Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States of America.
Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, United States of America.
J Neural Eng. 2021 Oct 11;18(5). doi: 10.1088/1741-2552/ac297d.
. We present an easy-to-implement technique for accurate electrode placement over repeated transcranial electrical stimulation (tES) sessions across participants and time. tES is an emerging, non-invasive neuromodulation technique that delivers electrical stimulation using scalp electrodes.The tES electrode placement technique was developed during an exploratory clinical trial aimed at targeting a specific MNI-atlas cortical coordinate in= 59 depressed participants (32 F, mean age: 31.1 ± 8.3 SD). Each participant completed 12 sessions of active or sham stimulation, administered using high-definition (HD) or conventional sized electrode montages placed according to the proposed technique. Neuronavigation data measuring the distances between the identified and the intended stimulation site, simulations, and cerebral blood flow (CBF) data at baseline and post-treatment were acquired to evaluate the targeting characteristics of the proposed technique.Neuronavigation measurements indicate accurate electrode placement to within 1 cm of the stimulation target on average across repeated sessions. Simulations predict that these placement characteristics result in minimal electric field differences at the stimulation target (>0.90 correlation, and <10% change in the modal electric field and targeted volume). Additionally, significant changes in %CBF (relative to baseline) under the stimulation target in the active stimulation group relative to sham confirmed that the proposed placement technique introduces minimal bias in the spatial location of the cortical coordinate ultimately targeted. Finally, we show proof of concept that the proposed technique provides similar accuracy of electrode placement at other cortical targets.For voxel-level cortical targets, existing techniques based on cranial landmarks are suboptimal. Our results show that the proposed electrode placement approach provides high consistency for the accurate targeting of such specific cortical regions. Overall, the proposed technique now enables the accurate targeting of locations not accessible with the existing 10-20 system such as scalp-projections of clinically-relevant cortical coordinates identified by brain mapping studies. Clinical trial ID: NCT03556124.
. 我们提出了一种易于实施的技术，可在参与者和时间上实现经颅电刺激（tES）重复治疗时的精确电极放置。tES 是一种新兴的非侵入性神经调节技术，使用头皮电极进行电刺激。该 tES 电极放置技术是在一项探索性临床试验中开发的，旨在针对特定的 MNI 图谱皮质坐标，该临床试验共纳入了 59 名抑郁患者（32 名女性，平均年龄：31.1±8.3 岁）。每位参与者完成 12 次主动或假刺激治疗，使用根据所提出的技术放置的高清晰度（HD）或常规大小的电极组合进行治疗。采集神经导航数据以测量识别刺激部位与目标刺激部位之间的距离、模拟和治疗前后的脑血流（CBF）数据，以评估所提出技术的靶向特征。神经导航测量结果表明，在重复治疗中，电极的平均放置精度可达到刺激目标的 1 厘米以内。模拟结果预测，这些放置特征可导致刺激目标处的电场差异最小（>0.90 相关性，模态电场和目标体积变化<10%）。此外，与假刺激组相比，主动刺激组刺激目标下的 CBF （相对于基线）显著增加，证实了所提出的放置技术在最终靶向的皮质坐标空间位置上引入的偏差最小。最后，我们证明了概念验证，即所提出的技术在其他皮质目标上也能提供类似的电极放置精度。对于体素级皮质目标，基于颅侧标志的现有技术并不理想。我们的结果表明，所提出的电极放置方法可高度一致地实现对这些特定皮质区域的精确靶向。总体而言，所提出的技术现在可以实现对现有 10-20 系统无法到达的位置进行精确靶向，例如通过脑映射研究确定的临床相关皮质坐标的头皮投影。临床试验注册号：NCT03556124。
