exists between the injected current, the electrode area and the current density at a fixed target point in the brain, which can be described in terms of a montage-specific I-A curve. SIGNIFICANCE I-A curves calculated using realistic head models or obtained experimentally should be used when adjusting the current for different electrode sizes or when comparing the effect of different current-electrode area combinations.

Feasibility of focal transcranial DC polarization with simultaneous EEG recording: preliminary assessment in healthy subjects and human epilepsy

We aimed to investigate the feasibility of an experimental system for simultaneous transcranial DC stimulation (tDCS) and EEG recording in human epilepsy. We report tolerability of this system in a cross-over controlled trial with 15 healthy subjects and preliminary effects of its use, testing repeated tDCS sessions, in two patients with drug-refractory Continuous Spike-Wave Discharges During Slow Sleep (CSWS). Our system combining continuous recording of the EEG with tDCS allows detailed evaluation of the interictal activity during the entire process. Stimulation with 1 mA was well-tolerated in both healthy volunteers and patients with refractory epilepsy. The large reduction in interictal epileptiform EEG discharges in the two subjects with epilepsy supports further investigation of tDCS using this combined method of stimulation and monitoring in epilepsy. Continuous monitoring of epileptic activity throughout tDCS improves safety and allows detailed evaluation of epileptic activity changes induced by tDCS in patients.

Comparing different electrode configurations using the 10-10 international system in tDCS: A finite element model analysis

For the past few years, the potential of transcranial direct current stimulation (tDCS) for the treatment of several pathologies has been investigated. Knowledge of the current density distribution is an important factor in optimizing such applications of tDCS. We use the finite element method to compare three different models in tDCS, where the stimulation electrodes (EEG electrodes) are placed in the 10-10 international system coordinates. We studied the focality and the distribution of the current density in depth and at the surface of the brain for three different electrode configurations. We show that the use of EEG electrodes increases the focality of tDCS, especially when one cathode and several anodes are used. Additionally, these electrodes need less injected current, can be placed at scalp positions whose relationship with the underlying cerebral cortex are known and allow the use of tDCS and EEG recording concomitantly.

QEEG indexed frontal connectivity effects of transcranial pulsed current stimulation (tPCS): A sham-controlled mechanistic trial.

Transcranial pulsed current stimulation (tPCS) is a non-invasive brain stimulation technique that employs weak, pulsed current at different frequency ranges, inducing electrical currents that reach cortical and subcortical structures. Very little is known about its effects on brain oscillations and functional connectivity and whether these effects are dependent on the frequency of stimulation. Our aim was to evaluate the effects of tPCS with different frequency ranges in cortical oscillations indexed by high-resolution qEEG changes for power and interhemispheric coherence. Thirty-eight healthy subjects were enrolled and received a single 20-min session of either sham or active stimulation with 1 Hz, 100 Hz or random frequency (1-5 Hz). We conducted an exploratory analysis to detect changes in mean power for theta, alpha and beta, and interhemispheric coherence for alpha and theta and four different sub-bands cognitive and non-specific adverse effects were recorded. We found that active stimulation with a random frequency ranging between 1 and 5 Hz is able to significantly increase functional connectivity for the theta and low-alpha band as compared to sham and active stimulation with either 1 or 100 Hz. Based on these findings, we discuss the possible effects of tPCS on resting functional connectivity for low-frequency bands in fronto-temporal areas. Future studies should be conducted to investigate the potential benefit of these induced changes in pathologic states.

Tremor modulations across periods with and without voluntary motion and limb load task demands using movement quantification

Understanding the neurobiological mechanisms underlying different types of tremor and the altered functional connectivity of the involved areas is a timely goal in clinical neuroscience. If successful, this quest may open new perspectives on how to achieve tremor modulation, which is notably relevant, in Parkinsons disease (PD). Tremor can be characterized by simple parameters such as frequency and amplitude. It is therefore prone to be objectively targeted by neuromodulation and quantitatively investigated using multimodal techniques, such as, accelerometry, EMG and functional Magnetic Resonance Imaging (fMRI). Embarking on the latter challenge requires an a priori knowledge of how effective functional connectivity is altered in PD tremor. This works aims to ascertain which postural and voluntary movement tasks with distinct types of physical load are suitable for designing efficient fMRI protocols, by performing an accelerometry analysis to measure spontaneous and imposed tremor modulation on cohorts of PD patients, essential tremor patients and a group of voluntary healthy controls.

The Role of Ultrasound Imaging of Musculotendinous Structures in the Elderly Population

Ultrasound (US) is a noninvasive and real-time method that allows the evaluating muscles and tendons. The enhanced echo-intensity (EI) on ultrasonography images of skeletal muscle is believed to reflect changes in muscle quality (MQ), and these changes accompany aging. Also related to aging, and that may more severely affect women than men, is the well-known loss of skeletal muscle mass. Often associated with the accumulation of connective tissues (e.g., adipose), it affects muscle strength and MQ and causes functional impairment. This chapter demonstrates the potential use of US imaging for assessing muscle changes associated with aging and functional decline.

Quantification and Modulation of Tremor in Rapid Upper Limb Movements

Tremor is a manifestation of a variety of human neurodegenerative diseases, notably Parkinson’s disease (PD), a chronic disease that affects one in 100 people over age 60 years. Recent research indicates that more than five million worldwide have PD. This disease is primarily caused by a progressive loss of dopamine neurons in the nigrostriatal system that leads to widespread motor symptoms such as bradykinesia, rigidity, tremor and postural instability. Although the diagnosis of PD remains clinical, advances in functional and structural imaging have improved the ability to differentiate between PD and Essential Tremor (ET), as well as between different akinetic-rigid syndromes. No definitive test or biomarker is available for PD, so the rate of misdiagnosis is relatively high. It is therefore crucial to be able to characterize tremor in PD and ET as it is a very common feature at the onset of both diseases. This is made possible with a combination of a neuroscientific and methodological multi-modal imaging approaches, namely kinetic recording methods using accelerometers to quantify tremor amplitude and frequency and functional magnetic resonance imaging (fMRI). These allow the identification of the neural underpinnings of tremor in both PD and ET patients, which in fact have been surprisingly difficult to decipher. In this work we aim to find which tasks involving upper limb movements are suitable to modulate both PD and ET tremor. The same tasks are considered with and without added loading. The resulting analysis will allow designing an efficient fMRI protocol aiming at the identification of the cortical circuits responsible for the modulation of tremor.

The Importance of the Numerical Resolution of the Laplace Equation in the optimization of a Neuronal Stimulation Technique

For the past few years, the potential of transcranial direct current stimulation (tDCS) for the treatment of several pathologies has been investigated. Knowledge of the current density distribution is an important factor in optimizing such applications of tDCS. For this goal, we used the finite element method to solve the Laplace equation in a spherical head model in order to investigate the three dimensional distribution of the current density and the variation of its intensity with depth using different electrodes montages: the traditional one with two sponge electrodes and new electrode montages: with sponge and EEG electrodes and with EEG electrodes varying the numbers of electrodes. The simulation results confirm the effectiveness of the mixed system which may allow the use of tDCS and EEG recording concomitantly and may help to optimize this neuronal stimulation technique. The numerical results were used in a promising application of tDCS in epilepsy.