Neuronavigation maximizes accuracy and precision in TMS positioning: Evidence from 11,230 distance, angle, and electric field modeling measurements

Caulfield, Kevin A.; Fleischmann, Holly; Cox, Claire; Wolf, Julia P; George, Mark S.; McTeague, Lisa M.

doi:10.1016/j.brs.2022.08.013

Cited by 47 publications

(29 citation statements)

References 57 publications

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“…A clinically friendly coil positioning approach for TMS is currently in demand [20][21]. Hence, this study focused on reducing the impacts of skin and hair on the coil positioning accuracy and head contact force of I-Helmet.…”

Section: Discussionmentioning

confidence: 99%

3D-Printed helmet-type Neuro-navigation approach (I-Helmet) for transcranial magnetic stimulation

Wang,

Cui,

Jin

et al. 2023

Preprint

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Neuro-navigation is a key technology to ensure the clinical efficacy of TMS. However, the neuro-navigation system based on positioning sensor is currently unable to be promoted and applied in clinical practice due to its time-consuming and high-cost. In the present study, we designed I-Helmet system to promote an individualized and clinically friendly neuro-navigation approach to TMS clinical application. I-Helmet system is based on C + + with a graphical user interface that allows users to design a 3D-printed helmet model for coil navigation. Besides, a dedicated coil positioning accuracy detection method was promoted based on three-dimensional (3D) printing and 3D laser scanning for evaluation. T1 images were collected from 24 subjects, and based on each image, phantom were created to simulate skin and hair. Six 3D-printed helmets with the head positioning hole enlarged by 0–5% tolerance in 1% increments were designed to evaluate the influences of skin, hair, and helmet-tolerance on the positioning accuracy and contact force of I-Helmet. Finally, I-Helmet system was evaluated by comparing its positioning accuracy with three skin hardnesses, three hair styles, three operators, and with or without landmarks. The accuracy of the proposed coil positioning accuracy detection method was about 0.30 mm in position and 0.22° in orientation. Skin and hair had significant influences on positioning accuracy (p < 0.0001), whereas different skin hardnesses, hair styles, and operators did not (p > 0.05). The tolerance of the helmet presented significant influences on positioning accuracy (p < 0.0001) and contact force (p < 0.0001). The positioning accuracy significantly increased (p < 0.0001) with landmark guided I-Helmet. 3D-printed helmet-type Neuro-navigation approach (I-Helmet) with 3% tolerance and landmarks met the positioning requirements for TMS in clinical practice with less than 5 N mean contact force, 3–5 mm positioning accuracy, 65.7 s mean operation time, and 50-yuan material cost.

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Section: Discussionmentioning

confidence: 99%

3D-Printed helmet-type Neuro-navigation approach (I-Helmet) for transcranial magnetic stimulation

Wang,

Cui,

Jin

et al. 2023

Preprint

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“…Neuronavigated TMS pulses were delivered through a single figure-of-eight 70mm Alpha Flat Coil (uncoated) connected to a paired-pulse BiStim 2 stimulator (MagStim, Whitland, UK). BrainSight (Rogue Research; Montreal, Canada) was used to ensure reliable coil positioning during every experiment and session 81 . The coil was positioned at a 45° angle in a posterior-anterior axis over the FDI motor hotspot of the left M1, defined as the area where MEPs of maximal amplitude could be reliably elicited with suprathreshold pulses in the right FDI.…”

Section: Methodsmentioning

confidence: 99%

The Neurochemical Mechanisms Underlying the Enhancing Effects of Rewards and Punishments on Motor Performance

Hamel

Pearson

Sifi

et al. 2023

Preprint

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Monetary rewards and punishments enhance motor performance and are associated with corticospinal excitability (CSE) increases within the motor cortex (M1) during movement preparation. However, such CSE changes have unclear origins; they could stem from increased glutamatergic (GLUTergic) facilitation and/or decreased type A gamma-aminobutyric acid (GABAA)-mediated inhibition within M1. To investigate this, paired-pulse transcranial magnetic stimulation was used to assess GLUTergic facilitation and GABAA inhibition within M1 whilst participants prepared to execute 4-element finger-press sequences. Behaviourally, rewards and punishments enhanced both reaction and movement times. Neurochemically, regardless of rewards or punishments, a digit-specific increase in GLUTergic facilitation and digit-unspecific decrease in GABAA inhibition occurred during preparation as movement onset approached. In parallel, both rewards and punishments non-specifically increased GLUTergic facilitation, but only rewards non-specifically decreased GABAA inhibition during preparation. This suggests that, to enhance performance, rewards both increase GLUTergic facilitation and decrease GABAA inhibition whilst punishments selectively increase GLUTergic facilitation. A control experiment revealed that such changes were not observed post-movement as participants processed reward and punishment feedback, indicating they were selective to movement preparation. Collectively, these results map the neurochemical changes in M1 by which incentives enhance motor performance.

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“…Neuronavigated TMS pulses were delivered over M1 through a single figure-of-eight 70mm Alpha Flat Coil (taped) connected to a paired-pulse BiStim 2 stimulator (MagStim, Whitland, UK) 29 . The coil was positioned at a 45° angle in a posterior-anterior axis over the FDI motor hotspot.…”

Section: Methodsmentioning

confidence: 99%

Bilateral Intracortical Inhibition during Unilateral Motor Preparation and Sequence Learning

Hamel,

Waltzing,

Hinder

et al. 2023

Preprint

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Motor sequence learning gradually quickens reaction time, suggesting that sequence learning alters motor preparation processes. Interestingly, evidence has shown that preparing sequence movements decreases short intracortical inhibition (SICI) in the contralateral motor cortex (M1), but also that sequence learning alters motor preparation processes in both the contralateral and ipsilateral M1s. Therefore, one possibility is that sequence learning alters the SICI decreases occurring during motor preparation in bilateral M1s. To examine this, two novel hypotheses were tested: unilateral sequence preparation would decrease SICI in bilateral M1s, and sequence learning would alter such bilateral SICI responses. Paired-pulse transcranial magnetic stimulation was delivered over the contralateral and ipsilateral M1s to assess SICI in an index finger muscle during the preparation of sequences initiated by either the right index or little finger. In the absence of sequence learning, SICI decreased in both the contralateral and ipsilateral M1s during the preparation of sequences initiated by the right index finger, suggesting that SICI decreases in bilateral M1s during unilateral motor preparation. As sequence learning progressed, SICI decreased in the contralateral M1 whilst it increased in the ipsilateral M1. Moreover, these bilateral SICI responses were observed at the onset of motor preparation, suggesting that sequence learning altered baseline SICI levels rather than the SICI decreases occurring during motor preparation per se. Altogether, these results suggest that SICI responses in bilateral M1s reflect two motor processes: an acute decrease of inhibition during motor preparation, and a cooperative but bidirectional shift of baseline inhibition levels as sequence learning progresses.

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Neuronavigation maximizes accuracy and precision in TMS positioning: Evidence from 11,230 distance, angle, and electric field modeling measurements

Cited by 47 publications

References 57 publications

3D-Printed helmet-type Neuro-navigation approach (I-Helmet) for transcranial magnetic stimulation

3D-Printed helmet-type Neuro-navigation approach (I-Helmet) for transcranial magnetic stimulation

The Neurochemical Mechanisms Underlying the Enhancing Effects of Rewards and Punishments on Motor Performance

Bilateral Intracortical Inhibition during Unilateral Motor Preparation and Sequence Learning

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