Prospective individualized transcranial electrical stimulation (tES) dosing using electric field modeling

Abstract Transcranial electrical stimulation (tES), comprising transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), and others, is an enticing form of noninvasive brain stimulation. By passing small electrical currents through scalp electrodes, tES can modulate brain activity in different neural networks and has great therapeutic potential transdiagnostically. However, tES has had inconsistent effects to date. This may be due to researchers typically applying the same scalp stimulation intensity despite anatomical differences between individuals. There is currently no widely used method of personalizing tES doses despite growing evidence that low cortical stimulation magnitude may impact clinical response. Electric field (E-field) modeling has been proposed as a candidate method that can inform prospective individualized dosing. By analyzing structural MRI scans, E-field modeling can account for different anatomical differences between patients, enabling each person to receive an adequate amount of stimulation at the cortical level. This symposium talk focuses on key questions that could further develop, refine, and disseminate individualized tES dosing using E-field modeling. These questions include: 1. Is there an optimal E-field magnitude at the cortical level? 2. Is there a linear dose-response relationship between E-field intensity and clinical outcome? 3. Can we more efficiently apply tES using optimized stimulation parameters? 4. Does individualized E-field dosing matter? To address these questions, I will present retrospective as well as prospective applications of E-field modeling compared to standard approaches and sham. Research Category and Technology and Methods Translational Research: 19. Modeling and computational methods Keywords: Transcranial electrical stimulation (tES), Transcranial direct current stimulation (tDCS), Electric field (E-field) modeling, Individualized dosing