Villamar Mauricio F, Volz Magdalena Sarah, Bikson Marom, Datta Abhishek, Dasilva Alexandre F, Fregni Felipe
Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, USA.
J Vis Exp. 2013 Jul 14(77):e50309. doi: 10.3791/50309.
High-definition transcranial direct current stimulation (HD-tDCS) has recently been developed as a noninvasive brain stimulation approach that increases the accuracy of current delivery to the brain by using arrays of smaller "high-definition" electrodes, instead of the larger pad-electrodes of conventional tDCS. Targeting is achieved by energizing electrodes placed in predetermined configurations. One of these is the 4x1-ring configuration. In this approach, a center ring electrode (anode or cathode) overlying the target cortical region is surrounded by four return electrodes, which help circumscribe the area of stimulation. Delivery of 4x1-ring HD-tDCS is capable of inducing significant neurophysiological and clinical effects in both healthy subjects and patients. Furthermore, its tolerability is supported by studies using intensities as high as 2.0 milliamperes for up to twenty minutes. Even though 4x1 HD-tDCS is simple to perform, correct electrode positioning is important in order to accurately stimulate target cortical regions and exert its neuromodulatory effects. The use of electrodes and hardware that have specifically been tested for HD-tDCS is critical for safety and tolerability. Given that most published studies on 4x1 HD-tDCS have targeted the primary motor cortex (M1), particularly for pain-related outcomes, the purpose of this article is to systematically describe its use for M1 stimulation, as well as the considerations to be taken for safe and effective stimulation. However, the methods outlined here can be adapted for other HD-tDCS configurations and cortical targets.
高清经颅直流电刺激(HD-tDCS)是最近开发的一种非侵入性脑刺激方法,它通过使用较小的“高清”电极阵列,而不是传统经颅直流电刺激的较大平板电极,提高了电流输送到大脑的准确性。通过为以预定配置放置的电极通电来实现靶向。其中一种配置是4x1环形配置。在这种方法中,覆盖目标皮质区域的中心环形电极(阳极或阴极)被四个返回电极包围,这有助于限定刺激区域。4x1环形HD-tDCS的应用能够在健康受试者和患者中诱导显著的神经生理和临床效应。此外,使用高达2.0毫安的强度持续长达20分钟的研究支持了其耐受性。尽管4x1 HD-tDCS操作简单,但正确的电极定位对于准确刺激目标皮质区域并发挥其神经调节作用很重要。使用经过专门测试用于HD-tDCS的电极和硬件对于安全性和耐受性至关重要。鉴于大多数关于4x1 HD-tDCS的已发表研究都针对初级运动皮层(M1),特别是与疼痛相关的结果,本文的目的是系统地描述其用于M1刺激的方法,以及安全有效刺激时应考虑的因素。然而,这里概述的方法可适用于其他HD-tDCS配置和皮质靶点。