Modeling implanted metals in electrical stimulation applications

Objective. Metal implants impact the dosimetry assessment in electrical stimulation techniques. Therefore, they need to be included in numerical models. While currents in the body are ionic, metals only allow electron transport. In fact, charge transfer between tissues and metals requires electric fields to drive electrochemical reactions at the interface. Thus, metal implants may act as insulators or as conductors depending on the scenario. The aim of this paper is to provide a theoretical argument that guides the choice of the correct representation of metal implants in electrical models while considering the electrochemical nature of the problemApproach.We built a simple model of a metal implant exposed to a homogeneous electric field of various magnitudes. The same geometry was solved using two different models: a purely electric one (with different conductivities for the implant), and an electrochemical one. As an example of application, we also modeled a transcranial electrical stimulation (tES) treatment in a realistic head model with a skull plate using a high and low conductivity value for the plate.Main results. Metal implants generally act as electric insulators when exposed to electric fields up to around 100 V m^-1and they only resemble a perfect conductor for fields in the order of 1000 V m^-1and above. The results are independent of the implant's metal, but they depend on its geometry. tES modeling with implants incorrectly treated as conductors can lead to errors of 50% or more in the estimation of the induced fieldsSignificance.Metal implants can be accurately represented by a simple electrical model of constant conductivity, but an incorrect model choice can lead to large errors in the dosimetry assessment. Our results can be used to guide the selection of the most appropriate model in each scenario.