Generating tumor treating fields (TTFields) with high uniformity throughout the brain

1. A method of applying an alternating electric field to a person's brain, the method comprising:

affixing a first set of electrode elements to a right side of the person's head, the first set of electrode elements having an upper section positioned above the external opening of the person's right ear canal with an orientation that is predominantly horizontal, and a rear section positioned behind the external opening of the person's right ear canal with an orientation that is predominantly vertical, wherein at least a portion of the rear section of the first set of electrode elements is positioned below the external opening of the person's right ear canal, and wherein at least a portion of the upper section of the first set of electrode elements is positioned in front of the external opening of the person's right ear canal;

affixing a second set of electrode elements to a left side of the person's head, the second set of electrode elements having an upper section positioned above the external opening of the person's left ear canal with an orientation that is predominantly horizontal, and a rear section positioned behind the external opening of the person's left ear canal with an orientation that is predominantly vertical, wherein at least a portion of the rear section of the second set of electrode elements is positioned below the external opening of the person's left ear canal, and wherein at least a portion of the upper section of the second set of electrode elements is positioned in front of the external opening of the person's left ear canal; and

applying an alternating voltage between the first set of electrode elements and the second set of electrode elements, wherein the applying is performed after affixing the first and second sets of electrode elements to the person's head.

2. The method of claim 1 , wherein the upper section of the first set of electrode elements includes at least three capacitively coupled electrode elements, the rear section of the first set of electrode elements includes at least three capacitively coupled electrode elements, the upper section of the second set of electrode elements includes at least three capacitively coupled electrode elements, and the rear section of the second set of electrode elements includes at least three capacitively coupled electrode elements.

3. The method of claim 1 , wherein the upper section of each of the first and second sets of electrode elements (a) has a length of at least 6 cm, (b) is positioned less than 6 cm above the external opening of the respective ear canal, (c) has a front end positioned at least 1 cm in front of the external opening of the respective ear canal, and (d) has a rear end positioned at least 1 cm behind the external opening of the respective ear canal.

4. The method of claim 1 , wherein the rear section of each of the first and second sets of electrode elements (a) has a length of at least 6 cm, (b) is positioned less than 6 cm behind the external opening of the respective ear canal, (c) has an upper end positioned at least 1 cm above the external opening of the respective ear canal, and (d) has a lower end positioned at least 3 cm below the external opening of the respective ear canal.

5. The method of claim 1 , further comprising:

affixing a third set of electrode elements having a third centroid to the person's head with the third centroid positioned on top of the person's head;

affixing a fourth set of electrode elements having a fourth centroid to the back of the person's neck with the fourth centroid positioned below the person's C2 vertebra and above the person's C7 vertebra; and

applying an alternating voltage between the third set of electrode elements and the fourth set of electrode elements, wherein the applying is performed after affixing the third and fourth sets of electrode elements to the person's head,

wherein the steps of (a) applying an alternating voltage between the first set of electrode elements and the second set of electrode elements and (b) applying an alternating voltage between the third set of electrode elements and the fourth set of electrode elements are repeated in an alternating sequence.

6. The method of claim 5 , wherein the third set of electrode elements is affixed with the third centroid positioned between 1 and 3 cm anterior to a vertex of the person's head, and

wherein the fourth set of electrode elements is affixed with the fourth centroid positioned below the person's C3 vertebra and above the person's C6 vertebra.

7. The method of claim 6 , wherein the upper section of the first set of electrode elements includes at least three capacitively coupled electrode elements, the rear section of the first set of electrode elements includes at least three capacitively coupled electrode elements, the upper section of the second set of electrode elements includes at least three capacitively coupled electrode elements, and the rear section of the second set of electrode elements includes at least three capacitively coupled electrode elements,

wherein the upper section of each of the first and second sets of electrode elements (a) has a length of at least 6 cm, (b) is positioned less than 6 cm above the external opening of the respective ear canal, (c) has a front end positioned at least 1 cm in front of the external opening of the respective ear canal, and (d) has a rear end positioned at least 1 cm behind the external opening of the respective ear canal, and

wherein the rear section of each of the first and second sets of electrode elements (a) has a length of at least 6 cm, (b) is positioned less than 6 cm behind the external opening of the respective ear canal, (c) has an upper end positioned at least 1 cm above the external opening of the respective ear canal, and (d) has a lower end positioned at least 3 cm below the external opening of the respective ear canal.

8. The method of claim 1 , wherein the specific locations at which the first and second sets of electrode elements are affixed to the right and left sides of the person's head, respectively, are determined by

running finite element simulations for an individual person to calculate a resulting electric field for each combination of positions for the first and second sets of electrode elements, and

selecting the combination of positions for the first and second sets of electrode elements that results in the lowest value of Ψ, where Ψ=σ T ÷MEAN T , where σ T is the standard deviation between the mean field intensity of the different compartments, MEANT T is the average field intensity of the different compartments, σ T =SD([μ i ]|i∈{α, β, γ, δ, in}), where SD is the standard deviation, μ i is the mean of each compartment i for the cerebral compartments α, β, γ, δ, and “in”, where “in” is the cerebellum/brain stem compartment, and MEAN T =mean([μ i ]|i∈{α, β, γ, δ, in}).

9. The method of claim 1 , wherein the alternating voltage has a frequency between 100 and 300 kHz.

10. A method of determining where to position a set of electrode elements on a person's head before the set of electrodes is used to apply an alternating electric field to the person's brain, the method comprising:

(a) simulating affixation of a first set of electrode elements to a right side of the person's head at a first plurality of positions, the first set of electrode elements having an upper section positioned above the external opening of the person's right ear canal with an orientation that is predominantly horizontal, and a rear section positioned behind the external opening of the person's right ear canal with an orientation that is predominantly vertical, wherein at least a portion of the rear section of the first set of electrode elements is positioned below the external opening of the person's right ear canal, and wherein at least a portion of the upper section of the first set of electrode elements is positioned in front of the external opening of the person's right ear canal;

(b) simulating affixation of a second set of electrode elements to a left side of the person's head at a second plurality of positions, the second set of electrode elements having an upper section positioned above the external opening of the person's left ear canal with an orientation that is predominantly horizontal, and a rear section positioned behind the external opening of the person's left ear canal with an orientation that is predominantly vertical, wherein at least a portion of the rear section of the second set of electrode elements is positioned below the external opening of the person's left ear canal, and wherein at least a portion of the upper section of the second set of electrode elements is positioned in front of the external opening of the person's left ear canal;

(c) simulating application of an alternating voltage between the first set of electrode elements and the second set of electrode elements at each of the first plurality of positions and at each of the second plurality of positions, respectively;

(d) determining, based on step (c), which of the first plurality of positions and which of the second plurality of positions results in an alternating electric field in the person's brain with high uniformity; and

(e) outputting, based on a result of step (d), a recommended position for the first set of electrode elements and a recommended position for the second set of electrode elements.

11. The method of claim 10 , wherein the upper section of each of the first and second sets of electrode elements (a) has a length of at least 6 cm, (b) is positioned less than 6 cm above the external opening of the respective ear canal, (c) has a front end positioned at least 1 cm in front of the external opening of the respective ear canal, and (d) has a rear end positioned at least 1 cm behind the external opening of the respective ear canal.

12. The method of claim 10 , wherein the rear section of each of the first and second sets of electrode elements (a) has a length of at least 6 cm, (b) is positioned less than 6 cm behind the external opening of the respective ear canal, (c) has an upper end positioned at least 1 cm above the external opening of the respective ear canal, and (d) has a lower end positioned at least 3 cm below the external opening of the respective ear canal.

13. The method of claim 10 , further comprising:

(g) simulating affixation of a third set of electrode elements having a third centroid to the person's head at a third plurality of positions with the third centroid positioned on top of the person's head;

(h) simulating affixation of a fourth set of electrode elements having a fourth centroid to the back of the person's neck at a fourth plurality of positions with the fourth centroid positioned below the person's C2 vertebra and above the person's C7 vertebra;

(i) simulating application of an alternating voltage between the third set of electrode elements and the fourth set of electrode elements at each of the third plurality of positions and at each of the fourth plurality of positions, respectively;

(j) determining which of the third plurality of positions and which of the fourth plurality of positions results in an alternating electric field in the person's brain with high uniformity; and

(k) outputting, based on a result of step (j), a recommended position for the third set of electrode elements and a recommended position for the fourth set of electrode elements.

14. The method of claim 10 , wherein step (d) comprises selecting the combination of positions for the first and second sets of electrode elements that results in the lowest value of Ψ, where Ψ=σ T ÷MEAN T , where σ T is the standard deviation between the mean field intensity of the different compartments, MEANT T is the average field intensity of the different compartments,

σ T =SD([μ i ]|i∈{α, β, γ, δ, in}), where SD is the standard deviation, μ i is the mean of each compartment i for the cerebral compartments α, β, γ, δ, and “in”, where “in” is the cerebellum/brain stem compartment, and MEAN T =mean([μ i ]|i∈{α, β, γ, δ, in}).