Genetic Algorithm for TMS Coil Position Optimization in Stroke Treatment

Precision non-invasive brain stimulation: anin silicopipeline for personalized control of brain dynamics

Objective.Non-invasive brain stimulation (NIBS) offers therapeutic benefits for various brain disorders. Personalization may enhance these benefits by optimizing stimulation parameters for individual subjects.Approach.We present a computational pipeline for simulating and assessing the effects of NIBS using personalized, large-scale brain network activity models. Using structural MRI and diffusion-weighted imaging data, the pipeline leverages a convolutional neural network-based segmentation algorithm to generate subject-specific head models with up to 40 tissue types and personalized dielectric properties. We integrate electromagnetic simulations of NIBS exposure with whole-brain network models to predict NIBS-dependent perturbations in brain dynamics, simulate the resulting EEG traces, and quantify metrics of brain dynamics.Main results.The pipeline is implemented on o2S2PARC, an open, cloud-based infrastructure designed for collaborative and reproducible computational life science. Furthermore, a dedicated planning tool provides guidance for optimizing electrode placements for transcranial temporal interference stimulation. In two proof-of-concept applications, we demonstrate that: (i) transcranial alternating current stimulation produces expected shifts in the EEG spectral response, and (ii) simulated baseline network activity exhibits physiologically plausible fluctuations in inter-hemispheric synchronization.Significance.This pipeline facilitates a shift from exposure-based to response-driven optimization of NIBS, supporting new stimulation paradigms that steer brain dynamics towards desired activity patterns in a controlled manner.

Clinical application of repetitive transcranial magnetic stimulation in the treatment of chronic pelvic pain syndrome: a scoping review

Introduction

Chronic pelvic pain syndrome is a common condition characterized by persistent symptoms that are difficult to treat. Repetitive transcranial magnetic stimulation (rTMS) is considered a safe treatment option for alleviating chronic pelvic pain, but different stimulation protocols can affect pain relief outcomes. Establishing an optimal stimulation protocol can enhance the uniformity and consistency of rTMS to provide a potentially effective therapeutic intervention. This review sought to systematically review and assess the existing literature on transcranial magnetic stimulation in patients experiencing chronic pelvic pain syndrome, evaluate the therapeutic efficacy, and determine the most effective stimulation protocol.

Methods

A comprehensive search was conducted across three databases, supplemented by manual searches. Two researchers independently reviewed and extracted relevant studies and subsequently performed a thorough analysis of all available clinical data.

Results

A total of eight studies were ultimately incorporated into the analysis. These comprised two randomized controlled trials, one self-controlled trial, two case reports, and three prospective studies. All studies demonstrated a notable reduction in pain scores post-treatment.

Conclusion

rTMS has demonstrated efficacy in alleviating pain in individuals suffering from chronic pelvic pain syndrome. It is regarded as a safe intervention with minimal adverse effects. Nonetheless, the variability observed across studies hindered our ability to conclusively determine the most effective stimulation sites and parameters. Additional research is essential to reduce bias, enhance methodological rigor, and ascertain the optimal conditions and indications for brain stimulation to optimize the therapeutic effectiveness of rTMS.

Systematic Review Registration

https://inplasy.com/projects/, identifier INPLASY2023120112.

Electric Field Modeling in Personalizing Transcranial Magnetic Stimulation Interventions

The modeling of transcranial magnetic stimulation (TMS)-induced electric fields (E-fields) is a versatile technique for evaluating and refining brain targeting and dosing strategies, while also providing insights into dose-response relationships in the brain. This review outlines the methodologies employed to derive E-field estimations, covering TMS physics, modeling assumptions, and aspects of subject-specific head tissue and coil modeling. We also summarize various numerical methods for solving the E-field and their suitability for various applications. Modeling methodologies have been optimized to efficiently execute numerous TMS simulations across diverse scalp coil configurations, facilitating the identification of optimal setups or rapid cortical E-field visualization for specific brain targets. These brain targets are extrapolated from neurophysiological measurements and neuroimaging, enabling precise and individualized E-field dosing in experimental and clinical applications. This necessitates the quantification of E-field estimates using metrics that enable the comparison of brain target engagement, functional localization, and TMS intensity adjustments across subjects. The integration of E-field modeling with empirical data has the potential to uncover pivotal insights into the aspects of E-fields responsible for stimulating and modulating brain function and states, enhancing behavioral task performance, and impacting the clinical outcomes of personalized TMS interventions.

Narrative Review of Noninvasive Brain Stimulation in Stroke Rehabilitation

Stroke is a disease with a high incidence and disability rate, resulting in changes in neural network and corticoid-subcortical excitability and various functional disabilities. The aim of the present study was to discuss the current status of research and limitations and potential direction in the application of noninvasive brain stimulation (NIBS) on post-stroke patients. This literature review focused on clinical studies and reviews. Literature retrieval was conducted in PubMed, Cochrane, Scopus, and CNKI, using the following keywords: Repeated transcranial magnetic stimulation, Transcranial direct current stimulation, Transcranial alternating current stimulation, Transcranial alternating current stimulation, Transcranial focused ultrasound, Noninvasive vagus nerve stimulation, Stroke, and Rehabilitation. We selected 200 relevant publications from 1985 to 2022. An overview of recent research on the use of NIBS on post-stroke patients, including its mechanism, therapeutic parameters, effects, and safety, is presented. It was found that NIBS has positive therapeutic effects on dysfunctions of motor, sensory, cognitive, speech, swallowing, and depression after stroke, but standardized stimulus programs are still lacking. The literature suggests that rTMS and tDCS are more beneficial to post-stroke patients, while tFUS and tVNS are currently less studied for post-stroke rehabilitation, but are also potential interventions.