Effects of transcranial direct current stimulation based on electric field distribution patterns and changes in brain activity

Transcranial direct current stimulation (tDCS) is the most-used non-invasive brain stimulation method. However, the main challenge in tDCS studies is its heterogeneity and large inter-individual variability in response. Brain anatomy, that varies from person to person, can change electric field distribution patterns in the brain and should be considered as a source of variation. Previous findings support that tDCS-induced EFs affect brain activity and ultimately change behavioral outcomes. Nonetheless, the exact relationship between EFs and brain activity alterations has not yet been investigated. In this randomized double-blinded sham-controlled crossover study, 14 subjects with methamphetamine use disorders were recruited and tDCS with 2 mA current intensity was applied over the dorsolateral prefrontal cortex. Each subject participated in two sessions for sham or real stimulation with at least a 1-week washout period. In each session, structural and functional MRI during a cue-induced craving task were collected immediately before and after tDCS. Individualized computational head models were simulated based on structural MR images and finite element methods. Group-level analysis of the models showed inter-individual variability across the subjects with maximum electric field intensity in frontal pole (0.3424±0.07). Furthermore, functional data, based on a drug minus neutral contrast, showed that real versus sham stimulation decreased brain activity in superior temporal gyrus and posterior cingulate cortex (p < 0.001). However, we did not find a significant correlation between induced EFs and brain activity alterations. In sum, in this study, we suggested a pipeline for integrating electric fields with functional neuroimaging data to bring new insights into the tDCS mechanism of action and future studies are required to establish, or to refute, this conclusion.