Brain Sciences

17 pages, 1215 KiB

Open AccessArticle

Spinal Cord Stimulation for Spinal Cord Injury-Related Pain: A Pilot Study

by Alexander Alamri, Meredith MacDonald, Alaa Al-Mohammad, Lucia Ricciardi, Michael G. Hart and Erlick A. Pereira

Brain Sci. 2024, 14(12), 1173; https://doi.org/10.3390/brainsci14121173 - 22 Nov 2024

Abstract

Background: Spinal cord stimulation (SCS) has emerged as an effective treatment for managing chronic pain that is unresponsive to traditional therapies. While SCS is well documented for conditions like failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS), its effectiveness in [...] Read more.

Background: Spinal cord stimulation (SCS) has emerged as an effective treatment for managing chronic pain that is unresponsive to traditional therapies. While SCS is well documented for conditions like failed back surgery syndrome (FBSS) and complex regional pain syndrome (CRPS), its effectiveness in managing pain related to spinal cord injuries (SCI) is less studied. This study aims to assess the efficacy of SCS in alleviating SCI-related pain and improving patients’ quality of life, filling a gap in the existing literature. Methods: This cohort study included 15 adult patients with traumatic and non-traumatic SCIs, treated between 2016 and 2022. Patients received SCS implants after either a trial or direct implantation. Pain levels were assessed using visual analog scale (VAS) scores, while quality of life was evaluated using the EuroQol five-dimensional (EQ-5D) scale. The SCS devices were implanted at different spinal levels, with various stimulation protocols applied, including high-frequency stimulation (10 kHz). Results: In patients with traumatic SCI, the mean VAS score decreased from 8.6 to 4.5, with 71% reporting more than 50% pain relief. Non-traumatic SCI patients experienced a reduction from 8.5 to 2.5, with all showing more than 50% pain relief. EQ-5D scores improved in both groups. A 49% reduction in pain medication usage was also observed, though one patient required revision surgery due to an adverse event. Conclusions: SCS significantly reduces pain and improves quality of life for SCI patients, particularly with high-frequency protocols. While promising, further research is needed to optimize patient selection and stimulation parameters for better long-term outcomes. Full article

(This article belongs to the Section Neuroscience of Pain)

17 pages, 1023 KiB

Open AccessArticle

Maintenance of Bodily Expressions Modulates Functional Connectivity Between Prefrontal Cortex and Extrastriate Body Area During Working Memory Processing

by Jie Ren, Mingming Zhang, Shuaicheng Liu, Weiqi He and Wenbo Luo

Brain Sci. 2024, 14(12), 1172; https://doi.org/10.3390/brainsci14121172 - 22 Nov 2024

Abstract

Background/Objectives: As a form of visual input, bodily expressions can be maintained and manipulated in visual working memory (VWM) over a short period of time. While the prefrontal cortex (PFC) plays an indispensable role in top-down control, it remains largely unclear whether this [...] Read more.

Background/Objectives: As a form of visual input, bodily expressions can be maintained and manipulated in visual working memory (VWM) over a short period of time. While the prefrontal cortex (PFC) plays an indispensable role in top-down control, it remains largely unclear whether this region also modulates the VWM storage of bodily expressions during a delay period. Therefore, the two primary goals of this study were to examine whether the emotional bodies would elicit heightened brain activity among areas such as the PFC and extrastriate body area (EBA) and whether the emotional effects subsequently modulate the functional connectivity patterns for active maintenance during delay periods. Methods: During functional magnetic resonance imaging (fMRI) scanning, participants performed a delayed-response task in which they were instructed to view and maintain a body stimulus in working memory before emotion categorization (happiness, anger, and neutral). If processing happy and angry bodies consume increased cognitive demands, stronger PFC activation and its functional connectivity with perceptual areas would be observed. Results: Results based on univariate and multivariate analyses conducted on the data collected during stimulus presentation revealed an enhanced processing of the left PFC and left EBA. Importantly, subsequent functional connectivity analyses performed on delayed-period data using a psychophysiological interaction model indicated that functional connectivity between the PFC and EBA increases for happy and angry bodies compared to neutral bodies. Conclusions: The emotion-modulated coupling between the PFC and EBA during maintenance deepens our understanding of the functional organization underlying the VWM processing of bodily information. Full article

(This article belongs to the Section Cognitive, Social and Affective Neuroscience)

20 pages, 10048 KiB

Open AccessReview

Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy

by Felix Geser, Tibor C. G. Mitrovics, Laura Obexer, Peter Streicher, Johannes Haybaeck and Deniz Yilmazer-Hanke

Brain Sci. 2024, 14(12), 1171; https://doi.org/10.3390/brainsci14121171 - 22 Nov 2024

Abstract

Creativity and the production of artwork can have an impact on the course and treatment of comorbid severe mental illness and neurodegeneration. We report on a 70-year-old male patient with highly original artistic behavior, who suffered from lifelong recurrent major depression and subsequently [...] Read more.

Creativity and the production of artwork can have an impact on the course and treatment of comorbid severe mental illness and neurodegeneration. We report on a 70-year-old male patient with highly original artistic behavior, who suffered from lifelong recurrent major depression and subsequently developed symptoms of progressive bulbar palsy (PBP). In the context of a systematic literature review, we detail the patient’s personal and artistic biographies and portray artwork from his artistic portfolio together with his disease history, clinical examination, psychopathological and neuropsychological evaluations, blood and cerebrospinal fluid analyses, neuroimaging, neurophysiological testing, and psychotherapeutic treatment. The patient’s 1–2-year history of primarily bulbar motor symptoms and signs aligned with electromyography, showing widespread signs of continuing denervation/chronic neurogenic changes. Slight impairments in semantic fluency, executive control, and visuoconstructive abilities were observed in neuropsychological testing, in conjunction with right-sided medial temporal lobe atrophy in an MRI. He was prescribed medication, including extended-release venlafaxine, trazodone, pramipexole, and zolpidem, and took his medication regularly, usually at high doses. For most of his life, the patient had attributed professional “success” and artistic output to, at times, excessive alcohol consumption. Later, however, his interest in creative work continued despite alcohol reduction and cessation. Psychotherapy grounded him in reality via goal-centered behaviors, making him realize that his physical and mental ailments rather hindered his creative output. In summary, creative behavior can be utilized in the treatment of patients with psychiatric conditions (affective or addictive disorders) and/or neurodegenerative diseases. In the reported case, specific psychopharmacology and psychotherapy that address goal-directed self-efficacy experiences of reality were critical to the patient’s treatment. Full article

(This article belongs to the Section Neuropsychology)

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17 pages, 466 KiB

Open AccessArticle

Obsessive–Compulsive Traits and Problematic Internet Use Are Increased Among Adults with Autism Spectrum Disorder: Is There a Role of Obsessive Doubts and Communication Impairment?

by Barbara Carpita, Benedetta Nardi, Francesca Parri, Gianluca Cerofolini, Chiara Bonelli, Cristina Gaia Bocchino, Gabriele Massimetti, Ivan Mirko Cremone, Stefano Pini and Liliana Dell’Osso

Brain Sci. 2024, 14(12), 1170; https://doi.org/10.3390/brainsci14121170 - 22 Nov 2024

Abstract

Background: The link between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) and the complexity of their differential diagnosis has been vastly investigated. Growing attention has been paid to the presence of problematic Internet use (PIU) in autistic individuals. Studies assessing OCD traits [...] Read more.

Background: The link between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) and the complexity of their differential diagnosis has been vastly investigated. Growing attention has been paid to the presence of problematic Internet use (PIU) in autistic individuals. Studies assessing OCD traits in autistic individuals are scarce and even less take into account the role that this overlap may have on the development and maintenance of PIU. We aimed to investigate OCD features in ASD individuals and their association with autism severity and the prevalence of PIU, and the potential dimensions associated with a greater probability of PIU. Methods: a total of 46 participants with ASD and 53 controls were assessed with the Adult Autism Subthreshold Spectrum questionnaire and the Obsessive–Compulsive Spectrum—Short Version. Results: There were significantly higher OCD features in ASD participants along with important correlations between OCD and ASD dimensions and a higher prevalence of PIU in the ASD group. Participants with putative PIU reported greater scores on some ASD and OCD dimensions, the with Doubt and Non-verbal communication domains emerging as significant predictors of the presence of putative PIU. Conclusions: These results support the three-way link between ASD, OCD, and PIU, contributing to the hypothesis of a neurodevelopmental basis for those conditions. Full article

(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)

10 pages, 1080 KiB

Open AccessArticle

Real-World Open-Label Experience with Rimegepant for the Acute Treatment of Migraine Attacks: A Multicenter Pilot Study

by Emmanouil V. Dermitzakis, Dimitrios Rikos, Michail Vikelis, Georgia Xiromerisiou, Styliani Zisopoulou, Dimitrios Rallis, Panagiotis Soldatos, George S. Vlachos, Georgios G. Vasiliadis and Andreas A. Argyriou

Brain Sci. 2024, 14(12), 1169; https://doi.org/10.3390/brainsci14121169 - 22 Nov 2024

Abstract

Objectives: The present open-label multicenter pilot study sought to prospectively evaluate the efficacy and safety of rimegepant in treating migraine attacks. Methods: The primary endpoint was pain freedom at two hours post-dose, while the co-primary efficacy endpoints included a reduction in the headache [...] Read more.

Objectives: The present open-label multicenter pilot study sought to prospectively evaluate the efficacy and safety of rimegepant in treating migraine attacks. Methods: The primary endpoint was pain freedom at two hours post-dose, while the co-primary efficacy endpoints included a reduction in the headache intensity and freedom from the most bothersome symptoms (MBS) associated with migraine at the same time point. To test the potential efficacy of rimegepant, patients were asked to record in a questionnaire all the relevant changes with each migraine attack treated with rimegepant at two hours post-dose vs. two hours before. The attending neurologists provided information on the basic demographics, medical anamnesis, and migraine history as well as the triptan use history. Results: A total of 54 patients (32 with episodic and 22 with chronic migraine) received rimegepant 75 mg at least once during a single migraine attack (overall, 140 dosage intakes). Pain freedom at 2 h was achieved in 45/140 (32.1%) intakes. Regarding the efficacy of the first rimegepant dose (n = 54), significant reductions in the headache intensity were observed between the pre- and 2 h post-treatment average VAS scores (−4.8 ± 2.8 mean; p < 0.001). Likewise, the same mean reductions in the average VAS scores occurred when the 2 h response to all 140 doses was analyzed (−5 ± 2.8; p < 0.001). Freedom from MBS at 2 h post-dose was achieved for photophobia in 43%, for phonophobia in 53%, and for nausea in 57%. The ability to fully return to everyday activities at 2 h post-dose was achieved in 83/140 instances (59%). We only recorded mild adverse events in 24/140 dosages. Conclusions: Our preliminary results demonstrate that rimegepant is effective, safe, and well tolerated in treating acute migraine attacks. Full article

(This article belongs to the Section Neuroscience of Pain)

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29 pages, 1859 KiB

Open AccessSystematic Review

Face Processing in Prematurely Born Individuals—A Systematic Review

by Tiffany Tang, Kasper Pledts, Matthijs Moerkerke, Stephanie Van der Donck, Bieke Bollen, Jean Steyaert, Kaat Alaerts, Els Ortibus, Gunnar Naulaers and Bart Boets

Brain Sci. 2024, 14(12), 1168; https://doi.org/10.3390/brainsci14121168 - 22 Nov 2024

Abstract

Background/Objectives: Prematurely born individuals are at risk for developing socio-emotional difficulties and psychopathologies such as autism spectrum disorder. Particular difficulties processing social information conveyed by the face may underlie these vulnerabilities. Methods: This comprehensive review provides an overview of 27 studies published between [...] Read more.

Background/Objectives: Prematurely born individuals are at risk for developing socio-emotional difficulties and psychopathologies such as autism spectrum disorder. Particular difficulties processing social information conveyed by the face may underlie these vulnerabilities. Methods: This comprehensive review provides an overview of 27 studies published between 2000 and mid-2022 concerning face processing in individuals born preterm and/or born with low birth weight across different age ranges, paradigms, and outcome measures. The results were interpreted across different developmental stages. Results: Behavioural studies indicated that prematurity is associated with poorer facial identity and expression processing compared to term-born controls, especially for negative emotions. Structural alterations and delayed maturation in key neural face processing structures could explain these findings. Neuroimaging also revealed functional atypicalities, which may either be rooted in the structural alterations or may partly compensate for the delayed maturation. Conclusions: The results suggest that altered face processing may be associated with an increased risk of developing psychopathologies in individuals born prematurely. Future studies should investigate the preterm behavioural phenotype and the potential need for face processing rehabilitation programs. Full article

(This article belongs to the Special Issue Face and Person Perception: Recent Updates and Future Perspectives)

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23 pages, 7363 KiB

Open AccessArticle

Relevant Factors in the Schooling of Children with Autism Spectrum Disorder in Early Childhood Education

by Francisco Villegas Lirola and Antonio Codina Sánchez

Brain Sci. 2024, 14(12), 1167; https://doi.org/10.3390/brainsci14121167 - 22 Nov 2024

Abstract

Background: Educational professionals face significant challenges in determining the most appropriate educational placement for each child with ASD, which is a major concern for their parents. The purpose of this paper is to identify the factors in the development of students with ASD [...] Read more.

Background: Educational professionals face significant challenges in determining the most appropriate educational placement for each child with ASD, which is a major concern for their parents. The purpose of this paper is to identify the factors in the development of students with ASD (language development, cognitive development, and socio-emotional development) that are most relevant in determining the modalities of schooling in early childhood education. Methods: A total of 381 Psychopedagogical Evaluation Reports from students with ASD aged 3 to 5 years were reviewed. The importance of each variable was identified using artificial neural network analysis. Classification trees were used to determine their distribution in the two schooling modalities. Results: A total of 42.9% of boys aged 3–5 years with ASD and 54.12% of girls aged 3–5 years with ASD were enrolled in specific modalities. Conclusions: Cognitive development and comprehensive language were the two variables that best explained whether children with ASD were educated in specific or ordinary modalities. The presence of a significantly impaired level of cognitive development was the best predictor of schooling in specific modalities, and for the rest of the cognitive levels, the greater the difficulties in comprehensive language, the greater the likelihood of schooling in specific modalities. Full article

(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)

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16 pages, 4866 KiB

Open AccessArticle

Emotion Recognition Based on a EEG–fNIRS Hybrid Brain Network in the Source Space

by Mingxing Hou, Xueying Zhang, Guijun Chen, Lixia Huang and Ying Sun

Brain Sci. 2024, 14(12), 1166; https://doi.org/10.3390/brainsci14121166 - 22 Nov 2024

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Abstract

Background/Objectives: Studies have shown that emotion recognition based on electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) multimodal physiological signals exhibits superior performance compared to that of unimodal approaches. Nonetheless, there remains a paucity of in-depth investigations analyzing the inherent relationship between EEG [...] Read more.

Background/Objectives: Studies have shown that emotion recognition based on electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) multimodal physiological signals exhibits superior performance compared to that of unimodal approaches. Nonetheless, there remains a paucity of in-depth investigations analyzing the inherent relationship between EEG and fNIRS and constructing brain networks to improve the performance of emotion recognition. Methods: In this study, we introduce an innovative method to construct hybrid brain networks in the source space based on simultaneous EEG-fNIRS signals for emotion recognition. Specifically, we perform source localization on EEG signals to derive the EEG source signals. Subsequently, causal brain networks are established in the source space by analyzing the Granger causality between the EEG source signals, while coupled brain networks in the source space are formed by assessing the coupling strength between the EEG source signals and the fNIRS signals. The resultant causal brain networks and coupled brain networks are integrated to create hybrid brain networks in the source space, which serve as features for emotion recognition. Results: The effectiveness of our proposed method is validated on multiple emotion datasets. The experimental results indicate that the recognition performance of our approach significantly surpasses that of the baseline method. Conclusions: This work offers a novel perspective on the fusion of EEG and fNIRS signals in an emotion-evoked experimental paradigm and provides a feasible solution for enhancing emotion recognition performance. Full article

(This article belongs to the Section Neurotechnology and Neuroimaging)

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14 pages, 889 KiB

Open AccessArticle

Reliability and Validity of the KFORCE Sens^® Inertial Sensor for Measuring Cervical Spine Proprioception in Patients with Non-Specific Chronic Neck Pain

by George A. Koumantakis, Stamatina Gkouma, Christina Floka, Petros I. Tatsios, Maria Moutzouri and Vasiliki Sakellari

Brain Sci. 2024, 14(12), 1165; https://doi.org/10.3390/brainsci14121165 - 22 Nov 2024

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Abstract

Background/Objectives: Patients with non-specific chronic neck pain (NSCNP) exhibit sensorimotor disturbances, with proprioception impairment considered an important aspect. The aim of this study was to assess the reliability and validity of a novel inertial sensor-based electrogoniometer (KFORCE Sens^®) for cervical spine [...] Read more.

Background/Objectives: Patients with non-specific chronic neck pain (NSCNP) exhibit sensorimotor disturbances, with proprioception impairment considered an important aspect. The aim of this study was to assess the reliability and validity of a novel inertial sensor-based electrogoniometer (KFORCE Sens^®) for cervical spine (CS) proprioception measurement in patients with NSCNP. Methods: The within-day intra-rater reliability of CS proprioception and its association with patient demographics and clinical status were examined in fifty-nine patients with NSCNP, aged between 25–65 years, recruited from primary care. CS proprioception was examined via angle reproduction, in angles set mid-range in the available CS range of motion (ROM) in each motion direction. The clinical status evaluation comprised the maximum and average pain intensity in the last week, disability, fear of movement/re-injury, catastrophizing, neck awareness, and CS-ROM. Reliability was assessed using the intraclass correlation coefficient (ICC_2,1), standard error of the measurement (SEM), and minimum detectable change (MDC_95%). Pearson’s R assessed between-measures associations. Results: CS proprioception reliability was good (ICC_2,1 = 0.75–0.89), with low measurement error (SEM = 1.38–3.02° and MDC_95% = 3.83–8.38°). Correlations between participants’ CS proprioception and their clinical status or demographics were not significant. Conclusions: The reliability of CS proprioception assessment with the KFORCE Sens^® was good in a sample of mildly to moderately disabled patients with CNP and thus deemed suitable for further research in this field. Full article

(This article belongs to the Section Sensory and Motor Neuroscience)

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14 pages, 1132 KiB

Open AccessPerspective

Noninvasive Ultra Low Intensity Light Photodynamic Treatment of Glioblastoma with Drug Augmentation: LoGlo PDT Regimen

by Richard E. Kast, Anton P. Kast, Jürgen Arnhold, Felix Capanni, Laura N. Milla Sanabria, Nicolas Bader, Bruno Marques Vieira, Alex Alfieri, Georg Karpel-Massler and Erasmo Barros da Silva, Jr.

Brain Sci. 2024, 14(12), 1164; https://doi.org/10.3390/brainsci14121164 - 21 Nov 2024

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Abstract

This paper presents the basis for LoGlo PDT, a new treatment for glioblastoma. Glioblastoma is currently treated with maximal safe resection, temozolomide, and ionizing irradiation. Mortality in 2024 remains over 80% within several years from diagnosis. Oral 5-aminolevulinic acid (5-ALA) is an FDA/EMA [...] Read more.

This paper presents the basis for LoGlo PDT, a new treatment for glioblastoma. Glioblastoma is currently treated with maximal safe resection, temozolomide, and ionizing irradiation. Mortality in 2024 remains over 80% within several years from diagnosis. Oral 5-aminolevulinic acid (5-ALA) is an FDA/EMA approved drug that is selectively taken up by malignant cells, including by glioblastoma. In photodynamic treatment of glioblastoma, intense intraoperative light causes glioblastoma tissue that has taken up 5-ALA to generate cytotoxic reactive oxygen species. The requirement for intense light flux has restricted photodynamic treatment to a single one-hour intraoperative session. We analyze here published data showing that external light, illuminating the entire intact scalp, can attain low μW/cm² flux several cm into intact brain that would be sufficient to mediate 5-ALA photodynamic treatment of glioblastoma if the light and 5-ALA are delivered continuously over 24 h. At the core of LoGlo PDT regimen is the dataset showing that, for a given fluence, as the duration of PDT light delivery goes down, light intensity (flux) delivered must go up to achieve the same glioblastoma cell cytotoxicity as would a weaker light (lower flux) delivered over a longer time. Thus, a repetitive, noninvasive PDT of glioblastoma using an external light source may be possible. We analyze 5-ALA cellular physiology to show that three non-oncology drugs, ciprofloxacin, deferiprone, and telmisartan, can be repurposed to increase light energy capture after 5-ALA, thereby increasing photodynamic treatment’s glioblastoma cell cytotoxicity. The LoGlo PDT approach uses both drug augmentation and prolonged ultra-low noninvasive transcranial light delivery for a repetitive, noninvasive 5-ALA photodynamic treatment of glioblastoma. Full article

(This article belongs to the Special Issue Innovation in Brain Tumor Treatment)

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22 pages, 1348 KiB

Open AccessReview

Galantamine-Memantine Combination in the Treatment of Parkinson’s Disease Dementia

by Emma D. Frost, Swanny X. Shi, Vishnu V. Byroju, Jamir Pitton Rissardo, Jack Donlon, Nicholas Vigilante, Briana P. Murray, Ian M. Walker, Andrew McGarry, Thomas N. Ferraro, Khalid A. Hanafy, Valentina Echeverria, Ludmil Mitrev, Mitchel A. Kling, Balaji Krishnaiah, David B. Lovejoy, Shafiqur Rahman, Trevor W. Stone and Maju Mathew Koola

Brain Sci. 2024, 14(12), 1163; https://doi.org/10.3390/brainsci14121163 - 21 Nov 2024

Viewed by 501

Abstract

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects over 1% of population over age 60. It is defined by motor and nonmotor symptoms including a spectrum of cognitive impairments known as Parkinson’s disease dementia (PDD). Currently, the only US Food and [...] Read more.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects over 1% of population over age 60. It is defined by motor and nonmotor symptoms including a spectrum of cognitive impairments known as Parkinson’s disease dementia (PDD). Currently, the only US Food and Drug Administration-approved treatment for PDD is rivastigmine, which inhibits acetylcholinesterase and butyrylcholinesterase increasing the level of acetylcholine in the brain. Due to its limited efficacy and side effect profile, rivastigmine is often not prescribed, leaving patients with no treatment options. PD has several derangements in neurotransmitter pathways (dopaminergic neurons in the nigrostriatal pathway, kynurenine pathway (KP), acetylcholine, α7 nicotinic receptor, and N-methyl-D-aspartate (NMDA) receptors) and rivastigmine is only partially effective as it only targets one pathway. Kynurenic acid (KYNA), a metabolite of tryptophan metabolism, affects the pathophysiology of PDD in multiple ways. Both galantamine (α7 nicotinic receptor) and memantine (antagonist of the NMDA subtype of the glutamate receptor) are KYNA modulators. When used in combination, they target multiple pathways. While randomized controlled trials (RCTs) with each drug alone for PD have failed, the combination of galantamine and memantine has demonstrated a synergistic effect on cognitive enhancement in animal models. It has therapeutic potential that has not been adequately assessed, warranting future randomized controlled trials. In this review, we summarize the KYNA-centric model for PD pathophysiology and discuss how this treatment combination is promising in improving cognitive function in patients with PDD through its action on KYNA. Full article

(This article belongs to the Section Neuropharmacology and Neuropathology)

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16 pages, 2647 KiB

Open AccessArticle

Personalized Dose Selection for Treatment of Patients with Neuropsychiatric Disorders Using tDCS

by Sagarika Bhattacharjee, Rajan Kashyap, Vanteemar S. Sreeraj, Palanimuthu T. Sivakumar, Ganesan Venkatasubramanian, John E. Desmond, S. H. Annabel Chen, T. N. Sathyaprabha and Kaviraja Udupa

Brain Sci. 2024, 14(12), 1162; https://doi.org/10.3390/brainsci14121162 - 21 Nov 2024

Viewed by 397

Abstract

Background: Individualizing transcranial direct current stimulation (tDCS) parameters can improve precision in neuropsychiatric disorders. One important decision for the clinician is the selection of an appropriate montage—conventional or high-definition (HD)—to implement dose-controlled tDCS while maintaining the patient’s safety. Method: The present [...] Read more.

Background: Individualizing transcranial direct current stimulation (tDCS) parameters can improve precision in neuropsychiatric disorders. One important decision for the clinician is the selection of an appropriate montage—conventional or high-definition (HD)—to implement dose-controlled tDCS while maintaining the patient’s safety. Method: The present study simulated tDCS administration using T1-weighted brain images of 50 dementia, 25 depression patients, and 25 healthy individuals for two conventional and HD montages, targeting the regions of interest (ROIs) in the dorsal and ventral pathways that support language processing. For each tDCS configuration, the electric fields at the ROIs and the individualized dose required to achieve the desired current intensity at the target ROI across the subjects were estimated. Linear regression was performed on these parameters. Result: A significant relationship between atrophy and current dose that varies according to the disease was found. The dementia patients with significant brain atrophy required a higher personalized dosage for HD montage, as the current intensity at the target ROIs was lower and more variable than that of conventional montage. For dementia, tDCS individualization is pathway-dependent, wherein HD configuration of the dorsal route requires current dosages above the safety limit (>4 mA) for 46% of individuals. However, there was no significant difference in electrode configurations between the HD and traditional setups for depression and healthy volunteers without significant brain atrophy. Conclusions: HD-tDCS with fixed locations is limited, making conventional tDCS more effective for dose-controlled applications. In patients with atrophy, individualized adjustments based on simulations are needed due to the variable stimulation strength in the ROI. Full article

(This article belongs to the Special Issue Brain Stimulation for Psychiatric Disorders: Emerging Evidence and New Perspectives)

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Brain Sci., Volume 14, Issue 12 (December 2024) – 12 articles

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