The effects of transcranial direct current stimulation on corticospinal and cortico-cortical excitability and response variability: conventional versus high definition montages

Response variability following transcranial direct current stimulation (tDCS) highlights need for exploring different tDCS electrode montages. This study compared corticospinal excitability (CSE), cortico-cortical excitability and intra-individual variability following conventional and HD anodal (a-tDCS) and cathodal (c-tDCS) tDCS. Fifteen healthy young males attended four sessions at least one-week apart: conventional a-tDCS, conventional c-tDCS, HD-a-tDCS, HD-c-tDCS. TDCS was administered (1mA, 10-minutes) over the primary motor cortex (M1), via 6x4cm active and 7x5cm return electrodes (conventional tDCS) and 4x1 ring-electrodes 3.5cm apart in ring formation around M1 (HD-tDCS). For CSE, twenty-five single-pulse transcranial magnetic stimulation (TMS) peak-to-peak motor evoked potentials (MEP) were recorded at baseline, 0-minutes and 30-minutes post-tDCS. For cortico-cortical excitability, twenty-five paired-pulse MEPs with 3-millisecond (ms) inter-pulse interval (IPI) and twenty-five at 10ms assessed short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) respectively. MEP standardised z-values standard deviations represented intra-individual variability. No significant differences were reported in CSE between conventional and HD a-tDCS, but significant differences between conventional and HD c-tDCS 0-minutes post-tDCS. Intra-individual variability was significantly reduced in conventional tDCS compared to HD-tDCS for a-tDCS (0-minutes) and c-tDCS (30-minutes). No significant changes were reported in SICI and ICF. These novel findings highlight current technical issues with HD-tDCS, suggesting future tDCS studies should utilise conventional tDCS to minimise intra-individual variability, ensuring tDCS after-effects are true changes in CSE and cortico-cortical excitability.