A Systematic Review and Large-Scale tES and TMS Electric Field Modeling Study Reveals How Outcome Measure Selection Alters Results in a Person- and Montage-Specific Manner.
A Systematic Review and Large-Scale tES and TMS Electric Field Modeling Study Reveals How Outcome Measure Selection Alters Results in a Person- and Montage-Specific Manner.
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系统回顾以及大规模 tES 和 TMS 电场建模研究揭示了结果测量选择如何以特定于个人和蒙太奇的方式改变结果。
DOI：
10.1101/2023.02.22.529540
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Caulfield,KevinA
中科院分区：
文献类型：
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作者：
VanHoornweder,Sybren;Nuyts,Marten;Frieske,Joana;Verstraelen,Stefanie;Meesen,RafLJ;Caulfield,KevinA
背景电场（E-field）建模是一种有效的工具，可以检查经颅磁刺激和电刺激（分别是TMS和tES）的皮质效应，并解决文献中观察到的疗效的高变异性。然而，用于报告电场强度的结果测量差异很大，尚未进行详细比较。目的这项由两部分组成的研究的目标，包括系统回顾和建模实验，是提供用于报告 tES 和 TMS 电场强度的不同结果测量的概述，并在不同的刺激蒙太奇中对这些测量进行直接比较。方法在三个电子数据库中搜索报告电场强度的 tES 和/或 TMS 研究。我们提取并讨论了符合纳入标准的研究中的结果衡量标准。此外，通过四种常见 tES 和两种 TMS 模式的模型对 100 名健康年轻人进行了比较结果测量。结果在系统评价中，我们纳入了 118 项研究，使用了 151 项与电场强度相关的结果测量。最常使用的是结构和球形感兴趣区域 (ROI) 分析以及基于百分位数的全脑分析。在建模分析中，我们发现同一个人的研究体积中 ROI 和基于百分位数的全脑分析之间平均只有 6% 的重叠。 ROI 和全脑百分位之间的重叠是蒙太奇和个人特定的，更多的焦点蒙太奇，如 4×1 和 APPS-tES，以及 8 字形 TMS 显示 ROI 和百分位方法之间的重叠分别高达 73%、60% 和 52%。然而，即使在这些情况下，每次分析中，27% 或更多的分析量在结果测量之间仍然存在差异。结论结果测量的选择有意义地改变了 tES 和 TMS 电场模型的解释。深思熟虑的结果测量选择对于准确解释结果、有效的研究间比较至关重要，并且取决于刺激焦点和研究目标。我们制定了四项建议，以提高电场建模结果测量的质量和严格性。借助这些数据和建议，我们希望指导未来的研究选择知情的结果指标，并提高研究的可比性。
BackgroundElectric field (E-field) modeling is a potent tool to examine the cortical effects of transcranial magnetic and electrical stimulation (TMS and tES, respectively) and to address the high variability in efficacy observed in the literature. However, outcome measures used to report E-field magnitude vary considerably and have not yet been compared in detail.ObjectivesThe goal of this two-part study, encompassing a systematic review and modeling experiment, was to provide an overview of the different outcome measures used to report the magnitude of tES and TMS E-fields, and to conduct a direct comparison of these measures across different stimulation montages.MethodsThree electronic databases were searched for tES and/or TMS studies reporting E-field magnitude. We extracted and discussed outcome measures in studies meeting the inclusion criteria. Additionally, outcome measures were compared via models of four common tES and two TMS modalities in 100 healthy younger adults.ResultsIn the systematic review, we included 118 studies using 151 outcome measures related to E-field magnitude. Structural and spherical regions of interest (ROI) analyses and percentile-based whole-brain analyses were used most often. In the modeling analyses, we found that there was an average of only 6% overlap between ROI and percentile-based whole-brain analyses in the investigated volumes within the same person. The overlap between ROI and whole-brain percentiles was montage- and person-specific, with more focal montages such as 4×1 and APPS-tES, and figure-of-eight TMS showing up to 73%, 60%, and 52% overlap between ROI and percentile approaches respectively. However, even in these cases, 27% or more of the analyzed volume still differed between outcome measures in every analyses.ConclusionsThe choice of outcome measures meaningfully alters the interpretation of tES and TMS E-field models. Well-considered outcome measure selection is imperative for accurate interpretation of results, valid between-study comparisons, and depends on stimulation focality and study goals. We formulated four recommendations to increase the quality and rigor of E-field modeling outcome measures. With these data and recommendations, we hope to guide future studies towards informed outcome measure selection, and improve the comparability of studies.