Electrical field measurements and simulations of the H7 and D-B80 coils: Non-equivalence of the TMS coils for obsessive compulsive disorder

Tzirini, Marietta; Roth, Yiftach; Harmelech, Tal; Zibman, Samuel; Pell, Gaby S.; Kimiskidis, Vasilios Κ.; Tendler, Aron; Zangen, Abraham; Samaras, Theodoros

doi:10.1016/j.brs.2021.10.382

Cited by 10 publications

(11 citation statements)

References 13 publications

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“…In previous open studies or RCTs that did not include a sham arm (17)(18)(19)(20), which included overall 482 MDD patients treated with the D-B80 coil over the MPFC, the weighted average response and remission rates were 41.4% and 31.5%, respectively, which are lower than the rates of 64.2% and 48.2% obtained in the present study following treatment with the H7 Coil. Comparison outcomes in various trials are limited due to variations in the protocol such as number of pulses, stimulation frequency, precise positioning and orientation, yet this discrepancy may be at least partially attributed to the much deeper and broader stimulation of the H7 Coil, which recruits much more MPFC-ACC structures associated with the reward system (22).…”

Section: Discussionmentioning

confidence: 99%

“…A sham-controlled study (21) found a significant effect in favor of the D-B80 coil (n=13) vs. figure-of-8 coil (n=15), but no significant effects for the D-B80 vs. sham stimulation (n=12), at the end of treatment (week 3). In addition, the MPFC and ACC are targeted by the Deep TMS H7 Coil, which stimulates significantly deeper and broader brain volume relative to the D-B80 coil (22). While the H7 Coil is used primarily for the treatment of obsessive-compulsive disorder (OCD) (23), recent preliminary results indicated that it can also induce significant antidepressant effects in MDD patients who failed treatment with the Deep TMS H1 Coil (24) The purpose of the current multicenter RCT was to explore whether the efficacy of the H7 Coil is non-inferior to that of the FDA-cleared H1 Coil in subjects with MDD, with the eventual goal of providing clinicians multiple options for patient treatment.…”

Section: Introductionmentioning

confidence: 99%

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Pursuing personalized medicine for depression by targeting the lateral or medial prefrontal cortex with Deep TMS

et al. 2023

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pursuing personalized medicine for depression by targeting the lateral or medial prefrontal cortex with Deep TMS

et al. 2023

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“…We performed analysis of the electric field (EF) distributions of the two coils using both measurements and simulations. A comparison of the volume and depth of stimulation in the whole brain found significant differences between the two coils [ 13 ]. The present work includes extensive and detailed characterization of the EF induced by the two coils in the brain as well as in specific brain structures.…”

Section: Introductionmentioning

confidence: 99%

Detailed measurements and simulations of electric field distribution of two TMS coils cleared for obsessive compulsive disorder in the brain and in specific regions associated with OCD

Tzirini

Roth

Harmelech³

et al. 2022

PLoS ONE

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The FDA cleared deep transcranial magnetic stimulation (Deep TMS) with the H7 coil for obsessive-compulsive disorder (OCD) treatment, following a double-blinded placebo-controlled multicenter trial. Two years later the FDA cleared TMS with the D-B80 coil on the basis of substantial equivalence. In order to investigate the induced electric field characteristics of the two coils, these were placed at the treatment position for OCD over the prefrontal cortex of a head phantom, and the field distribution was measured. Additionally, numerical simulations were performed in eight Population Head Model repository models with two sets of conductivity values and three Virtual Population anatomical head models and their homogeneous versions. The H7 was found to induce significantly higher maximal electric fields (p<0.0001, t = 11.08) and to stimulate two to five times larger volumes in the brain (p<0.0001, t = 6.71). The rate of decay of electric field with distance is significantly slower for the H7 coil (p < 0.0001, Wilcoxon matched-pairs test). The field at the scalp is 306% of the field at a 3 cm depth with the D-B80, and 155% with the H7 coil. The H7 induces significantly higher intensities in broader volumes within the brain and in specific brain regions known to be implicated in OCD (dorsal anterior cingulate cortex (dACC), dorsolateral prefrontal cortex (dlPFC), inferior frontal gyrus (IFG), orbitofrontal cortex (OFC) and pre-supplementary motor area (pre-SMA)) compared to the D-B80. Significant field ≥ 80 V/m is induced by the H7 (D-B80) in 15% (1%) of the dACC, 78% (29%) of the pre-SMA, 50% (20%) of the dlPFC, 30% (12%) of the OFC and 15% (1%) of the IFG. Considering the substantial differences between the two coils, the clinical efficacy in OCD should be tested and verified separately for each coil.

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Section: Introductionmentioning

confidence: 99%

“…4 Two years later another coil, D-B80 coil, was cleared by FDA for therapeutic use, however, a recent study compared the both FDA-cleared coils and proposed that some OCD specific prefrontal regions which constructs CSTC can be stimulated by H7 coil but not by D-B80 coil. 5 The clinical trial investigating clinical and electrophysiological effects of deep TMS effects on OCD patients applied 25 sessions H7 coil OCD protocol five times per week for 5 weeks. 2 Before the first sessions and after the last session, event related potentials (ERPs) of the patients were recorded using an electroencephalogram (EEG).…”

Section: Introductionmentioning

confidence: 99%

Deep Transcranial Magnetic Stimulation Effects on the Electrophysiological Parameters in Obsessive-Compulsive Disorder

Arıkan¹,

İlhan²,

Esmeray³

et al. 2022

Clin EEG Neurosci

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Backgrounds. Deep Transcranial Magnetic Stimulation (dTMS) is a non-invasive treatment cleared by FDA as a safe and efficient intervention for the treatment of depression and obsessive-compulsive disorder (OCD). Objectives. In this retrospective single-center study, the effects of dTMS on the electrophysiological parameters and the clinical outcomes of patients with OCD were tested. Methods. Thirty sessions of dTMS were administered to 29 OCD patients (15 female and 14 male). Quantitative electroencephalography (QEEG) recordings and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were measured at baseline and endpoint. Paired sample t-test was used to measure the change in Y-BOCS scores and QEEG activity after dTMS practice. Results. All 29 patients responded to the dTMS intervention by indicating at least 35% reduction in Y-BOCS scores. QEEG recordings revealed a significant decrease in theta, alpha and the beta rhythms. The decrease in the severity of OCD symptoms correlated with the decrease in beta activity at left central region. Conclusions. Historically, excess fast oscillations in OCD are correlated with the unresponsiveness to selective serotonin reuptake inhibitor (SSRI) treatment. We hypothesize that the decrease in the power of beta bands by deep TMS is related to the mechanism of the therapeutic response.

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Electrical field measurements and simulations of the H7 and D-B80 coils: Non-equivalence of the TMS coils for obsessive compulsive disorder

Cited by 10 publications

References 13 publications

Pursuing personalized medicine for depression by targeting the lateral or medial prefrontal cortex with Deep TMS

Pursuing personalized medicine for depression by targeting the lateral or medial prefrontal cortex with Deep TMS

Detailed measurements and simulations of electric field distribution of two TMS coils cleared for obsessive compulsive disorder in the brain and in specific regions associated with OCD

Deep Transcranial Magnetic Stimulation Effects on the Electrophysiological Parameters in Obsessive-Compulsive Disorder

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