Electric field dependent effects of motor cortical TDCS

Transcranial direct current stimulation (TDCS) can modulate motor cortical excitability. However, its after-effects are highly variable between individuals. Individual cranial and brain anatomy may contribute to this variability by producing varying electric fields in each subjects brain. Here we show that these fields are related to excitability changes following anodal TDCS of the primary motor cortex (M1). We found in two experiments (N=28 and N=9) that the after-effects of TDCS were proportional to the individual electric field in M1, calculated using MRI-based models. Individuals with the lowest and highest local electric fields in M1 tended to produce opposite changes in excitability. Furthermore, the effect was field-direction dependent and non-linear with stimulation duration or other experimental parameters. The electric field component pointing into the brain was negatively proportional to the excitability changes following 1 mA 20 min TDCS of right M1 (N=28); the effect was opposite after 1 mA 10 min TDCS of left M1 (N=9). Our results demonstrate that a large part of variability in the after-effects of motor cortical TDCS is due to inter-individual differences in the electric fields. We anticipate that individualized electric field dosimetry could be used to control the neuroplastic effects of TDCS, which is increasingly being explored as a treatment for various neuropsychiatric diseases.