A Future of Current Flow Modelling for Transcranial Electrical Stimulation?

Purpose of Review: Transcranialelectrical stimulation (tES) is used to non-invasively modulate brain activityin health and disease. Current flow modeling (CFM) provides estimates of whereand how much electrical current is delivered to in the brain during tES. Ittherefore holds promise as a method to reduce commonplace variability in tESdelivery and, in turn, the outcomes of stimulation. However, the adoption ofCFM has not yet been widespread and its impact on tES outcome variability isunclear. Here, we discuss the potential barriers to effective, practicalCFM-informed tES use. Recent Findings: CFMhas progressed from models based on concentric spheres to gyri-precise headmodels derived from individual MRI scans. Users can now estimate the intensityof electrical fields (E-fields), their spatial extent, and the direction ofcurrent flow in a target brain region during tES. Here. we consider the multi-dimensionalchallenge of implementing CFM to optimise stimulation dose: this requiresinformed decisions to prioritise E-field characteristics most likely to resultin desired stimulation outcomes, though the physiological consequences of themodelled current flow are often unknown. Second, we address the issue of adisconnect between predictions of E-field characteristics provided by CFMs andpredictions of the physiological consequences of stimulation which CFMs are notdesigned to address. Third, we discuss how ongoing development of CFM inconjunction with other modelling approaches could overcome these challengeswhile maintaining accessibility for widespread use. Summary: Theincreasing complexity and sophistication of CFM is a mandatory step towards dosecontrol and precise, individualised delivery of tES. However, it also riskscounteracting the appeal of tES as a straightforward, cost-effective tool forneuromodulation, particularly in clinical settings

Using reciprocity for relating the simulation of transcranial current stimulation to the EEG forward problem

To explore the relationship between transcranial current stimulation (tCS) and the electroencephalography (EEG) forward problem, we investigate and compare accuracy and efficiency of a reciprocal and a direct EEG forward approach for dipolar primary current sources both based on the finite element method (FEM), namely the adjoint approach (AA) and the partial integration approach in conjunction with a transfer matrix concept (PI). By analyzing numerical results, comparing to analytically derived EEG forward potentials and estimating computational complexity in spherical shell models, AA turns out to be essentially identical to PI. It is then proven that AA and PI are also algebraically identical even for general head models. This relation offers a direct link between the EEG forward problem and tCS. We then demonstrate how the quasi-analytical EEG forward solutions in sphere models can be used to validate the numerical accuracies of FEM-based tCS simulation approaches. These approaches differ with respect to the ease with which they can be employed for realistic head modeling based on MRI-derived segmentations. We show that while the accuracy of the most easy to realize approach based on regular hexahedral elements is already quite high, it can be significantly improved if a geometry-adaptation of the elements is employed in conjunction with an isoparametric FEM approach. While the latter approach does not involve any additional difficulties for the user, it reaches the high accuracies of surface-segmentation based tetrahedral FEM, which is considerably more difficult to implement and topologically less flexible in practice. Finally, in a highly realistic head volume conductor model and when compared to the regular alternative, the geometry-adapted hexahedral FEM is shown to result in significant changes in tCS current flow orientation and magnitude up to 45° and a factor of 1.66, respectively

Enhanced tES and tDCS computational models by meninges emulation

Objective. Understanding how current reaches the brain during transcranial electrical stimulation (tES) underpins efforts to rationalize outcomes and optimize interventions. To this end, computational models of current flow relate applied dose to brain electric field. Conventional tES modeling considers distinct tissues like scalp, skull, cerebrospinal fluid (CSF), gray matter and white matter. The properties of highly conductive CSF are especially important. However, modeling the space between skull and brain as entirely CSF is not an accurate representation of anatomy. The space conventionally modeled as CSF is approximately half meninges (dura, arachnoid, and pia) with lower conductivity. However, the resolution required to describe individual meningeal layers is computationally restrictive in an MRI-derived head model. Emulating the effect of meninges through CSF conductivity modification could improve accuracy with minimal cost. Approach. Models with meningeal layers were developed in a concentric sphere head model. Then, in a model with only CSF between skull and brain, CSF conductivity was optimized to emulate the effect of meningeal layers on cortical electric field for multiple electrode positions. This emulated conductivity was applied to MRI-derived models. Main results. Compared to a model with conventional CSF conductivity (1.65 S m−1), emulated CSF conductivity (0.85 S m−1) produced voltage fields better correlated with intracranial recordings from epilepsy patients. Significance. Conventional tES models have been validated using intracranial recording. Residual errors may nonetheless impact model utility. Because CSF is so conductive to current flow, misrepresentation of the skull-brain interface as entirely CSF is not realistic for tES modeling. Updating the conventional model with a CSF conductivity emulating the effect of the meninges enhances modeling accuracy without increasing model complexity. This allows existing modeling pipelines to be leveraged with a simple conductivity change. Using 0.85 S m−1 emulated CSF conductivity is recommended as the new standard in non-invasive brain stimulation modeling

Visualizing simulated electrical fields from electroencephalography and transcranial electric brain stimulation: a comparative evaluation

pre-printElectrical activity of neuronal populations is a crucial aspect of brain activity. This activity is not measured directly but recorded as electrical potential changes using head surface electrodes (electroencephalogram - EEG). Head surface electrodes can also be deployed to inject electrical currents in order to modulate brain activity (transcranial electric stimulation techniques) for therapeutic and neuroscientific purposes. In electroencephalography and noninvasive electric brain stimulation, electrical fields mediate between electrical signal sources and regions of interest (ROI). These fields can be very complicated in structure, and are influenced in a complex way by the conductivity profile of the human head. Visualization techniques play a central role to grasp the nature of those fields because such techniques allow for an effective conveyance of complex data and enable quick qualitative and quantitative assessments. The examination of volume conduction effects of particular head model parameterizations (e.g., skull thickness and layering), of brain anomalies (e.g., holes in the skull, tumors), location and extent of active brain areas (e.g., high concentrations of current densities) and around current injecting electrodes can be investigated using visualization. Here, we evaluate a number of widely used visualization techniques, based on either the potential distribution or on the current-flow. In particular, we focus on the extractability of quantitative and qualitative information from the obtained images, their effective integration of anatomical context information, and their interaction. We present illustrative examples from clinically and neuroscientifically relevant cases and discuss the pros and cons of the various visualization techniques

Applied Visualization in the Neurosciences and the Enhancement of Visualization through Computer Graphics

The complexity and size of measured and simulated data in many fields of science is increasing constantly. The technical evolution allows for capturing smaller features and more complex structures in the data. To make this data accessible by the scientists, efficient and specialized visualization techniques are required. Maximum efficiency and value for the user can only be achieved by adapting visualization to the specific application area and the specific requirements of the scientific field. Part I: In the first part of my work, I address the visualization in the neurosciences. The neuroscience tries to understand the human brain; beginning at its smallest parts, up to its global infrastructure. To achieve this ambitious goal, the neuroscience uses a combination of three-dimensional data from a myriad of sources, like MRI, CT, or functional MRI. To handle this diversity of different data types and sources, the neuroscience need specialized and well evaluated visualization techniques. As a start, I will introduce an extensive software called \"OpenWalnut\". It forms the common base for developing and using visualization techniques with our neuroscientific collaborators. Using OpenWalnut, standard and novel visualization approaches are available to the neuroscientific researchers too. Afterwards, I am introducing a very specialized method to illustrate the causal relation of brain areas, which was, prior to that, only representable via abstract graph models. I will finalize the first part of my work with an evaluation of several standard visualization techniques in the context of simulated electrical fields in the brain. The goal of this evaluation was clarify the advantages and disadvantages of the used visualization techniques to the neuroscientific community. We exemplified these, using clinically relevant scenarios. Part II: Besides the data preprocessing, which plays a tremendous role in visualization, the final graphical representation of the data is essential to understand structure and features in the data. The graphical representation of data can be seen as the interface between the data and the human mind. The second part of my work is focused on the improvement of structural and spatial perception of visualization -- the improvement of the interface. Unfortunately, visual improvements using computer graphics methods of the computer game industry is often seen sceptically. In the second part, I will show that such methods can be applied to existing visualization techniques to improve spatiality and to emphasize structural details in the data. I will use a computer graphics paradigm called \"screen space rendering\". Its advantage, amongst others, is its seamless applicability to nearly every visualization technique. I will start with two methods that improve the perception of mesh-like structures on arbitrary surfaces. Those mesh structures represent second-order tensors and are generated by a method named \"TensorMesh\". Afterwards I show a novel approach to optimally shade line and point data renderings. With this technique it is possible for the first time to emphasize local details and global, spatial relations in dense line and point data.In vielen Bereichen der Wissenschaft nimmt die Größe und Komplexität von gemessenen und simulierten Daten zu. Die technische Entwicklung erlaubt das Erfassen immer kleinerer Strukturen und komplexerer Sachverhalte. Um solche Daten dem Menschen zugänglich zu machen, benötigt man effiziente und spezialisierte Visualisierungswerkzeuge. Nur die Anpassung der Visualisierung auf ein Anwendungsgebiet und dessen Anforderungen erlaubt maximale Effizienz und Nutzen für den Anwender. Teil I: Im ersten Teil meiner Arbeit befasse ich mich mit der Visualisierung im Bereich der Neurowissenschaften. Ihr Ziel ist es, das menschliche Gehirn zu begreifen; von seinen kleinsten Teilen bis hin zu seiner Gesamtstruktur. Um dieses ehrgeizige Ziel zu erreichen nutzt die Neurowissenschaft vor allem kombinierte, dreidimensionale Daten aus vielzähligen Quellen, wie MRT, CT oder funktionalem MRT. Um mit dieser Vielfalt umgehen zu können, benötigt man in der Neurowissenschaft vor allem spezialisierte und evaluierte Visualisierungsmethoden. Zunächst stelle ich ein umfangreiches Softwareprojekt namens \"OpenWalnut\" vor. Es bildet die gemeinsame Basis für die Entwicklung und Nutzung von Visualisierungstechniken mit unseren neurowissenschaftlichen Kollaborationspartnern. Auf dieser Basis sind klassische und neu entwickelte Visualisierungen auch für Neurowissenschaftler zugänglich. Anschließend stelle ich ein spezialisiertes Visualisierungsverfahren vor, welches es ermöglicht, den kausalen Zusammenhang zwischen Gehirnarealen zu illustrieren. Das war vorher nur durch abstrakte Graphenmodelle möglich. Den ersten Teil der Arbeit schließe ich mit einer Evaluation verschiedener Standardmethoden unter dem Blickwinkel simulierter elektrischer Felder im Gehirn ab. Das Ziel dieser Evaluation war es, der neurowissenschaftlichen Gemeinde die Vor- und Nachteile bestimmter Techniken zu verdeutlichen und anhand klinisch relevanter Fälle zu erläutern. Teil II: Neben der eigentlichen Datenvorverarbeitung, welche in der Visualisierung eine enorme Rolle spielt, ist die grafische Darstellung essenziell für das Verständnis der Strukturen und Bestandteile in den Daten. Die grafische Repräsentation von Daten bildet die Schnittstelle zum Gehirn des Menschen. Der zweite Teile meiner Arbeit befasst sich mit der Verbesserung der strukturellen und räumlichen Wahrnehmung in Visualisierungsverfahren -- mit der Verbesserung der Schnittstelle. Leider werden viele visuelle Verbesserungen durch Computergrafikmethoden der Spieleindustrie mit Argwohn beäugt. Im zweiten Teil meiner Arbeit werde ich zeigen, dass solche Methoden in der Visualisierung angewendet werden können um den räumlichen Eindruck zu verbessern und Strukturen in den Daten hervorzuheben. Dazu nutze ich ein in der Computergrafik bekanntes Paradigma: das \"Screen Space Rendering\". Dieses Paradigma hat den Vorteil, dass es auf nahezu jede existierende Visualiserungsmethode als Nachbearbeitunsgschritt angewendet werden kann. Zunächst führe ich zwei Methoden ein, die die Wahrnehmung von gitterartigen Strukturen auf beliebigen Oberflächen verbessern. Diese Gitter repräsentieren die Struktur von Tensoren zweiter Ordnung und wurden durch eine Methode namens \"TensorMesh\" erzeugt. Anschließend zeige ich eine neuartige Technik für die optimale Schattierung von Linien und Punktdaten. Mit dieser Technik ist es erstmals möglich sowohl lokale Details als auch globale räumliche Zusammenhänge in dichten Linien- und Punktdaten zu erfassen

Recent trends in the use of electrical neuromodulation in Parkinson's disease

Purpose of Review: This review aims to survey recent trends in electrical forms of neuromodulation, with a specific application to Parkinson’s disease (PD). Emerging trends are identified, highlighting synergies in state-of-the-art neuromodulation strategies, with directions for future improvements in stimulation efficacy suggested. Recent Findings: Deep brain stimulation remains the most common and effective form of electrical stimulation for the treatment of PD. Evidence suggests that transcranial direct current stimulation (tDCS) most likely impacts the motor symptoms of the disease, with the most prominent results relating to rehabilitation. However, utility is limited due to its weak effects and high variability, with medication state a key confound for efficacy level. Recent innovations in transcranial alternating current stimulation (tACS) offer new areas for investigation. Summary: Our understanding of the mechanistic foundations of electrical current stimulation is advancing and as it does so, trends emerge which steer future clinical trials towards greater efficacy

Translational Modeling of Non-Invasive Electrical Stimulation

Seminal work in the early 2000’s demonstrated the effect of low amplitude non-invasive electrical stimulation in people using neurophysiological measures (motor evoked potentials, MEPs). Clinical applications of transcranial Direct Current Stimulation (tDCS) have since proliferated, though the mechanisms are not fully understood. Efforts to refine the technique to improve results are on-going as are mechanistic studies both in vivo and in vitro. Volume conduction models are being applied to these areas of research, especially in the design and analysis of clinical montages. However, additional research on the parameterization of models remains. In this dissertation, Finite Element Method (FEM) models of current flow were developed for clinical applications. The first image-derived models of obese subjects were developed to assess the relative impact of fat delineation from skin. Body mass index and more broadly inter-individual differences were considered. The effect of incorporating the meninges was predicted from CAD-based (Computer Aided Design) models before being translated into image-derived head models as an “emulated” CSF conductivity. These predictions were tested in a recently validated database of head models. Multi-scale models of transcutaneous vagus nerve stimulation (tVNS) were developed by coupling image-derived volume conduction models with physiological compartment modeling. The impact of local tissue inhomogeneities on fiber activation were considered

Measurements and models of electric fields in the in vivo human brain during transcranial electric stimulation

Transcranial electric stimulation aims to stimulate the brain by applying weak electrical currents at the scalp. However, the magnitude and spatial distribution of electric fields in the human brain are unknown. We measured electric potentials intracranially in ten epilepsy patients and estimated electric fields across the entire brain by leveraging calibrated current-flow models. When stimulating at 2 mA, cortical electric fields reach 0.8 V/m, the lower limit of effectiveness in animal studies. When individual whole-head anatomy is considered, the predicted electric field magnitudes correlate with the recorded values in cortical (r = 0.86) and depth (r = 0.88) electrodes. Accurate models require adjustment of tissue conductivity values reported in the literature, but accuracy is not improved when incorporating white matter anisotropy or different skull compartments. This is the first study to validate and calibrate current-flow models with in vivo intracranial recordings in humans, providing a solid foundation to target stimulation and interpret clinical trials