ArticleClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology2026
2 mA is NOT 2 mA: Electric field variability in high-definition tDCS and its implications for precision neuromodulation in aging.
Article in Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate intra- and inter-subject variability in electric field (EF) delivered by high-definition transcranial direct current stimulation (HD-tDCS) in neurologically mixed older adults, and test whether using multiple MRI sequences reduces variability.
methodsWe used ROAST to simulate EF distributions for two HD-tDCS 4 × 1 montages in 442 adults (age 50-94) across the "normal" to dementia continuum. Individualized head models were built from structural MRI, using T1-weighted alone or T1T2 dual-contrast segmentation. Montages targeted left inferior frontal gyrus (IFG) or right superior parietal lobule (SPL). EF magnitude was extracted from anatomically defined grey matter regions (left IFG, right SPL).
resultsEF magnitude varied by up to 400% across, and up to 35% within, individuals even after excluding segmentation and EF outliers. Left IFG consistently showed higher and more variable EF than the right SPL. Dual-contrast (T1T2) segmentation improved non-brain tissue delineation but EF variability persisted (up to 300%).
conclusionsConsonant with prior findings, 2 mA is NOT 2 mA within or across individuals, as delivered EF depends strongly on targeted region(s) and individual brain morphology. SIGNIFICANCE: These findings reinforce the need for individualized modeling, especially for older and clinical populations, and for moving beyond scalp-based to delivered dose at brain level.
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