Journal article
A new angle on transcranial magnetic stimulation coil orientation: A targeted narrative review
Biological psychiatry : cognitive neuroscience and neuroimaging, Vol.9(8), pp.744-753
05/08/2024
DOI: 10.1016/j.bpsc.2024.04.018
PMCID: PMC12221855
PMID: 38729243
Abstract
Transcranial magnetic stimulation (TMS) is used to treat several neuropsychiatric disorders including depression, where it is effective in approximately half of patients for whom pharmacological approaches have failed. Treatment response is related to stimulation parameters such as the stimulation frequency, pattern, intensity, location, total number of pulses and sessions applied, as well as target brain network engagement. One critical but underexplored component of the stimulation procedure is the orientation or yaw angle of the commonly used figure-of-eight TMS coil, which is known to impact neuronal response to TMS. However, coil orientation has remained largely unchanged since TMS was first used to treat depression and continues to be based on motor cortex anatomy which may not be optimal for the dorsolateral prefrontal cortex treatment site. This targeted narrative review evaluates experimental, clinical, and computational evidence indicating that optimizing coil orientation may potentially improve TMS treatment outcomes. The properties of the electric field induced by TMS, the changes to this field caused by the differing conductivities of head tissues, and the interaction between coil orientation and the underlying cortical anatomy are summarized. We describe evidence that the magnitude and site of cortical activation, surrogate markers of TMS dosing and brain network targeting considered central in clinical response to TMS, are influenced by coil orientation. We suggest that coil orientation should be considered when applying therapeutic TMS and propose several approaches to optimizing this potentially important treatment parameter.
Details
- Title: Subtitle
- A new angle on transcranial magnetic stimulation coil orientation: A targeted narrative review
- Creators
- Andris Cerins - Monash UniversityElizabeth H.X. Thomas - Monash UniversityTracy Barbour - Massachusetts General HospitalJoseph J. Taylor - Brigham and Women's HospitalShan H. Siddiqi - Brigham and Women's HospitalNicholas Trapp - University of IowaAlexander McGirr - University of CalgaryKevin A. Caulfield - Medical University of South CarolinaJoshua C. Brown - McLean HospitalLeo Chen - Monash University
- Resource Type
- Journal article
- Publication Details
- Biological psychiatry : cognitive neuroscience and neuroimaging, Vol.9(8), pp.744-753
- DOI
- 10.1016/j.bpsc.2024.04.018
- PMID
- 38729243
- PMCID
- PMC12221855
- NLM abbreviation
- Biol Psychiatry Cogn Neurosci Neuroimaging
- ISSN
- 2451-9022
- eISSN
- 2451-9030
- Publisher
- Elsevier Inc
- Grant note
- National Institute of Mental Health: 1K23MH125145 Brain and Behavior Research Foundation: 31275, 31081, 28705, 31748 National Institutes of Health: K23MH129829, R01MH113929, R21MH12671, R21AA030372, K23MH121657, R21MH126271 Department of Veterans Affairs: I01CX002293 Department of Defense Advanced Research Projects Agency: HR00112320037
This work was supported by the National Institute of Mental Health (Grant No. 1K23MH125145 [to NT]), Brain and Behavior Research Foundation Young Investigator (Grant Nos. 31275 [to NT], 31081 [to JJT], and 28705 [to SHS]), National Institutes of Health (Grant Nos. K23MH129829, R01MH113929, R21MH12671, and R21AA030372 [to JJT] and K23MH121657 and R21MH126271 [to SHS]), Neuronetics investigator-initiated grant, Baszucki Brain Research Fund (to SHS), Department of Veterans Affairs (Grant No. I01CX002293 [to SHS]), Brain and Behavior Research Foundation (Grant No. 31748 [to JCB]), Department of Defense Advanced Research Projects Agency (Grant No. HR00112320037 [to JCB]), and by philanthropic funding from the Blue Sky Foundation and the Natwes Foundation (to LC).TB is a site principal investigator for a clinical trial funded by Magnus Medical and has received in-kind equipment for research from Magnus Medical. AM reports funding from the Canadian Institutes of Health Research and the Natural Sciences Research and Engineering Council of Canada as well as his patents on augmentation of TMS with adjunctive d-cycloserine (63/282,297 and 63/193,643). KAC is a consultant for Magnus Medical. SHS is owner of intellectual property involving the use of brain connectivity to target TMS, is a scientific consultant for Magnus Medical, has received investigator-initiated research funding from Neuronetics and Brainsway and speaking fees from Brainsway and Otsuka (for PsychU.org), and is a shareholder in Brainsway (publicly traded) and Magnus Medical (not publicly traded). None of these entities were directly involved in the current work. All other authors report no biomedical financial interests or potential conflicts of interest.
- Language
- English
- Electronic publication date
- 05/08/2024
- Academic Unit
- Psychiatry; Iowa Neuroscience Institute
- Record Identifier
- 9984627153402771
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