MJHS Institute for Innovation in Palliative Care, New York, NY, USA.
Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
Neuromodulation. 2019 Dec;22(8):904-910. doi: 10.1111/ner.12786. Epub 2018 May 15.
Non-invasive transcranial direct current stimulation (tDCS) over the motor cortex is broadly investigated to modulate functional outcomes such as motor function, sleep characteristics, or pain. The most common montages that use two large electrodes (25-35 cm ) placed over the area of motor cortex and contralateral supraorbital region (M1-SO montages) require precise measurements, usually using the 10-20 EEG system, which is cumbersome in clinics and not suitable for applications by patients at home. The objective was to develop and test novel headgear allowing for reproduction of the M1-SO montage without the 10-20 EEG measurements, neuronavigation, or TMS.
Points C3/C4 of the 10-20 EEG system is the conventional reference for the M1 electrode. The headgear was designed using an orthogonal, fixed-angle approach for connection of frontal and coronal headgear components. The headgear prototype was evaluated for accuracy and replicability of the M1 electrode position in 600 repeated measurements compared to manually determined C3 in 30 volunteers. Computational modeling was used to estimate brain current flow at the mean and maximum recorded electrode placement deviations from C3.
The headgear includes navigational points for accurate placement and assemblies to hold electrodes in the M1-SO position without measurement by the user. Repeated measurements indicated accuracy and replicability of the electrode position: the mean [SD] deviation of the M1 electrode (size 5 × 5 cm) from C3 was 1.57 [1.51] mm, median 1 mm. Computational modeling suggests that the potential deviation from C3 does not produce a significant change in brain current flow.
The novel approach to M1-SO montage using a fixed-angle headgear not requiring measurements by patients or caregivers facilitates tDCS studies in home settings and can replace cumbersome C3 measurements for clinical tDCS applications.
经颅直流电刺激（tDCS）通过刺激大脑皮层来调节运动功能、睡眠特征或疼痛等功能结果，这种技术得到了广泛的研究。最常用的双电极（25-35cm）刺激模式，将两个大电极放置在运动皮层及其对侧眶上区域（M1-SO 刺激模式），需要精确的测量，通常使用 10-20 EEG 系统，但这种系统在临床中比较繁琐，不适合患者在家中使用。本研究旨在开发和测试一种新的头带，在不使用 10-20 EEG 测量、神经导航或 TMS 的情况下，重现 M1-SO 刺激模式。
10-20 EEG 系统的 C3/C4 点是 M1 电极的常规参考点。头带采用正交、固定角度的方法来连接额部和冠状部头带组件。在 30 名志愿者中，对头带原型进行了 600 次重复测量，比较了手动确定的 C3 与 M1 电极位置的准确性和可重复性。通过计算建模，估计了从 C3 电极记录的最大和平均电极放置偏差处的脑内电流。
头带包括用于准确放置的导航点和用于将电极保持在 M1-SO 位置的组件，而无需用户进行测量。重复测量表明电极位置的准确性和可重复性：M1 电极（5×5cm）与 C3 的平均[标准差]偏差为 1.57[1.51]mm，中位数为 1mm。计算建模表明，与 C3 相比，潜在的偏差不会导致脑内电流显著变化。
本研究采用固定角度头带的新型 M1-SO 刺激模式，无需患者或护理人员进行测量，方便了家庭环境中的 tDCS 研究，并且可以替代临床 tDCS 应用中繁琐的 C3 测量。
