Electric field simulations of transcranial direct current stimulation in children with perinatal stroke

Frontiers in Human Neuroscience

Neuroscience

Adrianna Giuffre¹  Helen L. Carlson¹  Patrick Ciechanski¹  Adam Kirton² 

[1] Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada;Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB, Canada;Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada;Department of Pediatrics, University of Calgary, Calgary, AB, Canada;Calgary Pediatric Stroke Program, Alberta Children’s Hospital, Calgary, AB, Canada;Alberta Children’s Hospital Research Institute (ACHRI), Calgary, AB, Canada;Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada;Department of Pediatrics, University of Calgary, Calgary, AB, Canada;Department of Clinical Neuroscience and Radiology, University of Calgary, Calgary, AB, Canada;

关键词: pediatric;    MRI;    hemiparesis;    cerebral palsy;    tDCS;    neuromodulation;    current;    electric field;   

DOI  :  10.3389/fnhum.2023.1075741

 received in 2022-10-20, accepted in 2023-01-16,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionPerinatal stroke (PS) is a focal vascular brain injury and the leading cause of hemiparetic cerebral palsy. Motor impairments last a lifetime but treatments are limited. Transcranial direct-current stimulation (tDCS) may enhance motor learning in adults but tDCS effects on motor learning are less studied in children. Imaging-based simulations of tDCS-induced electric fields (EF) suggest differences in the developing brain compared to adults but have not been applied to common pediatric disease states. We created estimates of tDCS-induced EF strength using five tDCS montages targeting the motor system in children with PS [arterial ischemic stroke (AIS) or periventricular infarction (PVI)] and typically developing controls (TDC) aged 6–19 years to explore associates between simulation values and underlying anatomy.MethodsSimulations were performed using SimNIBS https://simnibs.github.io/simnibs/build/html/index.html using T1, T2, and diffusion-weighted images. After tissue segmentation and tetrahedral mesh generation, tDCS-induced EF was estimated based on the finite element model (FEM). Five 1mA tDCS montages targeting motor function in the paretic (non-dominant) hand were simulated. Estimates of peak EF strength, EF angle, field focality, and mean EF in motor cortex (M1) were extracted for each montage and compared between groups.ResultsSimulations for eighty-three children were successfully completed (21 AIS, 30 PVI, 32 TDC). Conventional tDCS montages utilizing anodes over lesioned cortex had higher peak EF strength values for the AIS group compared to TDC. These montages showed lower mean EF strength within target M1 regions suggesting that peaks were not necessarily localized to motor network-related targets. EF angle was lower for TDC compared to PS groups for a subset of montages. Montages using anodes over lesioned cortex were more sensitive to variations in underlying anatomy (lesion and tissue volumes) than those using cathodes over non-lesioned cortex.DiscussionIndividualized patient-centered tDCS EF simulations are prudent for clinical trial planning and may provide insight into the efficacy of tDCS interventions in children with PS.

【 授权许可】

Unknown   
Copyright © 2023 Carlson, Giuffre, Ciechanski and Kirton.