Accurate Hippocampal Electric Field Modeling for Electroconvulsive Therapy: Numerical Accuracy and Convergence

Abstract

Accurate hippocampal electric field (E-field) prediction is important for individualized electroconvulsive therapy (ECT) dosing and emerging deep-brain stimulation approaches such as temporal interference. Because hippocampal fields are far weaker than those beneath the stimulation electrodes, they are highly sensitive to tissue interfaces, conductivity contrasts, and numerical discretization, so numerical error can rival the physical uncertainties of anatomy and conductivity. We investigate this numerical component of hippocampal dosimetry using individualized head models from eleven ECT patients. Identical head40 segmentations, comprising 40 tissue compartments including the bilateral hippocampi, were simulated with three independent numerical methods: a charge-based boundary-element fast multipole method (BEM-FMM), a voxel-based hexahedral finite-element solver, and a conformal tetrahedral finite-element solver. For each, resolution was increased systematically and convergence assessed from the average hippocampal E-field magnitude. At the highest attainable resolutions, the three methods agreed closely, differing by 6%-7% in the left hippocampus and 9%-12% in the right. At default or coarse resolutions, however, they disagreed by 28.8% on average and up to 50.3% in the right hippocampus. Numerical convergence should therefore be established before differences are attributed to anatomical or conductivity uncertainty, and independent-solver agreement provides a practical basis for reliable hippocampal dosimetry.