Modeling Electric Fields in Transcutaneous Spinal Direct Current Stimulation: A Clinical Perspective

Biomedicines, 2023 · DOI: 10.3390/biomedicines11051283 · Published: April 26, 2023

Simple Explanation

This review focuses on using computational models to understand how transcutaneous spinal direct current stimulation (tsDCS) affects the spinal cord. These models, based on MRI, help predict how electric fields from tsDCS interact with the spinal cord's anatomy. The review compares these model predictions with clinical findings to optimize tsDCS protocols. It looks at how the electric fields distribute in the spinal cord during tsDCS and discusses how this knowledge can improve the effectiveness and safety of tsDCS. The analysis emphasizes the importance of individualized, patient-specific models to account for differences in anatomy and electrode placement. This personalized approach could lead to better clinical outcomes in treatments like spinal cord injury.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Review

Key Findings

1
tsDCS-induced electric fields are generally safe and can induce both immediate and long-lasting changes in the spinal cord.
2
Electric field intensity is strongly influenced by individual anatomy and electrode placement, leading to hotspots of higher electric field values.
3
For a common tsDCS protocol (2–3 mA, 20–30 min, T10–T12 electrode placement), similar electric field intensities are generated in both the ventral and dorsal horns of the spinal cord.

Research Summary

This review examines the distribution of electric fields in the spinal cord during tsDCS, as predicted by MRI-based models, comparing this information with clinical findings to optimize tsDCS protocols. The modeling suggests tsDCS is safe and can induce transient and neuroplastic changes, potentially supporting new clinical applications like treating spinal cord injury. Individualized MRI-based computational models are needed to optimize tsDCS, tailoring electrode configuration, intensities, and duration to improve clinical outcomes by accounting for anatomical variations and electrode misplacements.

Practical Implications

Personalized tsDCS Protocols

Tailoring tsDCS protocols to individual anatomy using MRI-based models can improve the precision and effectiveness of the stimulation.

Optimized Electrode Placement

Understanding the impact of electrode placement on electric field distribution can help maximize the desired neuromodulatory effects.

Expanded Clinical Applications

The safety and potential neuroplastic effects of tsDCS support exploring new clinical applications, particularly in spinal cord injury and neurodegenerative diseases.

Study Limitations

1
Computational models are based on averaged data from healthy subjects, which may not accurately represent clinical populations.
2
The E-field is not the only factor predicting physiological and behavioral effects of electrical stimulation.
3
The homogeneity of methodologies, mechanisms, and effects are assumed in tsDCS modeling, but the principles of application for tES and tsDCS should be different, because the target tissues are different

Your Feedback

Was this summary helpful?

Back to Neurology