Resting fMRI-guided TMS results in subcortical and brain network modulation indexed by interleaved TMS/fMRI

Oathes, Desmond J.; Zimmerman, Jared P.; Duprat, Romain; Japp, Seda S; Scully, Morgan; Rosenberg, Benjamin M.; Flounders, Matthew W.; Long, Haixia; Deluisi, Joseph; Elliott, Mark A.; Shandler, Gavriella; Shinohara, Russell T.; Linn, Kristin A.

doi:10.1007/s00221-021-06036-5

Cited by 48 publications

(55 citation statements)

References 53 publications

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“…Thus, this network effect can be used to target a deeper structure. Oathes et al ( 77 ) used a resting-state fMRI-guided sTMS system (randomized frequency, 120%RMT) to target an individual frontal area that is functionally connected with sgACC and amygdala. This study demonstrated that individually targeted TMS can modulate the sgACC distributed brain network, as well as the activity in the amygdala itself.…”

Section: Overview Of Previous Concurrent Tms-fmri Studiesmentioning

confidence: 99%

Concurrent TMS-fMRI: Technical Challenges, Developments, and Overview of Previous Studies

et al. 2022

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Transcranial magnetic stimulation (TMS) is a promising treatment modality for psychiatric and neurological disorders. Repetitive TMS (rTMS) is widely used for the treatment of psychiatric and neurological diseases, such as depression, motor stroke, and neuropathic pain. However, the underlying mechanisms of rTMS-mediated neuronal modulation are not fully understood. In this respect, concurrent or simultaneous TMS-fMRI, in which TMS is applied during functional magnetic resonance imaging (fMRI), is a viable tool to gain insights, as it enables an investigation of the immediate effects of TMS. Concurrent application of TMS during neuroimaging usually causes severe artifacts due to magnetic field inhomogeneities induced by TMS. However, by carefully interleaving the TMS pulses with MR signal acquisition in the way that these are far enough apart, we can avoid any image distortions. While the very first feasibility studies date back to the 1990s, recent developments in coil hardware and acquisition techniques have boosted the number of TMS-fMRI applications. As such, a concurrent application requires expertise in both TMS and MRI mechanisms and sequencing, and the hurdle of initial technical set up and maintenance remains high. This review gives a comprehensive overview of concurrent TMS-fMRI techniques by collecting (1) basic information, (2) technical challenges and developments, (3) an overview of findings reported so far using concurrent TMS-fMRI, and (4) current limitations and our suggestions for improvement. By sharing this review, we hope to attract the interest of researchers from various backgrounds and create an educational knowledge base.

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Section: Overview Of Previous Concurrent Tms-fmri Studiesmentioning

confidence: 99%

Concurrent TMS-fMRI: Technical Challenges, Developments, and Overview of Previous Studies

et al. 2022

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“…with a downstream region, if that region is strongly functionally connected to the cortical stimulation site 27,[38][39][40][41][42] . High functional connectivity sites near the vlPFC were given priority based on our pilot study 27 , the accessibility of this cortical area to TMS, and monkey tract-tracing work 7 .…”

Section: Diffusion Mrimentioning

confidence: 99%

“…The acute fMRI BOLD response to TMS takes several seconds to peak, thus a time delay can be incorporated prior to the fMRI readout to prevent compromising functional recordings. Moreover, single pulses of TMS briefly evoke neural activity without exerting cumulative effects on firing 27 , enabling the averaging of single trial fMRI responses to TMS.…”

Section: Introductionmentioning

confidence: 99%

Cortical-subcortical structural connections support transcranial magnetic stimulation engagement of the amygdala

Sydnor

Cieslak

Duprat

et al. 2021

Preprint

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The amygdala processes valenced stimuli, influences affective states, and exhibits aberrant activity across anxiety disorders, depression, and PTSD. Interventions that modulate amygdala activity hold promise for treating transdiagnostic affective symptoms. We investigated (N=45) whether transcranial magnetic stimulation (TMS) elicits indirect changes in amygdala activity when applied to ventrolateral prefrontal cortex (vlPFC), a region important for affect regulation. Harnessing in-scanner interleaved TMS/functional MRI (fMRI), we reveal that vlPFC neurostimulation evoked acute, dose-dependent modulations of amygdala fMRI BOLD signal. Larger TMS-evoked changes in amygdala fMRI signal were associated with higher fiber density in a vlPFC-amygdala white matter pathway, suggesting this pathway facilitated stimulation-induced communication between cortex and subcortex. This work provides evidence of amygdala engagement by TMS, highlighting stimulation of vlPFC-amygdala circuits as a candidate treatment for affective psychopathology. More broadly, it indicates that targeting cortical-subcortical connections may enhance the impact of TMS on subcortical neural activity and, by extension, subcortex-subserved behaviors.

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“…Concurrent TMS-fMRI was first performed by (Bohning et al, 1997), and experiments have been on the rise in both healthy (Bohning et al, 1997; Nahas et al, 2001; Denslow et al, 2005; Bestmann et al, 2008b; de Vries et al, 2009; Moisa et al, 2009, 2010; Li et al, 2011; Ricci et al, 2012; Hanlon et al, 2013; Schintu et al, 2021; Oathes et al, 2021) and clinical populations (Li et al, 2004; Bestmann et al, 2006; de Vries et al, 2012; Webler et al, 2020). This is not surprising given that this multimodal approach allows to, not only examine the altered brain connectivity patterns of neurological and psychiatric patients but, also to investigate how local stimulation of focal brain regions can alter those same connectivity patterns, in vivo .…”

Section: Introductionmentioning

confidence: 99%

Implementation of a TMS-fMRI system: A primer

Alamian

et al. 2021

Preprint

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Transcranial magnetic stimulation (TMS) is a non-invasive and non-pharmacological intervention, approved for the treatment of individuals diagnosed with treatment-resistant depression. This well-tolerated approach uses magnetic pulses to stimulate specific brain regions and induce changes in brain networks at multiple levels of human functioning. Combining TMS with other neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), offers new insights into brain functioning, and allows to map out the causal alterations brought on by TMS interventions on neural network connectivity and behaviour. However, the implemention of concurrent TMS-fMRI brings on a number of technical challenges that must be overcome to ensure good quality of functional images. The goal of this study was thus to investigate the impact of TMS pulses in an MR-environment on the quality of BRAINO phantom images, in terms of the signal of the images, the temporal fluctuation noise, the spatial noise and the signal to fluctuation noise ratio, at the University of British Columbia (UBC) Neuroimaging facility. The results of our analyses replicated those of previous sites, and showed that the present set-up for concurrent TMS-fMRI ensures minimal noise artefact on functional images obtained through this multimodal approach. This step was a key stepping stone for future clinical trials at UBC.

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Resting fMRI-guided TMS results in subcortical and brain network modulation indexed by interleaved TMS/fMRI

Cited by 48 publications

References 53 publications

Concurrent TMS-fMRI: Technical Challenges, Developments, and Overview of Previous Studies

Concurrent TMS-fMRI: Technical Challenges, Developments, and Overview of Previous Studies

Cortical-subcortical structural connections support transcranial magnetic stimulation engagement of the amygdala

Implementation of a TMS-fMRI system: A primer

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