Dosage considerations for transcranial direct current stimulation in children: A computational modeling study

  • Kessler S
  • Woods A
  • Minhas P
 et al. 
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Objective: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method which uses weak electric currents applied on the scalp to modulate activity of underlying brain tissue. TDCS is a tool for neurophysiologic investigation, and has therapeutic potential in epilepsy, post-stroke rehabilitation, and other neurologic disorders. Though the safety and tolerability of tDCS in adults is well-established, safety information on tDCS in children is lacking. This study aimed to present computational models of tDCS current flow in pediatric subjects. Methods: High resolution MRI images of two healthy children, ages 8 and 12 years, and one healthy adult, were semi-manually segmented into skin, bone, air, eyes, CSF, gray and white matter. A volumetric mesh was generated and overlaid with digitally simulated stimulation electrodes. The electrical properties of the tissues were assigned average isotropic conductivity values. Using finite- element modeling, cortical electrical field maps were generated for 3 stimulation intensities and 5 electrode configurations. Results: The peak electrical fields for a given stimulus intensity were 2 to 4 times higher in the pediatric brains compared to the adult brain, depending on the electrode montage used. For example, 2 mA stimulation over motor cortex (anode) and contralateral forehead (cathode) produced peak electric fields of 1.01 V/m for the 8 year old, 1.04 V/m for the 12 year old and 0.35 V/m for the adult. Conclusions: Acceptable tDCS stimulation parameters may be different in children compared to adults. Further studies are needed to help guide decisions about applied current intensity.

Author-supplied keywords

  • adult
  • bone
  • brain
  • brain depth stimulation
  • brain tissue
  • cerebrospinal fluid
  • cerebrovascular accident
  • child
  • conductance
  • electric current
  • electric field
  • electrode
  • epilepsy
  • eye
  • forehead
  • human
  • model
  • motor cortex
  • neurologic disease
  • neurology
  • normal human
  • nuclear magnetic resonance imaging
  • parameters
  • rehabilitation
  • safety
  • scalp
  • skin
  • stimulation
  • stimulus
  • tissues
  • transcranial direct current stimulation
  • white matter

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