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"Wherever the art of Medicine is loved, there is also a love of Humanity."
— Hippocrates

Personalized tDCS stimulation is a groundbreaking approach that addresses the significant challenge of inter-individual variability in brain modulation therapy. Although transcranial direct current stimulation (tDCS) shows great potential for cognitive enhancement, clinical outcomes often vary between patients. Therefore, a recent study by Stoupis D et al. (2026) investigated how anatomy-informed recommendations can improve electrode montage and shape for better targeting.
The researchers utilized high-resolution MRI data from 590 participants to simulate electric fields (E-fields). Furthermore, they focused on anatomical features like cortical thickness, skull density, and sulcal depth. Consequently, the findings revealed that standard protocols often lead to E-fields extending beyond the intended site. This variability occurs because individual anatomy shapes the spatial distribution and intensity of the induced current.
Moreover, the study identified key determinants of network-level E-field distribution. These factors include the local gyrification index, skull thickness, and cerebrospinal fluid thickness. Because these features vary markedly between individuals, a "one-size-fits-all" protocol remains insufficient. Instead, an anatomy-guided workflow allows clinicians to account for these differences in stimulation planning. This transition toward personalized tDCS stimulation could significantly enhance the efficacy and reproducibility of treatments in both neurology and psychiatry.
Finally, the research showed that executive and default mode networks consistently received high-magnitude fields. However, the peak induced field still varied significantly across the cohort. Thus, accounting for individual differences is vital for consistent dosing. This framework provides a practical tool for personalized approaches in clinical practice.
Anatomical modeling is essential because variations in skull thickness and brain shape change how electricity flows through the head. By using MRI-based models, clinicians can ensure the electric field reaches the intended functional network accurately.
The primary determinants include skull thickness, cerebrospinal fluid (CSF) thickness, sulcal depth, and the local gyrification index. These factors influence both the intensity and the focality of the electric field delivered to the cortex.
Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.
References
Stoupis D et al. Anatomy-informed recommendations for electrode montage and shape in electrical stimulation methods: A tDCS case study. J Neural Eng. 2026 Feb 25. doi: 10.1088/1741-2552/ae4a4e. PMID: 41740190.
Bikson M et al. Safety of transcranial direct current stimulation: Evidence based update 2016. Brain Stimul. 2016;9(5):641-661.
Opitz A et al. Anatomical determinants of the electric field during transcranial direct current stimulation. NeuroImage. 2015;109:140-150.

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