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Cerins A, Thomas EHX, Barbour T, Taylor JJ, Siddiqi SH, Trapp N, McGirr A, Caulfield KA, Brown JC, Chen L. A new angle on transcranial magnetic stimulation coil orientation: A targeted narrative review. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00120-4. [PMID: 38729243 DOI: 10.1016/j.bpsc.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/19/2024] [Accepted: 04/26/2024] [Indexed: 05/12/2024]
Abstract
Transcranial magnetic stimulation (TMS) is used to treat several neuropsychiatric disorders including depression, where it is effective in approximately half of patients for whom pharmacological approaches have failed. Treatment response is related to stimulation parameters such as the stimulation frequency, pattern, intensity, location, total number of pulses and sessions applied, as well as target brain network engagement. One critical but underexplored component of the stimulation procedure is the orientation or yaw angle of the commonly used figure-of-eight TMS coil, which is known to impact neuronal response to TMS. However, coil orientation has remained largely unchanged since TMS was first used to treat depression and continues to be based on motor cortex anatomy which may not be optimal for the dorsolateral prefrontal cortex treatment site. This targeted narrative review evaluates experimental, clinical, and computational evidence indicating that optimizing coil orientation may potentially improve TMS treatment outcomes. The properties of the electric field induced by TMS, the changes to this field caused by the differing conductivities of head tissues, and the interaction between coil orientation and the underlying cortical anatomy are summarized. We describe evidence that the magnitude and site of cortical activation, surrogate markers of TMS dosing and brain network targeting considered central in clinical response to TMS, are influenced by coil orientation. We suggest that coil orientation should be considered when applying therapeutic TMS and propose several approaches to optimizing this potentially important treatment parameter.
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Affiliation(s)
- Andris Cerins
- Department of Psychiatry, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Elizabeth H X Thomas
- Department of Psychiatry, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tracy Barbour
- Massachusetts General Hospital, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph J Taylor
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Shan H Siddiqi
- Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nicholas Trapp
- University of Iowa Department of Psychiatry, Carver College of Medicine, Iowa City, Iowa, USA; Iowa Neuroscience Institute, Iowa City, Iowa, USA
| | - Alexander McGirr
- Department of Psychiatry, University of Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kevin A Caulfield
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Joshua C Brown
- Brain Stimulation Mechanisms Laboratory, Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Leo Chen
- Department of Psychiatry, School of Translational Medicine, Monash University, Melbourne, Victoria, Australia; Alfred Mental and Addiction Health, Alfred Health, Melbourne, Victoria, Australia
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Chen Y, Jiang Y, Zhang Z, Li Z, Zhu C. Transcranial magnetic stimulation mapping of the motor cortex: comparison of five estimation algorithms. Front Neurosci 2023; 17:1301075. [PMID: 38130697 PMCID: PMC10733534 DOI: 10.3389/fnins.2023.1301075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Background There are currently five different kinds of transcranial magnetic stimulation (TMS) motor mapping algorithms available, from ordinary point-based algorithms to advanced field-based algorithms. However, there have been only a limited number of comparison studies conducted, and they have not yet examined all of the currently available algorithms. This deficiency impedes the judicious selection of algorithms for application in both clinical and basic neuroscience, and hinders the potential promotion of a potential superior algorithm. Considering the influence of algorithm complexity, further investigation is needed to examine the differences between fMRI peaks and TMS cortical hotspots that were identified previously. Methods Twelve healthy participants underwent TMS motor mapping and a finger-tapping task during fMRI. The motor cortex TMS mapping results were estimated by five algorithms, and fMRI activation results were obtained. For each algorithm, the prediction error was defined as the distance between the measured scalp hotspot and optimized coil position, which was determined by the maximum electric field strength in the estimated motor cortex. Additionally, the study identified the minimum number of stimuli required for stable mapping. Finally, the location difference between the TMS mapping cortical hotspot and the fMRI activation peak was analyzed. Results The projection yielded the lowest prediction error (5.27 ± 4.24 mm) among the point-based algorithms and the association algorithm yielded the lowest (6.66 ± 3.48 mm) among field-based estimation algorithms. The projection algorithm required fewer stimuli, possibly resulting from its suitability for the grid-based mapping data collection method. The TMS cortical hotspots from all algorithms consistently deviated from the fMRI activation peak (20.52 ± 8.46 mm for five algorithms). Conclusion The association algorithm might be a superior choice for clinical applications and basic neuroscience research, due to its lower prediction error and higher estimation sensitivity in the deep cortical structure, especially for the sulcus. It also has potential applicability in various other TMS domains, including language area mapping and more. Otherwise, our results provide further evidence that TMS motor mapping intrinsically differs from fMRI motor mapping.
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Affiliation(s)
- Yuanyuan Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yihan Jiang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Center for the Cognitive Science of Language, Beijing Language and Culture University, Beijing, China
| | - Zong Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Zheng Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Center for Cognition and Neuroergonomics, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University Zhuhai, Zhuhai, China
| | - Chaozhe Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China
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Romanella SM, Mencarelli L, Seyedmadani K, Jillings S, Tomilovskaya E, Rukavishnikov I, Sprugnoli G, Rossi S, Wuyts FL, Santarnecchi E. Optimizing transcranial magnetic stimulation for spaceflight applications. NPJ Microgravity 2023; 9:26. [PMID: 36977683 PMCID: PMC10050431 DOI: 10.1038/s41526-023-00249-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 01/10/2023] [Indexed: 03/30/2023] Open
Abstract
As space agencies aim to reach and build installations on Mars, the crews will face longer exposure to extreme environments that may compromise their health and performance. Transcranial magnetic stimulation (TMS) is a painless non-invasive brain stimulation technique that could support space exploration in multiple ways. However, changes in brain morphology previously observed after long-term space missions may impact the efficacy of this intervention. We investigated how to optimize TMS for spaceflight-associated brain changes. Magnetic resonance imaging T1-weighted scans were collected from 15 Roscosmos cosmonauts and 14 non-flyer participants before, after 6 months on the International Space Station, and at a 7-month follow-up. Using biophysical modeling, we show that TMS generates different modeled responses in specific brain regions after spaceflight in cosmonauts compared to the control group. Differences are related to spaceflight-induced structural brain changes, such as those impacting cerebrospinal fluid volume and distribution. We suggest solutions to individualize TMS to enhance its efficacy and precision for potential applications in long-duration space missions.
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Affiliation(s)
- S M Romanella
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - L Mencarelli
- Non-invasive Brain Stimulation Unit, IRCSS "Santa Lucia" Foundation, Rome, Italy
| | - K Seyedmadani
- Biomedical Engineering Department, University of Houston, NASA Johnson Space Center Houston, Houston, TX, USA
| | - S Jillings
- Lab for Equilibrium Investigations and Aerospace (LEIA), University of Antwerp, Antwerp, Belgium
| | - E Tomilovskaya
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - I Rukavishnikov
- Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - G Sprugnoli
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Siena, Italy
| | - S Rossi
- Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Siena, Italy
- Human Physiology Section, Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - F L Wuyts
- Lab for Equilibrium Investigations and Aerospace (LEIA), University of Antwerp, Antwerp, Belgium
| | - E Santarnecchi
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Radiology Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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4
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Li S, Mu Y, Rao Y, Sun C, Li X, Liu H, Yu X, Yan X, Ding Y, Wang Y, Fei Z. Preoperative individual-target transcranial magnetic stimulation demonstrates an effect comparable to intraoperative direct electrical stimulation in language-eloquent glioma mapping and improves postsurgical outcome: A retrospective fiber-tracking and electromagnetic simulation study. Front Oncol 2023; 13:1089787. [PMID: 36816968 PMCID: PMC9936080 DOI: 10.3389/fonc.2023.1089787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023] Open
Abstract
Background Efforts to resection of glioma lesions located in brain-eloquent areas must balance the extent of resection (EOR) and functional preservation. Currently, intraoperative direct electrical stimulation (DES) is the gold standard for achieving the maximum EOR while preserving as much functionality as possible. However, intraoperative DES inevitably involves risks of infection and epilepsy. The aim of this study was to verify the reliability of individual-target transcranial magnetic stimulation (IT-TMS) in preoperative mapping relative to DES and evaluate its effectiveness based on postsurgical outcomes. Methods Sixteen language-eloquent glioma patients were enrolled. Nine of them underwent preoperative nTMS mapping (n=9, nTMS group), and the other seven were assigned to the non-nTMS group and did not undergo preoperative nTMS mapping (n=7). Before surgery, online IT-TMS was performed during a language task in the nTMS group. Sites in the cortex at which this task was disturbed in three consecutive trials were recorded and regarded as positive and designated nTMS hotspots (HSnTMS). Both groups then underwent awake surgery and intraoperative DES mapping. DES hotspots (HSDES) were also determined in a manner analogous to HSnTMS. The spatial distribution of HSnTMS and HSDES in the nTMS group was recorded, registered in a single brain template, and compared. The center of gravity (CoG) of HSnTMS (HSnTMS-CoG)-based and HSDES-CoG-based diffusion tensor imaging-fiber tracking (DTI-FT) was performed. The electromagnetic simulation was conducted, and the values were then compared between the nTMS and DES groups, as were the Western Aphasia Battery (WAB) scale and fiber-tracking values. Results HSnTMS and HSDES showed similar distributions (mean distance 6.32 ± 2.6 mm, distance range 2.2-9.3 mm, 95% CI 3.9-8.7 mm). A higher fractional anisotropy (FA) value in nTMS mapping (P=0.0373) and an analogous fiber tract length (P=0.2290) were observed. A similar distribution of the electric field within the brain tissues induced by nTMS and DES was noted. Compared with the non-nTMS group, the integration of nTMS led to a significant improvement in language performance (WAB scores averaging 78.4 in the nTMS group compared with 59.5 in the non-nTMS group, P=0.0321 < 0.05) as well as in brain-structure preservation (FA value, P=0.0156; tract length, P=0.0166). Conclusion Preoperative IT-TMS provides data equally crucial to DES and thus facilitates precise brain mapping and the preservation of linguistic function.
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Affiliation(s)
- Sanzhong Li
- Department of Neurosurgery, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi, China,*Correspondence: Sanzhong Li, ; Zhou Fei,
| | - Yunfeng Mu
- Department of Gynecological Oncology, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Yang Rao
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Chuanzhu Sun
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Xiang Li
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China,The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Huan Liu
- School of Mathematics and Statistics, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xun Yu
- Product Department, Solide Brain Medical Technology, Ltd., Xi’an, Shaanxi, China
| | - Xiao Yan
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Yunxia Ding
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Yangtao Wang
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Zhou Fei
- Department of Neurosurgery, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi, China,*Correspondence: Sanzhong Li, ; Zhou Fei,
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5
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Weise K, Numssen O, Kalloch B, Zier AL, Thielscher A, Haueisen J, Hartwigsen G, Knösche TR. Precise motor mapping with transcranial magnetic stimulation. Nat Protoc 2023; 18:293-318. [PMID: 36460808 DOI: 10.1038/s41596-022-00776-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/17/2022] [Indexed: 12/03/2022]
Abstract
We describe a routine to precisely localize cortical muscle representations within the primary motor cortex with transcranial magnetic stimulation (TMS) based on the functional relation between induced electric fields at the cortical level and peripheral muscle activation (motor-evoked potentials; MEPs). Besides providing insights into structure-function relationships, this routine lays the foundation for TMS dosing metrics based on subject-specific cortical electric field thresholds. MEPs for different coil positions and orientations are combined with electric field modeling, exploiting the causal nature of neuronal activation to pinpoint the cortical origin of the MEPs. This involves constructing an individual head model using magnetic resonance imaging, recording MEPs via electromyography during TMS and computing the induced electric fields with numerical modeling. The cortical muscle representations are determined by relating the TMS-induced electric fields to the MEP amplitudes. Subsequently, the coil position to optimally stimulate the origin of the identified cortical MEP can be determined by numerical modeling. The protocol requires 2 h of manual preparation, 10 h for the automated head model construction, one TMS session lasting 2 h, 12 h of computational postprocessing and an optional second TMS session lasting 30 min. A basic level of computer science expertise and standard TMS neuronavigation equipment suffices to perform the protocol.
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Affiliation(s)
- Konstantin Weise
- Methods and Development Group 'Brain Networks', Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. .,Technische Universität Ilmenau, Advanced Electromagnetics Group, Ilmenau, Germany.
| | - Ole Numssen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Benjamin Kalloch
- Methods and Development Group 'Brain Networks', Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Technische Universität Ilmenau, Institute of Biomedical Engineering and Informatics, Ilmenau, Germany
| | - Anna Leah Zier
- Institute of Medical Psychology, Medical Faculty, Goethe-University, Frankfurt/Main, Germany
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.,Technical University of Denmark, Center for Magnetic Resonance, Department of Health Technology, Kongens Lyngby, Denmark
| | - Jens Haueisen
- Technische Universität Ilmenau, Institute of Biomedical Engineering and Informatics, Ilmenau, Germany
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Thomas R Knösche
- Methods and Development Group 'Brain Networks', Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Technische Universität Ilmenau, Institute of Biomedical Engineering and Informatics, Ilmenau, Germany
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6
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Hikita K, Gomez-Tames J, Hirata A. Mapping Brain Motor Functions Using Transcranial Magnetic Stimulation with a Volume Conductor Model and Electrophysiological Experiments. Brain Sci 2023; 13:brainsci13010116. [PMID: 36672097 PMCID: PMC9856731 DOI: 10.3390/brainsci13010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 12/26/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Transcranial magnetic stimulation (TMS) activates brain cells in a noninvasive manner and can be used for mapping brain motor functions. However, the complexity of the brain anatomy prevents the determination of the exact location of the stimulated sites, resulting in the limitation of the spatial resolution of multiple targets. The aim of this study is to map two neighboring muscles in cortical motor areas accurately and quickly. Multiple stimuli were applied to the subject using a TMS stimulator to measure the motor-evoked potentials (MEPs) in the corresponding muscles. For each stimulation condition (coil location and angle), the induced electric field (EF) in the brain was computed using a volume conductor model for an individualized head model of the subject constructed from magnetic resonance images. A post-processing method was implemented to determine a TMS hotspot using EF corresponding to multiple stimuli, considering the amplitude of the measured MEPs. The dependence of the computationally estimated hotspot distribution on two target muscles was evaluated (n = 11). The center of gravity of the first dorsal interosseous cortical representation was lateral to the abductor digiti minimi by a minimum of 2 mm. The localizations were consistent with the putative sites obtained from previous EF-based studies and fMRI studies. The simultaneous cortical mapping of two finger muscles was achieved with only several stimuli, which is one or two orders of magnitude smaller than that in previous studies. Our proposal would be useful in the preoperative mapping of motor or speech areas to plan brain surgery interventions.
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Affiliation(s)
- Keigo Hikita
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Aichi, Japan
| | - Jose Gomez-Tames
- Center for Frontier Medical Engineering, Chiba University, Chiba 263-8522, Chiba, Japan
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Aichi, Japan
- Correspondence:
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7
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Siebner HR, Funke K, Aberra AS, Antal A, Bestmann S, Chen R, Classen J, Davare M, Di Lazzaro V, Fox PT, Hallett M, Karabanov AN, Kesselheim J, Beck MM, Koch G, Liebetanz D, Meunier S, Miniussi C, Paulus W, Peterchev AV, Popa T, Ridding MC, Thielscher A, Ziemann U, Rothwell JC, Ugawa Y. Transcranial magnetic stimulation of the brain: What is stimulated? - A consensus and critical position paper. Clin Neurophysiol 2022; 140:59-97. [PMID: 35738037 PMCID: PMC9753778 DOI: 10.1016/j.clinph.2022.04.022] [Citation(s) in RCA: 111] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 03/14/2022] [Accepted: 04/15/2022] [Indexed: 12/11/2022]
Abstract
Transcranial (electro)magnetic stimulation (TMS) is currently the method of choice to non-invasively induce neural activity in the human brain. A single transcranial stimulus induces a time-varying electric field in the brain that may evoke action potentials in cortical neurons. The spatial relationship between the locally induced electric field and the stimulated neurons determines axonal depolarization. The induced electric field is influenced by the conductive properties of the tissue compartments and is strongest in the superficial parts of the targeted cortical gyri and underlying white matter. TMS likely targets axons of both excitatory and inhibitory neurons. The propensity of individual axons to fire an action potential in response to TMS depends on their geometry, myelination and spatial relation to the imposed electric field and the physiological state of the neuron. The latter is determined by its transsynaptic dendritic and somatic inputs, intrinsic membrane potential and firing rate. Modeling work suggests that the primary target of TMS is axonal terminals in the crown top and lip regions of cortical gyri. The induced electric field may additionally excite bends of myelinated axons in the juxtacortical white matter below the gyral crown. Neuronal excitation spreads ortho- and antidromically along the stimulated axons and causes secondary excitation of connected neuronal populations within local intracortical microcircuits in the target area. Axonal and transsynaptic spread of excitation also occurs along cortico-cortical and cortico-subcortical connections, impacting on neuronal activity in the targeted network. Both local and remote neural excitation depend critically on the functional state of the stimulated target area and network. TMS also causes substantial direct co-stimulation of the peripheral nervous system. Peripheral co-excitation propagates centrally in auditory and somatosensory networks, but also produces brain responses in other networks subserving multisensory integration, orienting or arousal. The complexity of the response to TMS warrants cautious interpretation of its physiological and behavioural consequences, and a deeper understanding of the mechanistic underpinnings of TMS will be critical for advancing it as a scientific and therapeutic tool.
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Affiliation(s)
- Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Klaus Funke
- Department of Neurophysiology, Medical Faculty, Ruhr-University Bochum, Bochum, Germany
| | - Aman S Aberra
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Andrea Antal
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Sven Bestmann
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Robert Chen
- Krembil Brain Institute, University Health Network and Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - Marco Davare
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, via Álvaro del Portillo 21, 00128 Rome, Italy
| | - Peter T Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Anke N Karabanov
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Nutrition and Exercise, University of Copenhagen, Copenhagen, Denmark
| | - Janine Kesselheim
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Mikkel M Beck
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Giacomo Koch
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy; Non-invasive Brain Stimulation Unit, Laboratorio di NeurologiaClinica e Comportamentale, Fondazione Santa Lucia IRCCS, Rome, Italy
| | - David Liebetanz
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Sabine Meunier
- Sorbonne Université, Faculté de Médecine, INSERM U 1127, CNRS 4 UMR 7225, Institut du Cerveau, F-75013, Paris, France
| | - Carlo Miniussi
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Italy; Cognitive Neuroscience Section, IRCCS Centro San Giovanni di DioFatebenefratelli, Brescia, Italy
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Göttingen, Germany
| | - Angel V Peterchev
- Department of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Psychiatry & Behavioral Sciences, School of Medicine, Duke University, Durham, NC, USA; Department of Electrical & Computer Engineering, Duke University, Durham, NC, USA; Department of Neurosurgery, School of Medicine, Duke University, Durham, NC, USA
| | - Traian Popa
- Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland; Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL Valais), Clinique Romande de Réadaptation, Sion, Switzerland
| | - Michael C Ridding
- University of South Australia, IIMPACT in Health, Adelaide, Australia
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Ulf Ziemann
- Department of Neurology & Stroke, University Tübingen, Tübingen, Germany; Hertie Institute for Clinical Brain Research, University Tübingen, Tübingen, Germany
| | - John C Rothwell
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Yoshikazu Ugawa
- Department of Neurology, Fukushima Medical University, Fukushima, Japan; Fukushima Global Medical Science Centre, Advanced Clinical Research Centre, Fukushima Medical University, Fukushima, Japan
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8
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Jin F, Bruijn SM, Daffertshofer A. Accounting for Stimulations That Do Not Elicit Motor-Evoked Potentials When Mapping Cortical Representations of Multiple Muscles. Front Hum Neurosci 2022; 16:920538. [PMID: 35814946 PMCID: PMC9263445 DOI: 10.3389/fnhum.2022.920538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
The representation of muscles in the cortex can be mapped using navigated transcranial magnetic stimulation. The commonly employed measure to quantify the mapping are the center of gravity or the centroid of the region of excitability as well as its size. Determining these measures typically relies only on stimulation points that yield motor-evoked potentials (MEPs); stimulations that do not elicit an MEP, i.e., non-MEP points, are ignored entirely. In this study, we show how incorporating non-MEP points may affect the estimates of the size and centroid of the excitable area in eight hand and forearm muscles after mono-phasic single-pulse TMS. We performed test-retest assessments in twenty participants and estimated the reliability of centroids and sizes of the corresponding areas using inter-class correlation coefficients. For most muscles, the reliability turned out good. As expected, removing the non-MEP points significantly decreased area sizes and area weights, suggesting that conventional approaches that do not account for non-MEP points are likely to overestimate the regions of excitability.
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Affiliation(s)
- Fang Jin
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Faculty of Behavioural and Movement Sciences, Institute Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sjoerd M. Bruijn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Faculty of Behavioural and Movement Sciences, Institute Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Andreas Daffertshofer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Faculty of Behavioural and Movement Sciences, Institute Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- *Correspondence: Andreas Daffertshofer,
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Electric Field Distribution Induced by TMS: Differences Due to Anatomical Variation. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a well-established technique for the diagnosis and treatment of neuropsychiatric diseases. The numerical calculation of the induced electric field (EF) distribution in the brain increases the efficacy of stimulation and improves clinical outcomes. However, unique anatomical features, which distinguish each subject, suggest that personalized models should be preferentially used. The objective of the present study was to assess how anatomy affects the EF distribution and to determine to what extent personalized models are useful for clinical studies. The head models of nineteen healthy volunteers were automatically segmented. Two versions of each head model, a homogeneous and a five-tissue anatomical, were stimulated by the model of a Hesed coil (H-coil), employing magnetic quasi-static simulations. The H-coil was placed at two standard stimulating positions per model, over the frontal and central areas. The results show small, but indisputable, variations in the EFs for the homogeneous and anatomical models. The interquartile ranges in the anatomical versions were higher compared to the homogeneous ones, indicating that individual anatomical features may affect the prediction of stimulation volumes. It is concluded that personalized models provide complementary information and should be preferably employed in the context of diagnostic and therapeutic TMS studies.
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10
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Schiavao LJV, Neville Ribeiro I, Yukie Hayashi C, Gadelha Figueiredo E, Russowsky Brunoni A, Jacobsen Teixeira M, Pokorny G, Silva Paiva W. Assessing the Capabilities of Transcranial Magnetic Stimulation (TMS) to Aid in the Removal of Brain Tumors Affecting the Motor Cortex: A Systematic Review. Neuropsychiatr Dis Treat 2022; 18:1219-1235. [PMID: 35734549 PMCID: PMC9208734 DOI: 10.2147/ndt.s359855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/17/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The brain tumor is frequently related to severe motor impairment and impacts the quality of life. The corticospinal tract can sometimes be affected depending on the type and size of the neoplasm, so different tools can evaluate motor function and connections. It is essential to organize surgical procedures and plan the approach. Functional motor status is mapped before, during, and after surgery. Studying corticospinal tract status can help map the functional areas, predict postoperative outcomes, and help the decision, reducing neurological deficits, aiming to preserve functional networks, using the concepts of white matters localization and fibbers connections. Nowadays, there are new techniques that provide functional information regarding the motor cortex, such as transcranial magnetic stimulation (TMS), direct cortical stimulation (DCS), and navigated TMS (nTMS). These tools can be used to plan a customized surgical strategy and the role of motor evoked potentials (MEPs) is well described during intra-operative, using intraoperative neuromonitoring. MEPs can help to localize primary motor areas and delineate the cut-off point of resection in real-time, using direct stimulation. In the post-operative, the MEP has increased your function as a predictive marker of permanent or transitory neurological lesion marker. METHODS Systematic review performed in MEDLINE via PUBMED, EMBASE, and SCOPUS databases regarding the post-operative assessment of MEP in patients with brain tumors. The search strategy included the following terms: (("Evoked Potentials, Motor"[Mesh]) AND "Neoplasms"[Mesh]) AND "Transcranial Magnetic Stimulation"[Mesh] AND "Brain Tumor"[Mesh]), the analysis followed the PRISMA guidelines for systematic reviews, the review spanned until 06/04/2021, inclusion criteria were studies presenting confirmed diagnosis of brain tumor (primary or metastatic), patients >18 y/o, using TMS, Navigated TMS, and/or Evoked Potentials as tools in preoperative planning or at the intra-operative helping the evaluation of the neurological status of the motor cortex, articles published in peer-reviewed journals, and written in English or Portuguese. RESULTS A total of 38 studies were selected for this review, of which 14 investigated the potential of nTMS to predict the occurrence of motor deficits, while 25 of the articles investigated the capabilities of the nTMS technique in performing pre/intraoperative neuro mapping of the motor cortex. CONCLUSION Further studies regarding motor function assessment are needed and standardized protocols for MEPs also need to be defined.
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Affiliation(s)
- Lucas Jose Vaz Schiavao
- Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- FMUSP - University of São Paulo, São Paulo, Brazil.,Neurology, Instituto do Câncer do Estado de São Paulo - ICESP, São Paulo, Brazil
| | - Iuri Neville Ribeiro
- Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- FMUSP - University of São Paulo, São Paulo, Brazil.,Neurology, Instituto do Câncer do Estado de São Paulo - ICESP, São Paulo, Brazil
| | - Cintya Yukie Hayashi
- Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- FMUSP - University of São Paulo, São Paulo, Brazil
| | - Eberval Gadelha Figueiredo
- Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- FMUSP - University of São Paulo, São Paulo, Brazil
| | - Andre Russowsky Brunoni
- Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- FMUSP - University of São Paulo, São Paulo, Brazil
| | - Manoel Jacobsen Teixeira
- Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- FMUSP - University of São Paulo, São Paulo, Brazil
| | | | - Wellingson Silva Paiva
- Neurology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo- FMUSP - University of São Paulo, São Paulo, Brazil
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11
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Calvert GHM, Carson RG. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. Neurosci Biobehav Rev 2021; 132:260-288. [PMID: 34801578 DOI: 10.1016/j.neubiorev.2021.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022]
Abstract
CALVERT, G.H.M., and CARSON, R.G. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2021. - Cross education (CE) is the process whereby a regimen of unilateral limb training engenders bilateral improvements in motor function. The contralateral gains thus derived may impart therapeutic benefits for patients with unilateral deficits arising from orthopaedic injury or stroke. Despite this prospective therapeutic utility, there is little consensus concerning its mechanistic basis. The precise means through which the neuroanatomical structures and cellular processes that mediate CE may be influenced by age-related neurodegeneration are also almost entirely unknown. Notwithstanding the increased incidence of unilateral impairment in later life, age-related variations in the expression of CE have been examined only infrequently. In this narrative review, we consider several mechanisms which may mediate the expression of CE with specific reference to the ageing CNS. We focus on the adaptive potential of cellular processes that are subserved by a specific set of neuroanatomical pathways including: the corticospinal tract, corticoreticulospinal projections, transcallosal fibres, and thalamocortical radiations. This analysis may inform the development of interventions that exploit the therapeutic utility of CE training in older persons.
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Affiliation(s)
- Glenn H M Calvert
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland; School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
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12
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Kataja J, Soldati M, Matilainen N, Laakso I. A probabilistic transcranial magnetic stimulation localization method. J Neural Eng 2021; 18. [PMID: 34475274 DOI: 10.1088/1741-2552/ac1f2b] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/05/2021] [Indexed: 12/15/2022]
Abstract
Objective.Transcranial magnetic stimulation (TMS) can be used to safely and noninvasively activate brain tissue. However, the characteristic parameters of the neuronal activation have been largely unclear. In this work, we propose a novel neuronal activation model and develop a method to infer its parameters from measured motor evoked potential signals.Approach.The connection between neuronal activation due to an induced electric field and a measured motor threshold is modeled. The posterior distribution of the model parameters are inferred from measurement data using Bayes' formula. The measurements are the active motor thresholds obtained with multiple stimulating coil locations, and the parameters of the model are the location, preferred direction of activation, and threshold electric field value of the activation site. The posterior distribution is sampled using a Markov chain Monte Carlo method. We quantify the plausibility of the model by calculating the marginal likelihood of the measured thresholds. The method is validated with synthetic data and applied to motor threshold measurements from the first dorsal interosseus muscle in five healthy participants.Main results.The method produces a probability distribution for the activation location, from which a minimal volume where the activation occurs with 95% probability can be derived. For eight or nine stimulating coil locations, the smallest such a volume obtained was approximately 100 mm3. The 95% probability volume intersected the pre-central gyral crown and the anterior wall of the central sulcus, and the preferred direction was perpendicular to the central sulcus, both findings being consistent with the literature. Furthermore, it was not possible to rule out if the activation occurred either in the white or grey matter. In one participant, two distinct activations sites were found while others exhibited a unique site.Significance.The method is both generic and robust, and it lays a foundation for a framework that enables accurate analysis and characterization of TMS activation mechanisms.
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Affiliation(s)
- Juhani Kataja
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Marco Soldati
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Noora Matilainen
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Ilkka Laakso
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland.,Aalto Neuroimaging, Aalto University, Espoo, Finland
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13
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Colella M, Paffi A, De Santis V, Apollonio F, Liberti M. Effect of skin conductivity on the electric field induced by transcranial stimulation techniques in different head models. Phys Med Biol 2021; 66:035010. [PMID: 33496268 DOI: 10.1088/1361-6560/abcde7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study aims at quantifying the effect that using different skin conductivity values has on the estimation of the electric (E)-field distribution induced by transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in the brain of two anatomical models. The induced E-field was calculated with numerical simulations inside MIDA and Duke models, assigning to the skin a conductivity value estimated from a multi-layered skin model and three values taken from literature. The effect of skin conductivity variations on the local E-field induced by tDCS in the brain was up to 70%. In TMS, minor local differences, in the order of 20%, were obtained in regions of interest for the onset of possible side effects. Results suggested that an accurate model of the skin is necessary in all numerical studies that aim at precisely estimating the E-field induced during TMS and tDCS applications. This also highlights the importance of further experimental studies on human skin characterization, especially at low frequencies.
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Affiliation(s)
- Micol Colella
- Department of Information Engineering, Electronics and Telecommunications (DIET), University of Rome 'La Sapienza', Rome, Italy
| | - Alessandra Paffi
- Department of Information Engineering, Electronics and Telecommunications (DIET), University of Rome 'La Sapienza', Rome, Italy
| | - Valerio De Santis
- Department of Industrial and Information Engineering and Economics (DIIEE), University of L'Aquila, L'Aquila, Italy
| | - Francesca Apollonio
- Department of Information Engineering, Electronics and Telecommunications (DIET), University of Rome 'La Sapienza', Rome, Italy
| | - Micaela Liberti
- Department of Information Engineering, Electronics and Telecommunications (DIET), University of Rome 'La Sapienza', Rome, Italy
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14
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Mantell KE, Sutter EN, Shirinpour S, Nemanich ST, Lench DH, Gillick BT, Opitz A. Evaluating transcranial magnetic stimulation (TMS) induced electric fields in pediatric stroke. NEUROIMAGE-CLINICAL 2021; 29:102563. [PMID: 33516935 PMCID: PMC7847946 DOI: 10.1016/j.nicl.2021.102563] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 11/29/2022]
Abstract
Numerical TMS simulations were performed over and around perinatal stroke lesions. The presence of brain lesions locally affects the electric field distribution. Brain lesions do not significantly change the mean electric field strength. Model driven approaches can inform TMS dosing in a pediatric stroke population.
Transcranial magnetic stimulation (TMS) is an increasingly popular tool for stroke rehabilitation. Consequently, researchers have started to explore the use of TMS in pediatric stroke. However, the application of TMS in a developing brain with pathologies comes with a unique set of challenges. The effect of TMS-induced electric fields has not been explored in children with stroke lesions. Here, we used finite element method (FEM) modeling to study how the electric field strength is affected by the presence of a lesion. We created individual realistic head models from MRIs (n = 6) of children with unilateral cerebral palsy due to perinatal stroke. We conducted TMS electric field simulations for coil locations over lesioned and non-lesioned hemispheres. We found that the presence of a lesion can strongly affect the electric field distribution. On the group level, the mean electric field strength did not differ between lesioned and non-lesioned hemispheres but exhibited a greater variability in the lesioned hemisphere. Other factors such as coil-to-cortex distance have a strong influence on the TMS electric field even in the presence of lesions. Our study has important implications for the delivery of TMS in children with brain lesions with respect to TMS dosing and coil placement.
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Affiliation(s)
- Kathleen E Mantell
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, USA
| | - Ellen N Sutter
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, USA
| | - Sina Shirinpour
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, USA
| | - Samuel T Nemanich
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, USA
| | - Daniel H Lench
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, USA
| | - Bernadette T Gillick
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, USA
| | - Alexander Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, USA.
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15
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Gomez-Tames J, Laakso I, Hirata A. Review on biophysical modelling and simulation studies for transcranial magnetic stimulation. ACTA ACUST UNITED AC 2020; 65:24TR03. [DOI: 10.1088/1361-6560/aba40d] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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16
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Jeltema HR, Ohlerth AK, de Wit A, Wagemakers M, Rofes A, Bastiaanse R, Drost G. Comparing navigated transcranial magnetic stimulation mapping and "gold standard" direct cortical stimulation mapping in neurosurgery: a systematic review. Neurosurg Rev 2020; 44:1903-1920. [PMID: 33009990 PMCID: PMC8338816 DOI: 10.1007/s10143-020-01397-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 09/05/2020] [Accepted: 09/17/2020] [Indexed: 12/14/2022]
Abstract
The objective of this systematic review is to create an overview of the literature on the comparison of navigated transcranial magnetic stimulation (nTMS) as a mapping tool to the current gold standard, which is (intraoperative) direct cortical stimulation (DCS) mapping. A search in the databases of PubMed, EMBASE, and Web of Science was performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recommendations were used. Thirty-five publications were included in the review, describing a total of 552 patients. All studies concerned either mapping of motor or language function. No comparative data for nTMS and DCS for other neurological functions were found. For motor mapping, the distances between the cortical representation of the different muscle groups identified by nTMS and DCS varied between 2 and 16 mm. Regarding mapping of language function, solely an object naming task was performed in the comparative studies on nTMS and DCS. Sensitivity and specificity ranged from 10 to 100% and 13.3–98%, respectively, when nTMS language mapping was compared with DCS mapping. The positive predictive value (PPV) and negative predictive value (NPV) ranged from 17 to 75% and 57–100% respectively. The available evidence for nTMS as a mapping modality for motor and language function is discussed.
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Affiliation(s)
- Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Ann-Katrin Ohlerth
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands
| | - Aranka de Wit
- Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
| | - Michiel Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Adrià Rofes
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands
| | - Roelien Bastiaanse
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands.,Center for Language and Brain, National Research University, Higher School of Economics, Moscow, Russian Federation
| | - Gea Drost
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
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17
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Carson RG. Inter‐hemispheric inhibition sculpts the output of neural circuits by co‐opting the two cerebral hemispheres. J Physiol 2020; 598:4781-4802. [DOI: 10.1113/jp279793] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/04/2020] [Indexed: 01/11/2023] Open
Affiliation(s)
- Richard G. Carson
- Trinity College Institute of Neuroscience and School of Psychology Trinity College Dublin Dublin 2 Ireland
- School of Psychology Queen's University Belfast Belfast BT7 1NN UK
- School of Human Movement and Nutrition Sciences University of Queensland St Lucia QLD 4072 Australia
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18
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Reijonen J, Pitkänen M, Kallioniemi E, Mohammadi A, Ilmoniemi RJ, Julkunen P. Spatial extent of cortical motor hotspot in navigated transcranial magnetic stimulation. J Neurosci Methods 2020; 346:108893. [PMID: 32791087 DOI: 10.1016/j.jneumeth.2020.108893] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 07/05/2020] [Accepted: 08/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Motor mapping with navigated transcranial magnetic stimulation (nTMS) requires defining a "hotspot", a stimulation site consistently producing the highest-amplitude motor-evoked potentials (MEPs). The exact location of the hotspot is difficult to determine, and the spatial extent of high-amplitude MEPs usually remains undefined due to MEP variability and the spread of the TMS-induced electric field (E-field). Therefore, here we aim to define the hotspot as a sub-region of a motor map. NEW METHOD We analyzed MEP amplitude distributions in motor mappings of 30 healthy subjects in two orthogonal directions on the motor cortex. Based on the widths of these distributions, the hotspot extent was estimated as an elliptic area. In addition, E-field distributions induced by motor map edge stimulations were simulated for ten subjects, and the E-field attenuation was analyzed to obtain another estimate for hotspot extent. RESULTS The median MEP-based hotspot area was 13 mm2 (95% confidence interval (CI) = [10, 18] mm2). The mean E-field-based hotspot area was 26 mm2 (95% CI = [13, 38] mm2). COMPARISON WITH EXISTING METHODS In contrast to the conventional hotspot, the new definition considers its spatial extent, indicating the most easily excited area where subsequent nTMS stimuli should be targeted for maximal response. The E-field-based hotspot provides an estimate for the extent of cortical structures where the E-field is close to its maximum. CONCLUSIONS The nTMS hotspot should be considered as an area rather than a single qualitatively defined spot due to MEP variability and E-field spread.
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Affiliation(s)
- Jusa Reijonen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Minna Pitkänen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland; A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland.
| | - Elisa Kallioniemi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States.
| | - Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Risto J Ilmoniemi
- Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland.
| | - Petro Julkunen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
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19
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Corp DT, Bereznicki HGK, Clark GM, Youssef GJ, Fried PJ, Jannati A, Davies CB, Gomes-Osman J, Stamm J, Chung SW, Bowe SJ, Rogasch NC, Fitzgerald PB, Koch G, Di Lazzaro V, Pascual-Leone A, Enticott PG. Large-scale analysis of interindividual variability in theta-burst stimulation data: Results from the 'Big TMS Data Collaboration'. Brain Stimul 2020; 13:1476-1488. [PMID: 32758665 DOI: 10.1016/j.brs.2020.07.018] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Many studies have attempted to identify the sources of interindividual variability in response to theta-burst stimulation (TBS). However, these studies have been limited by small sample sizes, leading to conflicting results. OBJECTIVE/HYPOTHESIS This study brought together over 60 TMS researchers to form the 'Big TMS Data Collaboration', and create the largest known sample of individual participant TBS data to date. The goal was to enable a more comprehensive evaluation of factors driving TBS response variability. METHODS 118 corresponding authors of TMS studies were emailed and asked to provide deidentified individual TMS data. Mixed-effects regression investigated a range of individual and study level variables for their contribution to iTBS and cTBS response variability. RESULTS 430 healthy participants' TBS data was pooled across 22 studies (mean age = 41.9; range = 17-82; females = 217). Baseline MEP amplitude, age, target muscle, and time of day significantly predicted iTBS-induced plasticity. Baseline MEP amplitude and timepoint after TBS significantly predicted cTBS-induced plasticity. CONCLUSIONS This is the largest known study of interindividual variability in TBS. Our findings indicate that a significant portion of variability can be attributed to the methods used to measure the modulatory effects of TBS. We provide specific methodological recommendations in order to control and mitigate these sources of variability.
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Affiliation(s)
- Daniel T Corp
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Hannah G K Bereznicki
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Gillian M Clark
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - George J Youssef
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia
| | - Peter J Fried
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ali Jannati
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Charlotte B Davies
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Joyce Gomes-Osman
- Berenson-Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Julie Stamm
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Sung Wook Chung
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia
| | - Steven J Bowe
- Deakin Biostatistics Unit Faculty of Health Deakin University, Geelong, Australia
| | - Nigel C Rogasch
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia; Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia; The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Central Clinical School, The Alfred and Monash University, Melbourne, Australia; Epworth Centre for Innovation in Mental Health, Epworth HealthCare and Central Clinical School, Melbourne, Australia
| | - Giacomo Koch
- Non-invasive Brain Stimulation Unit, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Biomedical and Specialty Surgical Sciences, Section of Human Physiology, University of Ferrara, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology and Neurobiology, Università Campus Bio-Medico, Rome, Italy
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research. Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA; Guttmann Brain Health Institute, Institut Guttmann de Neurorehabilitació, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
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20
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Weiss Lucas C, Nettekoven C, Neuschmelting V, Oros-Peusquens AM, Stoffels G, Viswanathan S, Rehme AK, Faymonville AM, Shah NJ, Langen KJ, Goldbrunner R, Grefkes C. Invasive versus non-invasive mapping of the motor cortex. Hum Brain Mapp 2020; 41:3970-3983. [PMID: 32588936 PMCID: PMC7469817 DOI: 10.1002/hbm.25101] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 05/05/2020] [Accepted: 06/08/2020] [Indexed: 11/26/2022] Open
Abstract
Precise and comprehensive mapping of somatotopic representations in the motor cortex is clinically essential to achieve maximum resection of brain tumours whilst preserving motor function, especially since the current gold standard, that is, intraoperative direct cortical stimulation (DCS), holds limitations linked to the intraoperative setting such as time constraints or anatomical restrictions. Non‐invasive techniques are increasingly relevant with regard to pre‐operative risk‐assessment. Here, we assessed the congruency of neuronavigated transcranial magnetic stimulation (nTMS) and functional magnetic resonance imaging (fMRI) with DCS. The motor representations of the hand, the foot and the tongue regions of 36 patients with intracranial tumours were mapped pre‐operatively using nTMS and fMRI and by intraoperative DCS. Euclidean distances (ED) between hotspots/centres of gravity and (relative) overlaps of the maps were compared. We found significantly smaller EDs (11.4 ± 8.3 vs. 16.8 ± 7.0 mm) and better spatial overlaps (64 ± 38% vs. 37 ± 37%) between DCS and nTMS compared with DCS and fMRI. In contrast to DCS, fMRI and nTMS mappings were feasible for all regions and patients without complications. In summary, nTMS seems to be the more promising non‐invasive motor cortex mapping technique to approximate the gold standard DCS results.
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Affiliation(s)
- Carolin Weiss Lucas
- Medical Faculty and University Hospital, Center for Neurosurgery, University of Cologne, Cologne, Germany
| | - Charlotte Nettekoven
- Medical Faculty and University Hospital, Center for Neurosurgery, University of Cologne, Cologne, Germany
| | - Volker Neuschmelting
- Medical Faculty and University Hospital, Center for Neurosurgery, University of Cologne, Cologne, Germany
| | | | - Gabriele Stoffels
- Research Centre Jülich, Institute of Neuroscience and Medicine, Jülich, Germany
| | | | - Anne K Rehme
- Research Centre Jülich, Institute of Neuroscience and Medicine, Jülich, Germany.,Medical Faculty and University Hospital, Department of Neurology, University of Cologne, Cologne, Germany
| | - Andrea Maria Faymonville
- Medical Faculty and University Hospital, Center for Neurosurgery, University of Cologne, Cologne, Germany
| | - N Jon Shah
- Research Centre Jülich, Institute of Neuroscience and Medicine, Jülich, Germany.,Department of Neurology, RWTH Aachen University, University Clinic Aachen, Aachen, Germany
| | - Karl Josef Langen
- Research Centre Jülich, Institute of Neuroscience and Medicine, Jülich, Germany
| | - Roland Goldbrunner
- Medical Faculty and University Hospital, Center for Neurosurgery, University of Cologne, Cologne, Germany
| | - Christian Grefkes
- Research Centre Jülich, Institute of Neuroscience and Medicine, Jülich, Germany.,Medical Faculty and University Hospital, Department of Neurology, University of Cologne, Cologne, Germany
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21
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Gomez–Tames J, Laakso I, Murakami T, Ugawa Y, Hirata A. TMS activation site estimation using multiscale realistic head models. J Neural Eng 2020; 17:036004. [DOI: 10.1088/1741-2552/ab8ccf] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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22
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A novel approach to localize cortical TMS effects. Neuroimage 2020; 209:116486. [DOI: 10.1016/j.neuroimage.2019.116486] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 12/12/2019] [Accepted: 12/19/2019] [Indexed: 11/21/2022] Open
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23
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Rezaee Z, Dutta A. Lobule‐Specific Dosage Considerations for Cerebellar Transcranial Direct Current Stimulation During Healthy Aging: A Computational Modeling Study Using Age‐Specific Magnetic Resonance Imaging Templates. Neuromodulation 2020; 23:341-365. [DOI: 10.1111/ner.13098] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 12/02/2019] [Accepted: 12/18/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Zeynab Rezaee
- Department of Biomedical Engineering University at Buffalo Buffalo NY USA
| | - Anirban Dutta
- Department of Biomedical Engineering University at Buffalo Buffalo NY USA
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24
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Reijonen J, Säisänen L, Könönen M, Mohammadi A, Julkunen P. The effect of coil placement and orientation on the assessment of focal excitability in motor mapping with navigated transcranial magnetic stimulation. J Neurosci Methods 2019; 331:108521. [PMID: 31733284 DOI: 10.1016/j.jneumeth.2019.108521] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/26/2019] [Accepted: 11/12/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Navigated transcranial magnetic stimulation (nTMS) is used for mapping muscle representations in the primary motor cortex. We used sulcus-aligned mapping and electric field (E-field) modeling to investigate the excitability of the motor hand area for further understanding the methodological limitations of nTMS. NEW METHOD We studied 10 healthy volunteers to locate the cortical target eliciting the largest responses (the hotspot) in the first dorsal interosseous (FDI) muscle. Six additional targets were placed along the central sulcus at 5-mm distances. Resting motor thresholds (rMTs) and optimal coil orientations were determined at all targets, and a conventional motor mapping was conducted. The cortical E-fields, induced by stimulating the targets with rMT intensities and optimal coil orientations, were modeled in a realistic head geometry to estimate the activated cortical sites. RESULTS The rMTs increased with increasing distance from the hotspot (p < 0.001). The greatest motor-evoked potential (MEP) amplitudes occurred with the coil perpendicular to the sulcus and with the coil pointing towards the hotspot or the center of gravity of the motor map. The E-field strengths at the hotspot (99±26 V/m) remained above previously estimated thresholds for activation. COMPARISON WITH EXISTING METHODS Depending on the target location, optimal coil orientations may deviate significantly from the conventional perpendicular-to-sulcus angle, which is often assumed optimal. These orientations seem to maintain the E-field stable in the hand knob, regardless of the sulcal shape near the stimulated target. CONCLUSIONS The coil orientation is crucial for the accuracy of motor mapping, and the apparent motor map may extend due to remote hotspot activation.
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Affiliation(s)
- Jusa Reijonen
- Department of Clinical Neurophysiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
| | - Laura Säisänen
- Department of Clinical Neurophysiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
| | - Mervi Könönen
- Department of Clinical Neurophysiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland; Department of Clinical Radiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland.
| | - Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
| | - Petro Julkunen
- Department of Clinical Neurophysiology, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
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25
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Yokota T, Maki T, Nagata T, Murakami T, Ugawa Y, Laakso I, Hirata A, Hontani H. Real-time estimation of electric fields induced by transcranial magnetic stimulation with deep neural networks. Brain Stimul 2019; 12:1500-1507. [PMID: 31262697 DOI: 10.1016/j.brs.2019.06.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 06/11/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) plays an important role in treatment of mental and neurological illnesses, and neurosurgery. However, it is difficult to target specific brain regions accurately because the complex anatomy of the brain substantially affects the shape and strength of the electric fields induced by the TMS coil. A volume conductor model can be used for determining the accurate electric fields; however, the construction of subject-specific anatomical head structures is time-consuming. OBJECTIVE The aim of this study is to propose a method to estimate electric fields induced by TMS from only T1 magnetic resonance (MR) images, without constructing a subject-specific anatomical model. METHODS Very large sets of electric fields in the brain of subject-specific anatomical models, which are constructed from T1 and T2 MR images, are computed by a volume conductor model. The relation between electric field distribution and T1 MR images is used for machine learning. Deep neural network (DNN) models are applied for the first time to electric field estimation. RESULTS By determining the relationships between the T1 MR images and electric fields by DNN models, the process of electric field estimation is markedly accelerated (to 0.03 s) due to the absence of a requirement for anatomical head structure reconstruction and volume conductor computation. Validation shows promising estimation accuracy, and rapid computations of the DNN model are apt for practical applications. CONCLUSION The study showed that the DNN model can estimate the electric fields from only T1 MR images and requires low computation time, suggesting the possibility of using machine learning for real-time electric field estimation in navigated TMS.
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Affiliation(s)
- Tatsuya Yokota
- Department of Computer Science, Nagoya Institute of Technology, Aichi, Japan; Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Aichi, Japan.
| | - Toyohiro Maki
- Department of Computer Science, Nagoya Institute of Technology, Aichi, Japan
| | - Tatsuya Nagata
- Department of Computer Science, Nagoya Institute of Technology, Aichi, Japan
| | - Takenobu Murakami
- Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | - Yoshikazu Ugawa
- Department of Neuro-Regeneration, Fukushima Medical University, Fukushima, Japan
| | - Ilkka Laakso
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Aichi, Japan; Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Aichi, Japan
| | - Hidekata Hontani
- Department of Computer Science, Nagoya Institute of Technology, Aichi, Japan; Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Aichi, Japan.
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26
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Sinitsyn DO, Chernyavskiy AY, Poydasheva AG, Bakulin IS, Suponeva NA, Piradov MA. Optimization of the Navigated TMS Mapping Algorithm for Accurate Estimation of Cortical Muscle Representation Characteristics. Brain Sci 2019; 9:brainsci9040088. [PMID: 31010190 PMCID: PMC6523347 DOI: 10.3390/brainsci9040088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 12/13/2022] Open
Abstract
Navigated transcranial magnetic stimulation (nTMS) mapping of cortical muscle representations allows noninvasive assessment of the state of a healthy or diseased motor system, and monitoring changes over time. These applications are hampered by the heterogeneity of existing mapping algorithms and the lack of detailed information about their accuracy. We aimed to find an optimal motor evoked potential (MEP) sampling scheme in the grid-based mapping algorithm in terms of the accuracy of muscle representation parameters. The abductor pollicis brevis (APB) muscles of eight healthy subjects were mapped three times on consecutive days using a seven-by-seven grid with ten stimuli per cell. The effect of the MEP variability on the parameter accuracy was assessed using bootstrapping. The accuracy of representation parameters increased with the number of stimuli without saturation up to at least ten stimuli per cell. The detailed sampling showed that the between-session representation area changes in the absence of interventions were significantly larger than the within-session fluctuations and thus could not be explained solely by the trial-to-trial variability of MEPs. The results demonstrate that the number of stimuli has no universally optimal value and must be chosen by balancing the accuracy requirements with the mapping time constraints in a given problem.
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Affiliation(s)
- Dmitry O Sinitsyn
- Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology, 125367 Moscow, Russia.
| | - Andrey Yu Chernyavskiy
- Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology, 125367 Moscow, Russia.
- Quantum Computer Physics Laboratory, Valiev Institute of Physics and Technology of Russian Academy of Sciences, 117218 Moscow, Russia.
| | - Alexandra G Poydasheva
- Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology, 125367 Moscow, Russia.
| | - Ilya S Bakulin
- Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology, 125367 Moscow, Russia.
| | - Natalia A Suponeva
- Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology, 125367 Moscow, Russia.
| | - Michael A Piradov
- Department of Neurorehabilitation and Physiotherapy, Research Center of Neurology, 125367 Moscow, Russia.
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27
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Nord CL, Popa T, Smith E, Hannah R, Doñamayor N, Weidacker K, Bays PM, Rothwell J, Voon V. The effect of frontoparietal paired associative stimulation on decision-making and working memory. Cortex 2019; 117:266-276. [PMID: 31009813 PMCID: PMC6664322 DOI: 10.1016/j.cortex.2019.03.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/29/2019] [Accepted: 03/13/2019] [Indexed: 11/30/2022]
Abstract
Previous single-site neurostimulation experiments have unsuccessfully attempted to shift decision-making away from habitual control, a fast, inflexible cognitive strategy, towards goal-directed control, a flexible, though computationally expensive strategy. We employed a dual-target neurostimulation approach in 30 healthy participants, using cortico-cortical paired associative stimulation (ccPAS) to target two key nodes: lateral prefrontal cortex (LPFC) and intraparietal sulcus (IPS), to test whether decision-making can be artificially shifted from habitual toward goal-directed control. Participants received three active stimulations, delivered at least six days apart (each involving 100 paired pulses over the IPS and LPFC, varying the interstimulus interval): two interventional, time-relevant ccPAS (10 msec interval) and one control, non-time-relevant ccPAS (100 msec interval). Following stimulation, participants completed a sequential learning task, measuring goal-directed/habitual control, and a working memory task. IPS→LPFC ccPAS (stimulating IPS, then LPFC with a 10 msec interval) shifted decision-making from habitual toward goal-directed control, compared to control ccPAS. There was no effect of LPFC→IPS ccPAS, nor an effect of any PAS condition on working memory. Previous studies have shown ccPAS effects outside the motor domain targeting prefrontal regions on response inhibition, attentional bias, and alpha asymmetry. The present study measures the behavioural effects of parietal-prefrontal PAS, focusing on a highly complex decision-making task and working memory. If confirmed in larger studies, this would be the first instance of neurostimulation successfully shifting decision-making from habitual to goal-directed control, putatively via inducing long-term potentiation between the IPS and LPFC. However, we found no effect in the other direction (LPFC→IPS ccPAS), and no effect on working memory overall. PAS is a relatively new neuromodulatory technique in the cognitive arsenal, and this study could help guide future approaches in healthy and disordered decision-making.
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Affiliation(s)
- Camilla L Nord
- Department of Psychiatry, University of Cambridge, Cambridge, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
| | - Traian Popa
- Center for Neuroprosthetics, École Polytechnique Fédérale de Lausanne, Switzerland; National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Emma Smith
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Ricci Hannah
- Sobell Centre for Motor Neuroscience and Movement Disorders, University College London, London, UK
| | - Nuria Doñamayor
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Germany
| | | | - Paul M Bays
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - John Rothwell
- Sobell Centre for Motor Neuroscience and Movement Disorders, University College London, London, UK
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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28
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Karabanov AN, Saturnino GB, Thielscher A, Siebner HR. Can Transcranial Electrical Stimulation Localize Brain Function? Front Psychol 2019; 10:213. [PMID: 30837911 PMCID: PMC6389710 DOI: 10.3389/fpsyg.2019.00213] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/22/2019] [Indexed: 11/13/2022] Open
Abstract
Transcranial electrical stimulation (TES) uses constant (TDCS) or alternating currents (TACS) to modulate brain activity. Most TES studies apply low-intensity currents through scalp electrodes (≤2 mA) using bipolar electrode arrangements, producing weak electrical fields in the brain (<1 V/m). Low-intensity TES has been employed in humans to induce changes in task performance during or after stimulation. In analogy to focal transcranial magnetic stimulation, TES-induced behavioral effects have often been taken as evidence for a causal involvement of the brain region underlying one of the two stimulation electrodes, often referred to as the active electrode. Here, we critically review the utility of bipolar low-intensity TES to localize human brain function. We summarize physiological substrates that constitute peripheral targets for TES and may mediate subliminal or overtly perceived peripheral stimulation during TES. We argue that peripheral co-stimulation may contribute to the behavioral effects of TES and should be controlled for by "sham" TES. We discuss biophysical properties of TES, which need to be considered, if one wishes to make realistic assumptions about which brain regions were preferentially targeted by TES. Using results from electric field calculations, we evaluate the validity of different strategies that have been used for selective spatial targeting. Finally, we comment on the challenge of adjusting the dose of TES considering dose-response relationships between the weak tissue currents and the physiological effects in targeted cortical areas. These considerations call for caution when attributing behavioral effects during or after low-intensity TES studies to a specific brain region and may facilitate the selection of best practices for future TES studies.
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Affiliation(s)
- Anke Ninija Karabanov
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Guilherme Bicalho Saturnino
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Electrical Engineering, Technical University of Denmark, Copenhagen, Denmark
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Electrical Engineering, Technical University of Denmark, Copenhagen, Denmark
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Institute for Clinical Medicine, Faculty of Health Sciences and Medicine, University of Copenhagen, Copenhagen, Denmark
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29
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Excitability of the supplementary motor area in Parkinson's disease depends on subcortical damage. Brain Stimul 2019; 12:152-160. [DOI: 10.1016/j.brs.2018.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/01/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022] Open
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30
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Gomez-Tames J, Hamasaka A, Laakso I, Hirata A, Ugawa Y. Atlas of optimal coil orientation and position for TMS: A computational study. Brain Stimul 2018; 11:839-848. [DOI: 10.1016/j.brs.2018.04.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 01/19/2023] Open
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31
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Mikkonen M, Laakso I, Sumiya M, Koyama S, Hirata A, Tanaka S. TMS Motor Thresholds Correlate With TDCS Electric Field Strengths in Hand Motor Area. Front Neurosci 2018; 12:426. [PMID: 29988501 PMCID: PMC6026630 DOI: 10.3389/fnins.2018.00426] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 07/06/2018] [Indexed: 12/05/2022] Open
Abstract
Transcranial direct current stimulation (TDCS) modulates cortical activity and influences motor and cognitive functions in both healthy and clinical populations. However, there is large inter-individual variability in the responses to TDCS. Computational studies have suggested that inter-individual differences in cranial and brain anatomy may contribute to this variability via creating varying electric fields in the brain. This implies that the electric fields or their strength and orientation should be considered and incorporated when selecting the TDCS dose. Unfortunately, electric field modeling is difficult to perform; thus, a more-robust and practical method of estimating the strength of TDCS electric fields for experimental use is required. As recent studies have revealed a relationship between the sensitivity to TMS and motor cortical TDCS after-effects, the aim of the present study was to investigate whether the resting motor threshold (RMT), a simple measure of transcranial magnetic stimulation (TMS) sensitivity, would be useful for estimating TDCS electric field strengths in the hand area of primary motor cortex (M1). To achieve this, we measured the RMT in 28 subjects. We also obtained magnetic resonance images from each subject to build individual three-dimensional anatomic models, which were used in solving the TDCS and TMS electric fields using the finite element method (FEM). Then, we calculated the correlation between the measured RMT and the modeled TDCS electric fields. We found that the RMT correlated with the TDCS electric fields in hand M1 (R2 = 0.58), but no obvious correlations were identified in regions outside M1. The found correlation was mainly due to a correlation between the TDCS and TMS electric fields, both of which were affected by individual's anatomic features. In conclusion, the RMT could provide a useful tool for estimating cortical electric fields for motor cortical TDCS.
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Affiliation(s)
- Marko Mikkonen
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Ilkka Laakso
- Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - Motofumi Sumiya
- Department of System Neuroscience, National Institute for Physiological Sciences, Okazaki, Japan
| | - Soichiro Koyama
- School of Health Sciences, Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Akimasa Hirata
- Department of Computer Science and Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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32
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Bungert A, Antunes A, Espenhahn S, Thielscher A. Where does TMS Stimulate the Motor Cortex? Combining Electrophysiological Measurements and Realistic Field Estimates to Reveal the Affected Cortex Position. Cereb Cortex 2018; 27:5083-5094. [PMID: 27664963 DOI: 10.1093/cercor/bhw292] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 08/29/2016] [Indexed: 11/13/2022] Open
Abstract
Much of our knowledge on the physiological mechanisms of transcranial magnetic stimulation (TMS) stems from studies which targeted the human motor cortex. However, it is still unclear which part of the motor cortex is predominantly affected by TMS. Considering that the motor cortex consists of functionally and histologically distinct subareas, this also renders the hypotheses on the physiological TMS effects uncertain. We use the finite element method (FEM) and magnetic resonance image-based individual head models to get realistic estimates of the electric field induced by TMS. The field changes in different subparts of the motor cortex are compared with electrophysiological threshold changes of 2 hand muscles when systematically varying the coil orientation in measurements. We demonstrate that TMS stimulates the region around the gyral crown and that the maximal electric field strength in this region is significantly related to the electrophysiological response. Our study is one of the most extensive comparisons between FEM-based field calculations and physiological TMS effects so far, being based on data for 2 hand muscles in 9 subjects. The results help to improve our understanding of the basic mechanisms of TMS. They also pave the way for a systematic exploration of realistic field estimates for dosage control in TMS.
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Affiliation(s)
- Andreas Bungert
- Max Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany
| | - André Antunes
- Max Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany
| | - Svenja Espenhahn
- Max Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany.,Institute of Neurology, University College London, London, WC1E 6BT, UK
| | - Axel Thielscher
- Danish Research Center for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650 Hvidovre, Denmark.,Max Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany.,Department of Electrical Engineering, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
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33
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MRI Verification of a 10-20 Targeting Protocol Used During Transcranial Magnetic Stimulation Sessions for Tinnitus. Brain Topogr 2018; 31:690-699. [PMID: 29464519 PMCID: PMC5999188 DOI: 10.1007/s10548-018-0636-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 02/06/2018] [Indexed: 01/19/2023]
Abstract
Langguth et al. (2006) described a method for targeting primary auditory cortex (PAC) during transcranial magnetic stimulation (TMS) using the 10–20 electroencephalography system. Study aims were to measure the degree of accuracy in placing the TMS coil on the scalp overlying PAC using the 10–20 method and determine the extent to which accuracy depends on the hemisphere of the coil placement. Twelve participants underwent anatomical magnetic resonance imaging (MRI) of their head in a 3T scanner. Before imaging, a fiducial marker was placed on their scalp corresponding to the TMS coil position. MRI scans were analyzed to determine the distance from the fiducial marker to PAC for each participant. On average, the 10–20 method resulted in distances in the medial–lateral, anterior-posterior, and inferior-superior dimensions that were within a few millimeters (~ 4 mm) of each other between the left and right hemispheres. The fiducial marker was, on average, 10.4 mm superior and 10.8 mm posterior to the optimal scalp location that minimized the distance to PAC. Individual asymmetries and other systematic differences found in this study raise important considerations to keep in mind that might necessitate using an MRI-guided method of coil-positioning when targeting PAC for TMS.
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34
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Aonuma S, Gomez-Tames J, Laakso I, Hirata A, Takakura T, Tamura M, Muragaki Y. A high-resolution computational localization method for transcranial magnetic stimulation mapping. Neuroimage 2018; 172:85-93. [PMID: 29360575 DOI: 10.1016/j.neuroimage.2018.01.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/25/2017] [Accepted: 01/15/2018] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Transcranial magnetic stimulation (TMS) is used for the mapping of brain motor functions. The complexity of the brain deters determining the exact localization of the stimulation site using simplified methods (e.g., the region below the center of the TMS coil) or conventional computational approaches. OBJECTIVE This study aimed to present a high-precision localization method for a specific motor area by synthesizing computed non-uniform current distributions in the brain for multiple sessions of TMS. METHODS Peritumoral mapping by TMS was conducted on patients who had intra-axial brain neoplasms located within or close to the motor speech area. The electric field induced by TMS was computed using realistic head models constructed from magnetic resonance images of patients. A post-processing method was implemented to determine a TMS hotspot by combining the computed electric fields for the coil orientations and positions that delivered high motor-evoked potentials during peritumoral mapping. The method was compared to the stimulation site localized via intraoperative direct brain stimulation and navigated TMS. RESULTS Four main results were obtained: 1) the dependence of the computed hotspot area on the number of peritumoral measurements was evaluated; 2) the estimated localization of the hand motor area in eight non-affected hemispheres was in good agreement with the position of a so-called "hand-knob"; 3) the estimated hotspot areas were not sensitive to variations in tissue conductivity; and 4) the hand motor areas estimated by this proposal and direct electric stimulation (DES) were in good agreement in the ipsilateral hemisphere of four glioma patients. CONCLUSION(S) The TMS localization method was validated by well-known positions of the "hand-knob" in brains for the non-affected hemisphere, and by a hotspot localized via DES during awake craniotomy for the tumor-containing hemisphere.
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Affiliation(s)
- Shinta Aonuma
- Nagoya Institute of Technology, Department of Electrical and Mechanical Engineering, Nagoya, Aichi, 466-8555, Japan
| | - Jose Gomez-Tames
- Nagoya Institute of Technology, Department of Electrical and Mechanical Engineering, Nagoya, Aichi, 466-8555, Japan
| | - Ilkka Laakso
- Aalto University, Department of Electrical Engineering and Automation, Espoo, FI-00076, Finland
| | - Akimasa Hirata
- Nagoya Institute of Technology, Department of Electrical and Mechanical Engineering, Nagoya, Aichi, 466-8555, Japan.
| | - Tomokazu Takakura
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Manabu Tamura
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, 162-8666, Japan; Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yoshihiro Muragaki
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, 162-8666, Japan; Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, 162-8666, Japan
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Where and what TMS activates: Experiments and modeling. Brain Stimul 2018; 11:166-174. [DOI: 10.1016/j.brs.2017.09.011] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/22/2017] [Accepted: 09/22/2017] [Indexed: 11/21/2022] Open
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Sakreida K, Lange I, Willmes K, Heim S, Binkofski F, Clusmann H, Neuloh G. High-resolution language mapping of Broca's region with transcranial magnetic stimulation. Brain Struct Funct 2017; 223:1297-1312. [PMID: 29116426 DOI: 10.1007/s00429-017-1550-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
Abstract
Broca's region, corresponding roughly to cytoarchitectonic areas 44 and 45 in the inferior frontal cortex, holds a multifunctional role in language processing, as shown, e.g., by functional imaging data. Neuro-navigated transcranial magnetic stimulation (TMS) enables complementary non-invasive mapping of cortical functions with high spatial resolution. Here, we report on detailed TMS language mapping of Broca's region in 12 healthy participants. The test protocol with an object naming task was adapted for high-resolution and semi-quantitative mapping of TMS-induced effects on speech and language performance. Hierarchical cluster analysis of normalized ratings of error frequency and severity revealed a clear focus of TMS impact at dorso-posterior target sites, close to the inferior frontal junction. Adjacent clusters of moderate and slightly affected stimulation sites yielded a posterosuperior-to-anteroinferior gradient of TMS susceptibility. Our findings indicate that the part of Broca's region most susceptible to TMS-induced language inhibition in object naming is located in the dorsal area 44.
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Affiliation(s)
- Katrin Sakreida
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Inga Lange
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.,Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Klaus Willmes
- Department of Neurology, Faculty of Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Stefan Heim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52074, Aachen, Germany.,Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1), 52425, Jülich, Germany.,JARA - Translational Brain Medicine, Aachen, Germany
| | - Ferdinand Binkofski
- Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, 52074, Aachen, Germany.,Research Centre Jülich, Institute of Neuroscience and Medicine (INM-4), 52425, Jülich, Germany.,JARA - Translational Brain Medicine, Aachen, Germany
| | - Hans Clusmann
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Georg Neuloh
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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Diana M, Raij T, Melis M, Nummenmaa A, Leggio L, Bonci A. Rehabilitating the addicted brain with transcranial magnetic stimulation. Nat Rev Neurosci 2017; 18:685-693. [PMID: 28951609 DOI: 10.1038/nrn.2017.113] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Substance use disorders (SUDs) are one of the leading causes of morbidity and mortality worldwide. In spite of considerable advances in understanding the neural underpinnings of SUDs, therapeutic options remain limited. Recent studies have highlighted the potential of transcranial magnetic stimulation (TMS) as an innovative, safe and cost-effective treatment for some SUDs. Repetitive TMS (rTMS) influences neural activity in the short and long term by mechanisms involving neuroplasticity both locally, under the stimulating coil, and at the network level, throughout the brain. The long-term neurophysiological changes induced by rTMS have the potential to affect behaviours relating to drug craving, intake and relapse. Here, we review TMS mechanisms and evidence that rTMS is opening new avenues in addiction treatments.
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Affiliation(s)
- Marco Diana
- 'G. Minardi' Laboratory for Cognitive Neuroscience, Department of Chemistry and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Tommi Raij
- Shirley Ryan AbilityLab, Center for Brain Stimulation, the Department of Physical Medicine and Rehabilitation and the Department of Neurobiology, Northwestern University, Chicago, Illinois 60611, USA
| | - Miriam Melis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy
| | - Aapo Nummenmaa
- Massachusetts General Hospital (MGH)/Massachusetts Institute of Technology (MIT)/Harvard Medical School (HMS) Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts 02129, USA
| | - Lorenzo Leggio
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, US National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research (NIAAA DICBR) and US National Institute on Drug Abuse Intramural Research Program (NIDA IRP), NIH (National Institutes of Health), Bethesda, Maryland 20892, USA; and at the Center for Alcohol and Addiction Studies, Brown University, Providence, Rhode Island 02912, USA
| | - Antonello Bonci
- US National Institute on Drug Abuse Intramural Research Program (NIDA IRP); and at the Departments of Neuroscience and Psychiatry, Johns Hopkins University, Baltimore, Maryland 21224, USA
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Minimum-Norm Estimation of Motor Representations in Navigated TMS Mappings. Brain Topogr 2017; 30:711-722. [PMID: 28721533 DOI: 10.1007/s10548-017-0577-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/11/2017] [Indexed: 10/19/2022]
Abstract
Navigated transcranial magnetic stimulation (nTMS) can be applied to locate and outline cortical motor representations. This may be important, e.g., when planning neurosurgery or focused nTMS therapy, or when assessing plastic changes during neurorehabilitation. Conventionally, a cortical location is considered to belong to the motor cortex if the maximum electric field (E-field) targeted there evokes a motor-evoked potential in a muscle. However, the cortex is affected by a broad E-field distribution, which tends to broaden estimates of representation areas by stimulating also the neighboring areas in addition to the maximum E-field location. Our aim was to improve the estimation of nTMS-based motor maps by taking into account the E-field distribution of the stimulation pulse. The effect of the E-field distribution was considered by calculating the minimum-norm estimate (MNE) of the motor representation area. We tested the method on simulated data and then applied it to recordings from six healthy volunteers and one stroke patient. We compared the motor representation areas obtained with the MNE method and a previously introduced interpolation method. The MNE hotspots and centers of gravity were close to those obtained with the interpolation method. The areas of the maps, however, depend on the thresholds used for outlining the areas. The MNE method may improve the definition of cortical motor areas, but its accuracy should be validated by comparing the results with maps obtained with direct cortical stimulation of the cortex where the E-field distribution can be better focused.
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Iwahashi M, Gomez-Tames J, Laakso I, Hirata A. Evaluation method for in situ electric field in standardized human brain for different transcranial magnetic stimulation coils. Phys Med Biol 2017; 62:2224-2238. [DOI: 10.1088/1361-6560/aa5b70] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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40
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Takakura T, Muragaki Y, Tamura M, Maruyama T, Nitta M, Niki C, Kawamata T. Navigated transcranial magnetic stimulation for glioma removal: prognostic value in motor function recovery from postsurgical neurological deficits. J Neurosurg 2017; 127:877-891. [PMID: 28059664 DOI: 10.3171/2016.8.jns16442] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of the present study was to evaluate the usefulness of navigated transcranial magnetic stimulation (nTMS) as a prognostic predictor for upper-extremity motor functional recovery from postsurgical neurological deficits. METHODS Preoperative and postoperative nTMS studies were prospectively applied in 14 patients (mean age 39 ± 12 years) who had intraparenchymal brain neoplasms located within or adjacent to the motor eloquent area in the cerebral hemisphere. Mapping by nTMS was done 3 times, i.e., before surgery, and 1 week and 3 weeks after surgery. To assess the response induced by nTMS, motor evoked potential (nTMS-MEP) was recorded using a surface electromyography electrode attached to the abductor pollicis brevis (APB). The cortical locations that elicited the largest electromyography response by nTMS were defined as hotspots. Hotspots for APB were confirmed as positive responsive sites by direct electrical stimulation (DES) during awake craniotomy. The distances between hotspots and lesions (DHS-L) were measured. Postoperative neurological deficits were assessed by manual muscle test and dynamometer. To validate the prognostic value of nTMS in recovery from upper-extremity paresis, the following were investigated: 1) the correlation between DHS-L and the serial grip strength change, and 2) the correlation between positive nTMS-MEP at 1 week after surgery and the serial grip strength change. RESULTS From the presurgical nTMS study, MEPs from targeted muscles were identified in 13 cases from affected hemispheres. In one case, MEP was not evoked due to a huge tumor. Among 9 cases from which intraoperative DES mapping for hand motor area was available, hotspots for APB identified by nTMS were concordant with DES-positive sites. Compared with the adjacent group (DHS-L < 10 mm, n = 6), the nonadjacent group (DHS-L ≥ 10 mm, n = 7) showed significantly better recovery of grip strength at 3 months after surgery (p < 0.01). There were correlations between DHS-L and recovery of grip strength at 1 week, 3 weeks, and 3 months after surgery (r = 0.74, 0.68, and 0.65, respectively). Postsurgical nTMS was accomplished in 13 patients. In 9 of 13 cases, nTMS-MEP from APB muscle was positive at 1 week after surgery. Excluding the case in which nTMS-MEP was negative from the presurgical nTMS study, recoveries in grip strength were compared between 2 groups, in which nTMS-MEP at 1 week after surgery was positive (n = 9) or negative (n = 3). Significant differences were observed between the 2 groups at 1 week, 3 weeks, and 3 months after surgery (p < 0.01). Positive nTMS-MEP at 1 week after surgery correlated well with the motor recovery at 1 week, 3 weeks, and 3 months after surgery (r = 0.87, 0.88, and 0.77, respectively). CONCLUSIONS Navigated TMS is a useful tool for identifying motor eloquent areas. The results of the present study have demonstrated the predictive value of nTMS in upper-extremity motor function recovery from postsurgical neurological deficits. The longer DHS-L and positive nTMS-MEP at 1 week after surgery have prognostic values of better recovery from postsurgical neurological deficits.
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Affiliation(s)
- Tomokazu Takakura
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering & Science, Graduate School of Medicine.,Department of Physical Medicine and Rehabilitation, Tokyo Rosai Hospital, Tokyo, Japan
| | - Yoshihiro Muragaki
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering & Science, Graduate School of Medicine.,Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University; and
| | - Manabu Tamura
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering & Science, Graduate School of Medicine.,Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University; and
| | - Takashi Maruyama
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering & Science, Graduate School of Medicine.,Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University; and
| | - Masayuki Nitta
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering & Science, Graduate School of Medicine.,Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University; and
| | - Chiharu Niki
- Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University; and
| | - Takakazu Kawamata
- Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University; and
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Kallioniemi E, Pitkänen M, Könönen M, Vanninen R, Julkunen P. Localization of cortical primary motor area of the hand using navigated transcranial magnetic stimulation, BOLD and arterial spin labeling fMRI. J Neurosci Methods 2016; 273:138-148. [PMID: 27615740 DOI: 10.1016/j.jneumeth.2016.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 07/12/2016] [Accepted: 09/07/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although the relationship between neuronavigated transcranial magnetic stimulation (nTMS) and functional magnetic resonance imaging (fMRI) has been widely studied in motor mapping, it is unknown how the motor response type or the choice of motor task affect this relationship. NEW METHOD Centers of gravity (CoGs) and response maxima were measured with blood-oxygen-level dependent (BOLD) and arterial spin labeling (ASL) fMRI during motor tasks against nTMS CoGs and response maxima, which were mapped with motor evoked potentials (MEPs) and silent periods (SPs). RESULTS No differences in motor representations (CoGs and response maxima) were observed in lateral-medial direction (p=0.265). fMRI methods localized the motor representation more posterior than nTMS (p<0.001). This was not affected by the BOLD fMRI motor task (p>0.999) nor nTMS response type (p>0.999). ASL fMRI maxima did not differ from the nTMS nor BOLD fMRI CoGs (p≥0.070), but the ASL CoG was deeper in comparison to other methods (p≤0.042). The BOLD fMRI motor task did not influence the depth of the motor representation (p≥0.745). The median Euclidean distances between the nTMS and fMRI motor representations varied between 7.7mm and 14.5mm and did not differ between the methods (F≤1.23, p≥0.318). COMPARISON WITH EXISTING METHODS The relationship between fMRI and nTMS mapped excitatory (MEP) and inhibitory (SP) responses, and whether the choice of motor task affects this relationship, have not been studied before. CONCLUSIONS The congruence between fMRI and nTMS is good. The choice of nTMS motor response type nor BOLD fMRI motor task had no effect on this relationship.
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Affiliation(s)
- Elisa Kallioniemi
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
| | - Minna Pitkänen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
| | - Mervi Könönen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
| | - Ritva Vanninen
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Petro Julkunen
- Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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Neuromuscular Plasticity: Disentangling Stable and Variable Motor Maps in the Human Sensorimotor Cortex. Neural Plast 2016; 2016:7365609. [PMID: 27610248 PMCID: PMC5004060 DOI: 10.1155/2016/7365609] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/28/2016] [Accepted: 07/19/2016] [Indexed: 02/02/2023] Open
Abstract
Motor maps acquired with transcranial magnetic stimulation (TMS) are evolving as a biomarker for monitoring disease progression or the effects of therapeutic interventions. High test-retest reliability of this technique for long observation periods is therefore required to differentiate daily or weekly fluctuations from stable plastic reorganization of corticospinal connectivity. In this study, a novel projection, interpolation, and coregistration technique, which considers the individual gyral anatomy, was applied in healthy subjects for biweekly acquired TMS motor maps over a period of twelve weeks. The intraclass correlation coefficient revealed long-term reliability of motor maps with relevant interhemispheric differences. The sensorimotor cortex and nonprimary motor areas of the dominant hemisphere showed more extended and more stable corticospinal connectivity. Long-term correlations of the MEP amplitudes at each stimulation site revealed mosaic-like clusters of consistent corticospinal excitability. The resting motor threshold, centre of gravity, and mean MEPs across all TMS sites, as highly reliable cortical map parameters, could be disentangled from more variable parameters such as MEP area and volume. Cortical TMS motor maps provide high test-retest reliability for long-term monitoring when analyzed with refined techniques. They may guide restorative interventions which target dormant corticospinal connectivity for neurorehabilitation.
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Naro A, Corallo F, De Salvo S, Marra A, Di Lorenzo G, Muscarà N, Russo M, Marino S, De Luca R, Bramanti P, Calabrò RS. Promising Role of Neuromodulation in Predicting the Progression of Mild Cognitive Impairment to Dementia. J Alzheimers Dis 2016; 53:1375-88. [DOI: 10.3233/jad-160305] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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44
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Alternative Stimulation Intensities for Mapping Cortical Motor Area with Navigated TMS. Brain Topogr 2016; 29:395-404. [DOI: 10.1007/s10548-016-0470-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/16/2016] [Indexed: 10/22/2022]
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45
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Opitz A, Fox MD, Craddock RC, Colcombe S, Milham MP. An integrated framework for targeting functional networks via transcranial magnetic stimulation. Neuroimage 2015; 127:86-96. [PMID: 26608241 DOI: 10.1016/j.neuroimage.2015.11.040] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 11/13/2015] [Accepted: 11/15/2015] [Indexed: 12/17/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is a powerful investigational tool for in vivo manipulation of regional or network activity, with a growing number of potential clinical applications. Unfortunately, the vast majority of targeting strategies remain limited by their reliance on non-realistic brain models and assumptions that anatomo-functional relationships are 1:1. Here, we present an integrated framework that combines anatomically realistic finite element models of the human head with resting functional MRI to predict functional networks targeted via TMS at a given coil location and orientation. Using data from the Human Connectome Project, we provide an example implementation focused on dorsolateral prefrontal cortex (DLPFC). Three distinct DLPFC stimulation zones were identified, differing with respect to the network to be affected (default, frontoparietal) and sensitivity to coil orientation. Network profiles generated for DLPFC targets previously published for treating depression revealed substantial variability across studies, highlighting a potentially critical technical issue.
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Affiliation(s)
- Alexander Opitz
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Center for the Developing Brain, Child Mind Institute, New York, NY, USA.
| | - Michael D Fox
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, USA
| | - R Cameron Craddock
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Center for the Developing Brain, Child Mind Institute, New York, NY, USA
| | - Stan Colcombe
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Michael P Milham
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Center for the Developing Brain, Child Mind Institute, New York, NY, USA.
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Levy RM, Harvey RL, Kissela BM, Winstein CJ, Lutsep HL, Parrish TB, Cramer SC, Venkatesan L. Epidural Electrical Stimulation for Stroke Rehabilitation: Results of the Prospective, Multicenter, Randomized, Single-Blinded Everest Trial. Neurorehabil Neural Repair 2015; 30:107-19. [PMID: 25748452 DOI: 10.1177/1545968315575613] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND This prospective, single-blinded, multicenter study assessed the safety and efficacy of electrical epidural motor cortex stimulation (EECS) in improving upper limb motor function of ischemic stroke patients with moderate to moderately severe hemiparesis. METHODS Patients ≥ 4 months poststroke were randomized 2:1 to an investigational (n = 104) or control (n = 60) group, respectively. Investigational patients were implanted (n = 94) with an epidural 6-contact lead perpendicular to the primary motor cortex and a pulse generator. Both groups underwent 6 weeks of rehabilitation, but EECS was delivered to investigational patients during rehabilitation. The primary efficacy endpoint (PE) was defined as attaining a minimum improvement of 4.5 points in the upper extremity Fugl-Meyer (UEFM) scale as well as 0.21 points in the Arm Motor Ability Test (AMAT) 4 weeks postrehabilitation. Follow-up assessments were performed 1, 4, 12, and 24 weeks postrehabilitation. Safety was evaluated by monitoring adverse events (AEs) that occurred between enrollment and the end of rehabilitation. RESULTS Primary intent-to-treat analysis showed no group differences at 4 weeks, with PE being met by 32% and 29% of investigational and control patients, respectively (P = .36). Repeated-measures secondary analyses revealed no significant treatment group differences in mean UEFM or AMAT scores. However, post hoc comparisons showed that a greater proportion of investigational (39%) than control (15%) patients maintained or achieved PE (P = .003) at 24 weeks postrehabilitation. Investigational group mean AMAT scores also improved significantly (P < .05) when compared to the control group at 24 weeks postrehabilitation. Post hoc analyses also showed that 69% (n = 9/13) of the investigational patients who elicited movement thresholds during stimulation testing met PE at 4 weeks, and mean UEFM and AMAT scores was also significantly higher (P < .05) in this subgroup at the 4-, 12-, and 24-week assessments when compared to the control group. Headache (19%), pain (13%), swelling (7%), and infection (7%) were the most commonly observed implant procedure-related AEs. Overall, there were 11 serious AEs in 9 investigational group patients (7 procedure related, 4 anesthesia related). CONCLUSIONS The primary analysis pertaining to efficacy of EECS during upper limb motor rehabilitation in chronic stroke patients was negative at 4 weeks postrehabilitation. A better treatment response was observed in a subset of patients eliciting stimulation induced upper limb movements during motor threshold assessments performed prior to each rehabilitation session. Post hoc comparisons indicated treatment effect differences at 24 weeks, with the control group showing significant decline in the combined primary outcome measure relative to the investigational group. These results have the potential to inform future chronic stroke rehabilitation trial design.
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Affiliation(s)
| | - Richard L Harvey
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA The Rehabilitation Institute of Chicago, Chicago, IL, USA
| | | | | | | | - Todd B Parrish
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Rossini PM, Burke D, Chen R, Cohen LG, Daskalakis Z, Di Iorio R, Di Lazzaro V, Ferreri F, Fitzgerald PB, George MS, Hallett M, Lefaucheur JP, Langguth B, Matsumoto H, Miniussi C, Nitsche MA, Pascual-Leone A, Paulus W, Rossi S, Rothwell JC, Siebner HR, Ugawa Y, Walsh V, Ziemann U. Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee. Clin Neurophysiol 2015; 126:1071-1107. [PMID: 25797650 PMCID: PMC6350257 DOI: 10.1016/j.clinph.2015.02.001] [Citation(s) in RCA: 1709] [Impact Index Per Article: 189.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 01/22/2015] [Accepted: 02/01/2015] [Indexed: 12/14/2022]
Abstract
These guidelines provide an up-date of previous IFCN report on “Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application” (Rossini et al., 1994). A new Committee, composed of international experts, some of whom were in the panel of the 1994 “Report”, was selected to produce a current state-of-the-art review of non-invasive stimulation both for clinical application and research in neuroscience. Since 1994, the international scientific community has seen a rapid increase in non-invasive brain stimulation in studying cognition, brain–behavior relationship and pathophysiology of various neurologic and psychiatric disorders. New paradigms of stimulation and new techniques have been developed. Furthermore, a large number of studies and clinical trials have demonstrated potential therapeutic applications of non-invasive brain stimulation, especially for TMS. Recent guidelines can be found in the literature covering specific aspects of non-invasive brain stimulation, such as safety (Rossi et al., 2009), methodology (Groppa et al., 2012) and therapeutic applications (Lefaucheur et al., 2014). This up-dated review covers theoretical, physiological and practical aspects of non-invasive stimulation of brain, spinal cord, nerve roots and peripheral nerves in the light of more updated knowledge, and include some recent extensions and developments.
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Affiliation(s)
- P M Rossini
- Institute of Neurology, Department of Geriatrics, Neuroscience and Orthopedics, Catholic University, Policlinic A. Gemelli, Rome, Italy
| | - D Burke
- Department of Neurology, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia
| | - R Chen
- Division of Neurology, Toronto Western Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - L G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - Z Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - R Di Iorio
- Institute of Neurology, Department of Geriatrics, Neuroscience and Orthopedics, Catholic University, Policlinic A. Gemelli, Rome, Italy.
| | - V Di Lazzaro
- Department of Neurology, University Campus Bio-medico, Rome, Italy
| | - F Ferreri
- Department of Neurology, University Campus Bio-medico, Rome, Italy; Department of Clinical Neurophysiology, University of Eastern Finland, Kuopio, Finland
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred, Melbourne, Australia
| | - M S George
- Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - M Hallett
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, Bethesda, MD, USA
| | - J P Lefaucheur
- Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; EA 4391, Nerve Excitability and Therapeutic Team, Faculty of Medicine, Paris Est Créteil University, Créteil, France
| | - B Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - H Matsumoto
- Department of Neurology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - C Miniussi
- Department of Clinical and Experimental Sciences University of Brescia, Brescia, Italy; IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - M A Nitsche
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Georg-August-University, Göttingen, Germany
| | - A Pascual-Leone
- Berenson-Allen Center for Non-invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - W Paulus
- Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
| | - S Rossi
- Brain Investigation & Neuromodulation Lab, Unit of Neurology and Clinical Neurophysiology, Department of Neuroscience, University of Siena, Siena, Italy
| | - J C Rothwell
- Institute of Neurology, University College London, London, United Kingdom
| | - H R Siebner
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Y Ugawa
- Department of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - V Walsh
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - U Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
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Opitz A, Paulus W, Will S, Antunes A, Thielscher A. Determinants of the electric field during transcranial direct current stimulation. Neuroimage 2015; 109:140-50. [PMID: 25613437 DOI: 10.1016/j.neuroimage.2015.01.033] [Citation(s) in RCA: 395] [Impact Index Per Article: 43.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 12/19/2014] [Accepted: 01/10/2015] [Indexed: 10/24/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) causes a complex spatial distribution of the electric current flow in the head which hampers the accurate localization of the stimulated brain areas. In this study we show how various anatomical features systematically shape the electric field distribution in the brain during tDCS. We constructed anatomically realistic finite element (FEM) models of two individual heads including conductivity anisotropy and different skull layers. We simulated a widely employed electrode montage to induce motor cortex plasticity and moved the stimulating electrode over the motor cortex in small steps to examine the resulting changes of the electric field distribution in the underlying cortex. We examined the effect of skull thickness and composition on the passing currents showing that thinner skull regions lead to higher electric field strengths. This effect is counteracted by a larger proportion of higher conducting spongy bone in thicker regions leading to a more homogenous current over the skull. Using a multiple regression model we could identify key factors that determine the field distribution to a significant extent, namely the thicknesses of the cerebrospinal fluid and the skull, the gyral depth and the distance to the anode and cathode. These factors account for up to 50% of the spatial variation of the electric field strength. Further, we demonstrate that individual anatomical factors can lead to stimulation "hotspots" which are partly resistant to electrode positioning. Our results give valuable novel insights in the biophysical foundation of tDCS and highlight the importance to account for individual anatomical factors when choosing an electrode montage.
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Affiliation(s)
- Alexander Opitz
- Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Germany; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; Center for the Developing Brain, Child Mind Institute, New York, NY 10022, USA.
| | - Walter Paulus
- Department of Clinical Neurophysiology, Georg-August-University, Göttingen, Germany
| | - Susanne Will
- Department of Diagnostic and Interventional Radiology, University Clinics of Tübingen, Germany
| | - Andre Antunes
- Max-Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Denmark; Biomedical Engineering Section, Technical University of Denmark, Kgs. Lyngby, Denmark; Max-Planck Institute for Biological Cybernetics, Tübingen, Germany
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Triesch J, Zrenner C, Ziemann U. Modeling TMS-induced I-waves in human motor cortex. PROGRESS IN BRAIN RESEARCH 2015; 222:105-24. [PMID: 26541378 DOI: 10.1016/bs.pbr.2015.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite many years of research, it is still unknown how exactly transcranial magnetic stimulation activates cortical circuits. A recent computational model by Rusu et al. (2014) has attempted to shed light on potential underlying mechanisms and has successfully explained key experimental findings on I-wave physiology. Here, we critically discuss this model, point out some of its shortcomings, and suggest a number of extensions that may be necessary for it to capture additional existing and emerging data on the physiology of I-waves.
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Affiliation(s)
- Jochen Triesch
- Frankfurt Institute for Advanced Studies, Goethe University, Frankfurt, Germany
| | - Christoph Zrenner
- Department of Neurology & Stroke, Hertie Institute for Clinical Brain Research, Eberhard-Karls University Tübingen, Germany
| | - Ulf Ziemann
- Department of Neurology & Stroke, Hertie Institute for Clinical Brain Research, Eberhard-Karls University Tübingen, Germany.
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Neggers SF, Petrov PI, Mandija S, Sommer IE, van den Berg NA. Understanding the biophysical effects of transcranial magnetic stimulation on brain tissue. PROGRESS IN BRAIN RESEARCH 2015; 222:229-59. [DOI: 10.1016/bs.pbr.2015.06.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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