Draft:Temporal interference brain stimulation

Temporal Interference Brain Stimulation

Temporal interference brain stimulation (TI) is a non-invasive form of deep brain stimulation (DBS). External electrodes apply high-frequency alternating currents of slightly different frequencies to the brain, and the superposition of the two waves produces a low-frequency envelope. As neurones are responsive to low-frequency electrical signals but not high-frequency signals[1], TI can use this envelope to focally stimulate deep brain tissues without impacting the overlying and surrounding ones. Since the stimulation strength depends not only on the absolute amplitude but also on the relative amplitude and orientation of the applied fields, this enables precise three-dimensional targeting of deep brain regions[2].

Technical details

TIS modelled on a bust of the human head – an electric current oscillating at 2010Hz is delivered to the right side of the head and another oscillating at 2000Hz is delivered to the left side. The stimulation target is the right visual cortex, where there is maximal temporal interference between both oscillations; the interfering waveform is visualised on the monitor.

TI stimulation is delivered by using two current sources, which both operate at high frequency with a defined difference in frequency between them. This frequency difference creates an envelope which modulates the target region. Frequencies of operation are typically in the kHz range.[3] The currents are delivered to the scalp using carbon-rubber or silver-silver chloride electrodes. Due to the high frequency and low amplitude of the currents (1-2 mA), there is typically little sensation on the skin compared to other methods, like tACS as the strongest sensations for stimulation frequencies lie in the low frequency range (<4Hz)[4]. Traditional transcranial electrical stimulation methods are also limited to targeting of cortical regions only – TI stimulation does not have this limitation and can target deep brain regions as well as cortical regions.

The stimulation strength depends not only on the absolute amplitude but also on the relative amplitude and orientation of the applied fields, which enables precise three-dimensional targeting of deep brain regions. This can be modelled in software such as Sim4Life or SimNIBS.

Potential applications

DBS via implanted electrodes is already used worldwide to treat patients with severe neurological and psychiatric disorders such as Parkinson's disease and Obsessive–compulsive disorder (OCD)[5][6], and has been investigated as a treatment option for Alzheimer's disease[7][8] and depression[9][10], but its invasiveness makes widespread clinical use and deployment in research impractical.[11] TI has been posited as an alternative treatment to invasive implants for epilepsy patients who are ineligible for resective surgery, or for whom such surgery was unsuccessful.[12]

Manufacturers

The first TI stimulator, built in 2017

Safety

Compared to other non-invasive stimulation methods, experiments suggest that adverse effects are generally rare, with just a few incidences of mild common stimulation side effects such as tingling or fatigue.[11] Below certain frequency thresholds, exposure conditions appear to be equivalent to those known to be safe in other stimulation methods.[13]

History

In 2017, Grossman et al proposed temporal interference stimulation as a non-invasive method for deep brain stimulation, validating TI as a stimulation method in rodents[2]. The concept of TI stimulation was later independently validated by other labs in in-vitro studies[14], in-vivo rodent[15] and non-human primate studies[16], and in humans[11][17]. In 2018, temporal interference brain stimulation received the Science and PINS Prize for Neuromodulation. TI has also garnered coverage in international press as a potential treatment for several brain disorders[18][19].

Limitations

TI has a high propensity for shallow brain stimulation as a side effect, and isolated neurons do not respond individually to TI stimulation, but instead respond as part of a network.[20]

References

  1. ^ Hutcheon, B.; Yarom, Y. (May 2000). "Resonance, oscillation and the intrinsic frequency preferences of neurons". Trends in Neurosciences. 23 (5): 216–222. doi:10.1016/s0166-2236(00)01547-2. ISSN 0166-2236. PMID 10782127.
  2. ^ a b Grossman, Nir; Bono, David; Dedic, Nina; Kodandaramaiah, Suhasa B.; Rudenko, Andrii; Suk, Ho-Jun; Cassara, Antonino M.; Neufeld, Esra; Kuster, Niels; Tsai, Li-Huei; Pascual-Leone, Alvaro; Boyden, Edward S. (2017-06-01). "Noninvasive Deep Brain Stimulation via Temporally Interfering Electric Fields". Cell. 169 (6): 1029–1041.e16. doi:10.1016/j.cell.2017.05.024. ISSN 1097-4172. PMC 5520675. PMID 28575667.
  3. ^ Grossman, Nir (2023-01-01). "Principles, preclinical validation, and mechanism of TI brain stimulation". Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation. 16 (1): 122–123. doi:10.1016/j.brs.2023.01.032. ISSN 1935-861X.
  4. ^ Raco, Valerio; Bauer, Robert; Olenik, Mark; Brkic, Diandra; Gharabaghi, Alireza (2014-11-01). "Neurosensory Effects of Transcranial Alternating Current Stimulation". Brain Stimulation. Special Issue: NYC Neuromodulation 2015 Conference. 7 (6): 823–831. doi:10.1016/j.brs.2014.08.005. ISSN 1935-861X. PMID 25442154.
  5. ^ Benabid, Alim Louis; Chabardes, Stephan; Mitrofanis, John; Pollak, Pierre (2009-01-01). "Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease". The Lancet Neurology. 8 (1): 67–81. doi:10.1016/S1474-4422(08)70291-6. ISSN 1474-4422. PMID 19081516.
  6. ^ Greenberg, B. D.; Gabriels, L. A.; Malone, D. A.; Rezai, A. R.; Friehs, G. M.; Okun, M. S.; Shapira, N. A.; Foote, K. D.; Cosyns, P. R.; Kubu, C. S.; Malloy, P. F.; Salloway, S. P.; Giftakis, J. E.; Rise, M. T.; Machado, A. G. (January 2010). "Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience". Molecular Psychiatry. 15 (1): 64–79. doi:10.1038/mp.2008.55. ISSN 1476-5578. PMC 3790898. PMID 18490925.
  7. ^ Kuhn, J.; Hardenacke, K.; Lenartz, D.; Gruendler, T.; Ullsperger, M.; Bartsch, C.; Mai, J. K.; Zilles, K.; Bauer, A.; Matusch, A.; Schulz, R.-J.; Noreik, M.; Bührle, C. P.; Maintz, D.; Woopen, C. (March 2015). "Deep brain stimulation of the nucleus basalis of Meynert in Alzheimer's dementia". Molecular Psychiatry. 20 (3): 353–360. doi:10.1038/mp.2014.32. ISSN 1476-5578. PMID 24798585.
  8. ^ Lozano, Andres M.; Fosdick, Lisa; Chakravarty, M. Mallar; Leoutsakos, Jeannie-Marie; Munro, Cynthia; Oh, Esther; Drake, Kristen E.; Lyman, Christopher H.; Rosenberg, Paul B.; Anderson, William S.; Tang-Wai, David F.; Pendergrass, Jo Cara; Salloway, Stephen; Asaad, Wael F.; Ponce, Francisco A. (2016-09-06). "A Phase II Study of Fornix Deep Brain Stimulation in Mild Alzheimer's Disease". Journal of Alzheimer's Disease. 54 (2): 777–787. doi:10.3233/JAD-160017. ISSN 1387-2877. PMC 5026133. PMID 27567810.
  9. ^ Scangos, Katherine W.; Khambhati, Ankit N.; Daly, Patrick M.; Makhoul, Ghassan S.; Sugrue, Leo P.; Zamanian, Hashem; Liu, Tony X.; Rao, Vikram R.; Sellers, Kristin K.; Dawes, Heather E.; Starr, Philip A.; Krystal, Andrew D.; Chang, Edward F. (October 2021). "Closed-loop neuromodulation in an individual with treatment-resistant depression". Nature Medicine. 27 (10): 1696–1700. doi:10.1038/s41591-021-01480-w. ISSN 1546-170X. PMC 11219029. PMID 34608328.
  10. ^ Mayberg, Helen S.; Lozano, Andres M.; Voon, Valerie; McNeely, Heather E.; Seminowicz, David; Hamani, Clement; Schwalb, Jason M.; Kennedy, Sidney H. (2005-03-03). "Deep Brain Stimulation for Treatment-Resistant Depression". Neuron. 45 (5): 651–660. doi:10.1016/j.neuron.2005.02.014. ISSN 0896-6273. PMID 15748841.
  11. ^ a b c Violante, Ines R.; Alania, Ketevan; Cassarà, Antonino M.; Neufeld, Esra; Acerbo, Emma; Carron, Romain; Williamson, Adam; Kurtin, Danielle L.; Rhodes, Edward; Hampshire, Adam; Kuster, Niels; Boyden, Edward S.; Pascual-Leone, Alvaro; Grossman, Nir (November 2023). "Non-invasive temporal interference electrical stimulation of the human hippocampus". Nature Neuroscience. 26 (11): 1994–2004. doi:10.1038/s41593-023-01456-8. ISSN 1546-1726. PMC 10620081. PMID 37857775.
  12. ^ Acerbo, Emma; Jegou, Aude; Luff, Charlotte; Dzialecka, Patrycja; Botzanowski, Boris; Missey, Florian; Ngom, Ibrahima; Lagarde, Stanislas; Bartolomei, Fabrice; Cassara, Antonino; Neufeld, Esra; Jirsa, Viktor; Carron, Romain; Grossman, Nir; Williamson, Adam (2022-08-17). "Focal non-invasive deep-brain stimulation with temporal interference for the suppression of epileptic biomarkers". Frontiers in Neuroscience. 16 945221. doi:10.3389/fnins.2022.945221. ISSN 1662-453X. PMC 9431367. PMID 36061593.
  13. ^ Cassarà, Antonino M.; Newton, Taylor H.; Zhuang, Katie; Regel, Sabine J.; Achermann, Peter; Pascual-Leone, Alvaro; Kuster, Niels; Neufeld, Esra (2025). "Recommendations for the Safe Application of Temporal Interference Stimulation in the Human Brain Part II: Biophysics, Dosimetry, and Safety Recommendations". Bioelectromagnetics. 46 (1) e22536. doi:10.1002/bem.22536. ISSN 1521-186X. PMC 11733664. PMID 39810626.
  14. ^ Ahtiainen, Annika; Leydolph, Lilly; Tanskanen, Jarno M. A.; Hunold, Alexander; Haueisen, Jens; Hyttinen, Jari A. K. (2024-08-06). "Electric field temporal interference stimulation of neurons in vitro". Lab on a Chip. 24 (16): 3945–3957. doi:10.1039/D4LC00224E. ISSN 1473-0189. PMID 38994783.
  15. ^ Qi, Shuo; Liu, Xiaodong; Yu, Jinglun; Liang, Zhiqiang; Liu, Yu; Wang, Xiaohui (2024-03-01). "Temporally interfering electric fields brain stimulation in primary motor cortex of mice promotes motor skill through enhancing neuroplasticity". Brain Stimulation. 17 (2): 245–257. doi:10.1016/j.brs.2024.02.014. ISSN 1935-861X. PMID 38428583.
  16. ^ Vieira, Pedro G.; Krause, Matthew R.; Pack, Christopher C. (2024-05-29). "Temporal interference stimulation disrupts spike timing in the primate brain". Nature Communications. 15 (1): 4558. doi:10.1038/s41467-024-48962-2. ISSN 2041-1723. PMC 11137077. PMID 38811618.
  17. ^ Wessel, Maximilian J.; Beanato, Elena; Popa, Traian; Windel, Fabienne; Vassiliadis, Pierre; Menoud, Pauline; Beliaeva, Valeriia; Violante, Ines R.; Abderrahmane, Hedjoudje; Dzialecka, Patrycja; Park, Chang-Hyun; Maceira-Elvira, Pablo; Morishita, Takuya; Cassara, Antonino M.; Steiner, Melanie (November 2023). "Noninvasive theta-burst stimulation of the human striatum enhances striatal activity and motor skill learning". Nature Neuroscience. 26 (11): 2005–2016. doi:10.1038/s41593-023-01457-7. ISSN 1546-1726. PMC 10620076. PMID 37857774.
  18. ^ Costandi, Mo (2017-06-01). "Researchers develop non-invasive deep brain stimulation method". The Guardian. ISSN 0261-3077. Retrieved 2025-06-05.
  19. ^ Belluck, Pam (2017-06-01). "New Electrical Brain Stimulation Technique Shows Promise in Mice". The New York Times. ISSN 0362-4331. Retrieved 2025-06-05.
  20. ^ Caldas-Martinez, Sara; Goswami, Chaitanya; Forssell, Mats; Cao, Jiaming; Barth, Alison L.; Grover, Pulkit (2024-09-02). "Cell-specific effects of temporal interference stimulation on cortical function". Communications Biology. 7 (1) 1076: 1–12. doi:10.1038/s42003-024-06728-y. ISSN 2399-3642.

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