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01-07-2020 | Aphasia | Original Article

Impact of brain atrophy on tDCS and HD-tDCS current flow: a modeling study in three variants of primary progressive aphasia

Authors: Gozde Unal, Bronte Ficek, Kimberly Webster, Syed Shahabuddin, Dennis Truong, Benjamin Hampstead, Marom Bikson, Kyrana Tsapkini

Published in: Neurological Sciences | Issue 7/2020

Abstract

Background

During transcranial direct current stimulation (tDCS), the amount and distribution of current that reaches the brain depends on individual anatomy. Many progressive neurodegenerative diseases are associated with cortical atrophy, but the importance of individual brain atrophy during tDCS in patients with progressive atrophy, including primary progressive aphasia (PPA), remains unclear.

Objective

In the present study, we addressed the question whether brain anatomy in patients with distinct cortical atrophy patterns would impact brain current intensity and distribution during tDCS over the left IFG.

Method

We developed state-of-the-art, gyri-precise models of three subjects, each representing a variant of primary progressive aphasia: non-fluent variant PPA (nfvPPA), semantic variant PPA (svPPA), and logopenic variant PPA (lvPPA). We considered two exemplary montages over the left inferior frontal gyrus (IFG): a conventional pad montage (anode over F7, cathode over the right cheek) and a 4 × 1 high-definition tDCS montage. We further considered whether local anatomical features, specifically distance of the cortex to skull, can directly predict local electric field intensity.

Results

We found that the differences in brain current flow across the three PPA variants fall within the distribution of anatomically typical adults. While clustering of electric fields was often around individual gyri or sulci, the minimal distance from the gyri/sulci to skull was not correlated with electric field intensity.

Conclusion

Limited to the conditions and assumptions considered here, this argues against a specific need to adjust the tDCS montage for these patients any more than might be considered useful in anatomically typical adults. Therefore, local atrophy does not, in isolation, reliably predict local electric field. Rather, our results are consistent with holistic head anatomy influencing brain current flow, with tDCS producing diffuse and individualized brain current flow patterns and HD-tDCS producing targeted brain current flow across individuals.

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Title: Impact of brain atrophy on tDCS and HD-tDCS current flow: a modeling study in three variants of primary progressive aphasia
Authors: Gozde Unal
Bronte Ficek
Kimberly Webster
Syed Shahabuddin
Dennis Truong
Benjamin Hampstead
Marom Bikson
Kyrana Tsapkini
Publication date: 01-07-2020
Publisher: Springer International Publishing
Keyword: Aphasia
Published in: Neurological Sciences / Issue 7/2020
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-019-04229-z

At a glance: The STEP trials

Springer Medicine

Impact of brain atrophy on tDCS and HD-tDCS current flow: a modeling study in three variants of primary progressive aphasia

Abstract

Background

Objective

Method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Method

Results

Conclusion

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