A Leadfield-Free Optimization Framework for Transcranially Applied Electric Currents.

Background: Transcranial Electrical Stimulation (TES), Temporal Interference Stimulation (TIS), Electroconvulsive Therapy (ECT) and Tumor Treating Fields (TTFields) are based on the application of electric current patterns to the brain. Objective: The optimal electrode positions, shapes and alignments for generating a desired current pattern in the brain vary between persons due to anatomical variability. The aim is to develop a flexible and efficient computational approach to determine individually optimal montages based on electric field simulations. Methods: We propose a leadfield-free optimization framework that allows the electrodes to be placed freely on the head surface. It is designed for the optimization of montages with a low to moderate number of spatially extended electrodes or electrode arrays. Spatial overlaps are systematically prevented during optimization, enabling arbitrary electrode shapes and configurations. The approach supports maximizing the field intensity in target region-of-interests (ROI) and optimizing for a desired focality-intensity tradeoff. Results: We demonstrate montage optimization for standard two-electrode TES, focal center-surround TES, TIS, ECT and TTFields. Comparisons against reference simulations are used to validate the performance of the algorithm. The system requirements are kept moderate, allowing the optimization to run on regular notebooks and promoting its use in basic and clinical research. Conclusions: The new framework complements existing optimization methods that require small electrodes, a predetermined discretization of the electrode positions on the scalp and work best for multi-channel systems. It strongly extends the possibilities to optimize electrode montages towards application-specific aims and supports researchers in discovering innovative stimulation schemes. The framework is available in SimNIBS.