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Proof of concept study to develop a novel connectivity-based electric-field modelling approach for individualized targeting of transcranial magnetic stimulation treatment.

Publication ,  Journal Article
Balderston, NL; Beer, JC; Seok, D; Makhoul, W; Deng, Z-D; Girelli, T; Teferi, M; Smyk, N; Jaskir, M; Oathes, DJ; Sheline, YI
Published in: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology
January 2022

Resting state functional connectivity (rsFC) offers promise for individualizing stimulation targets for transcranial magnetic stimulation (TMS) treatments. However, current targeting approaches do not account for non-focal TMS effects or large-scale connectivity patterns. To overcome these limitations, we propose a novel targeting optimization approach that combines whole-brain rsFC and electric-field (e-field) modelling to identify single-subject, symptom-specific TMS targets. In this proof of concept study, we recruited 91 anxious misery (AM) patients and 25 controls. We measured depression symptoms (MADRS/HAMD) and recorded rsFC. We used a PCA regression to predict symptoms from rsFC and estimate the parameter vector, for input into our e-field augmented model. We modeled 17 left dlPFC and 7 M1 sites using 24 equally spaced coil orientations. We computed single-subject predicted ΔMADRS/HAMD scores for each site/orientation using the e-field augmented model, which comprises a linear combination of the following elementwise products (1) the estimated connectivity/symptom coefficients, (2) a vectorized e-field model for site/orientation, (3) rsFC matrix, scaled by a proportionality constant. In AM patients, our connectivity-based model predicted a significant decrease depression for sites near BA9, but not M1 for coil orientations perpendicular to the cortical gyrus. In control subjects, no site/orientation combination showed a significant predicted change. These results corroborate previous work suggesting the efficacy of left dlPFC stimulation for depression treatment, and predict better outcomes with individualized targeting. They also suggest that our novel connectivity-based e-field modelling approach may effectively identify potential TMS treatment responders and individualize TMS targeting to maximize the therapeutic impact.

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Published In

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology

DOI

EISSN

1740-634X

ISSN

0893-133X

Publication Date

January 2022

Volume

47

Issue

2

Start / End Page

588 / 598

Related Subject Headings

  • Transcranial Magnetic Stimulation
  • Psychiatry
  • Proof of Concept Study
  • Magnetic Resonance Imaging
  • Humans
  • Brain Mapping
  • Brain
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 17 Psychology and Cognitive Sciences
 

Citation

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ICMJE
MLA
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Balderston, N. L., Beer, J. C., Seok, D., Makhoul, W., Deng, Z.-D., Girelli, T., … Sheline, Y. I. (2022). Proof of concept study to develop a novel connectivity-based electric-field modelling approach for individualized targeting of transcranial magnetic stimulation treatment. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, 47(2), 588–598. https://doi.org/10.1038/s41386-021-01110-6
Balderston, Nicholas L., Joanne C. Beer, Darsol Seok, Walid Makhoul, Zhi-De Deng, Tommaso Girelli, Marta Teferi, et al. “Proof of concept study to develop a novel connectivity-based electric-field modelling approach for individualized targeting of transcranial magnetic stimulation treatment.Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology 47, no. 2 (January 2022): 588–98. https://doi.org/10.1038/s41386-021-01110-6.
Balderston NL, Beer JC, Seok D, Makhoul W, Deng Z-D, Girelli T, et al. Proof of concept study to develop a novel connectivity-based electric-field modelling approach for individualized targeting of transcranial magnetic stimulation treatment. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2022 Jan;47(2):588–98.
Balderston, Nicholas L., et al. “Proof of concept study to develop a novel connectivity-based electric-field modelling approach for individualized targeting of transcranial magnetic stimulation treatment.Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, vol. 47, no. 2, Jan. 2022, pp. 588–98. Epmc, doi:10.1038/s41386-021-01110-6.
Balderston NL, Beer JC, Seok D, Makhoul W, Deng Z-D, Girelli T, Teferi M, Smyk N, Jaskir M, Oathes DJ, Sheline YI. Proof of concept study to develop a novel connectivity-based electric-field modelling approach for individualized targeting of transcranial magnetic stimulation treatment. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. 2022 Jan;47(2):588–598.

Published In

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology

DOI

EISSN

1740-634X

ISSN

0893-133X

Publication Date

January 2022

Volume

47

Issue

2

Start / End Page

588 / 598

Related Subject Headings

  • Transcranial Magnetic Stimulation
  • Psychiatry
  • Proof of Concept Study
  • Magnetic Resonance Imaging
  • Humans
  • Brain Mapping
  • Brain
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 17 Psychology and Cognitive Sciences