Journal Article

DZNE-2026-00279

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Simulating tDCS-induced electric fields in stroke patients: Realistic-lesion head models are needed.

Kimura, I. ; Meinzer, M. ; Antonenko, D. ; Darkow, R. ; Flöel, A.DZNE* ; Thielscher, A.

2026
Elsevier [Amsterdam u.a.]

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Please use a persistent id in citations: doi:10.1016/j.nicl.2025.103931

Abstract: Transcranial direct current stimulation (tDCS) is tested as tool for post-stroke rehabilitation in aphasia, and individualized simulations of tDCS-induced electric fields (E-fields) can guide its application. However, the accuracy of simulations is challenged by complex and variable tissue properties of stroke lesions. Here, we assessed the impact of stroke lesions on tDCS-induced E-fields realistically in terms of lesion size, shape, and conductivity.Structural and diffusion MRI datasets of stroke patients with aphasia (n = 13, six females, age = 38-70 years) and age-matched healthy controls (n = 13, eight females, age = 24-76 years) from a previous study were analyzed. Simulated E-fields were first compared between healthy head models with and without artificial lesions homogenously filled with cerebrospinal fluid. Then, the effects of lesion heterogeneity were tested by comparing E-fields for models of stroke patients with homogenous versus inhomogeneous (realistic) lesion conductivity informed by diffusion-to-conductivity mapping.Adding artificial lesions to healthy head models altered the E-field strengths (|E|) near the target region-of-interest (ROI) by up to 47%. Diffusion-to-conductivity mapping revealed substantial variability in lesion conductivities within and across patients. Modifying homogenous to realistic lesion models showed mostly small to moderate |E| differences within the ROI depending on montage type, lesion size, and lesion-to-target distance.Stroke lesions affect tDCS-induced E-fields with substantial variability across montages and individuals. These findings support the use of head models that include realistic representations of the shape, size and conductivity of the lesions to improve the accuracy of individualized tDCS simulations and guide personalized stimulation protocols in stroke rehabilitation.

Keyword(s): Humans (MeSH) ; Transcranial Direct Current Stimulation: methods (MeSH) ; Female (MeSH) ; Middle Aged (MeSH) ; Aged (MeSH) ; Stroke: diagnostic imaging (MeSH) ; Stroke: complications (MeSH) ; Stroke: physiopathology (MeSH) ; Stroke: pathology (MeSH) ; Stroke: therapy (MeSH) ; Male (MeSH) ; Adult (MeSH) ; Stroke Rehabilitation: methods (MeSH) ; Aphasia: etiology (MeSH) ; Aphasia: diagnostic imaging (MeSH) ; Computer Simulation (MeSH) ; Head: diagnostic imaging (MeSH) ; Diffusion Magnetic Resonance Imaging (MeSH) ; Young Adult (MeSH) ; Aphasia ; Diffusion-to-conductivity mapping ; Neurorehabilitation ; SimNIBS ; Transcranial electric stimulation ; diffusion MRI

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Contributing Institute(s):

1. Dementia Prevention – Mechanisms and Clinical Implementation (AG Flöel)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2026

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Database coverage:
; ; ; ; Article Processing Charges ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DOAJ Seal ; Essential Science Indicators ; Fees ; IF < 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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