Automated optimization of TMS coil placement for personalized functional network engagement

• Published in: Neuron (Cambridge, Mass.) Vol. 110; no. 20; pp. 3263 - 3277.e4
• Main Authors: Lynch, Charles J., Elbau, Immanuel G., Ng, Tommy H., Wolk, Danielle, Zhu, Shasha, Ayaz, Aliza, Power, Jonathan D., Zebley, Benjamin, Gunning, Faith M., Liston, Conor
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 19-10-2022
• Subjects: Brain - physiology; Brain Mapping; electric field modeling; functional brain networks; Head; Humans; Magnetic Resonance Imaging; precision functional mapping; Transcranial Magnetic Stimulation; transcranial magnetic stimulation; electric field modeling; precision functional mapping; functional brain networks
• ISSN: 0896-6273; 1097-4199; 1097-4199
• DOI: 10.1016/j.neuron.2022.08.012

Transcranial magnetic stimulation (TMS) is used to treat multiple psychiatric and neurological conditions by manipulating activity in particular brain networks and circuits, but individual responses are highly variable. In clinical settings, TMS coil placement is typically based on either group average functional maps or scalp heuristics. Here, we found that this approach can inadvertently target different functional networks in depressed patients due to variability in their functional brain organization. More precise TMS targeting should be feasible by accounting for each patient’s unique functional neuroanatomy. To this end, we developed a targeting approach, termed targeted functional network stimulation (TANS). The TANS approach improved stimulation specificity in silico in 8 highly sampled patients with depression and 6 healthy individuals and in vivo when targeting somatomotor functional networks representing the upper and lower limbs. Code for implementing TANS and an example dataset are provided as a resource.
•Current TMS targeting approaches stimulate different functional networks across patients•A method for selective stimulation of patient-specific functional networks is introduced•Targeted functional network stimulation (TANS) improves stimulation specificity•Code for implementing TANS and an example dataset are provided as a public resource
Transcranial magnetic stimulation (TMS) is used to treat multiple psychiatric and neurological conditions by manipulating activity in particular brain networks and circuits. Lynch et al. demonstrate that more precise TMS targeting is possible by accounting for each patient’s unique functional neuroanatomy and cortical folding patterns using their method called targeted functional network stimulation (TANS).