High-resolution modeling assisted design of customized and individualized transcranial direct current stimulation protocols.
OBJECTIVE
Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity currents facilitating or inhibiting spontaneous neuronal activity. tDCS is attractive since dose is readily adjustable by simply changing electrode number, position, size, shape, and current. In the recent past, computational models have been developed with increased precision with the goal to help customize tDCS dose. The aim of this review is to discuss the incorporation of high-resolution patient-specific computer modeling to guide and optimize tDCS.


METHODS
In this review, we discuss the following topics: 1) The clinical motivation and rationale for models of transcranial stimulation is considered pivotal in order to leverage the flexibility of neuromodulation; 2) the protocols and the workflow for developing high-resolution models; 3) the technical challenges and limitations of interpreting modeling predictions; and 4) real cases merging modeling and clinical data illustrating the impact of computational models on the rational design of rehabilitative electrotherapy.


CONCLUSIONS
Though modeling for noninvasive brain stimulation is still in its development phase, it is predicted that with increased validation, dissemination, simplification, and democratization of modeling tools, computational forward models of neuromodulation will become useful tools to guide the optimization of clinical electrotherapy.
Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY 10031, USA.
Marom
M
Bikson
Asif
A
Rahman
Abhishek
A
Datta
Felipe
F
Fregni
Lotfi
L
Merabet
D000328:Adult; D002648:Child; D003198:Computer Simulation; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008959:Models, Neurological; D057285:Precision Medicine; D015203:Reproducibility of Results; D012886:Skull / Q000002:abnormalities; D020521:Stroke / Q000503:physiopathology / Q000628:therapy