Targeting of White Matter Tracts With Transcranial Magnetic Stimulation. 


Author: Nummenmaa A, McNab JA, Savadjiev P, Okada Y, Hämäläinen MS, Wang R, Wald LL, Pascual-Leone A, Wedeen VJ, Raij T.

Affiliation: MGH/MIT/HMS Athinoula A. Martinos Center for Biomedical Imaging, MA, USA; Harvard Medical School, MA, USA. 
Conference/Journal: Brain Stimul.
Date published: 2013 Oct 16
Other:
  Pages: S1935-861X(13)00296-9   ,  Special Notes: doi: 10.1016/j.brs.2013.10.001   ,  Word Count: 201  
    

BACKGROUND:

TMS activations of white matter depend not only on the distance from the coil, but also on the orientation of the axons relative to the TMS-induced electric field, and especially on axonal bends that create strong local field gradient maxima. Therefore, tractography contains potentially useful information for TMS targeting.

OBJECTIVE/METHODS:

Here, we utilized 1-mm resolution diffusion and structural T1-weighted MRI to construct large-scale tractography models, and localized TMS white matter activations in motor cortex using electromagnetic forward modeling in a boundary element model (BEM).

RESULTS:

As expected, in sulcal walls, pyramidal cell axonal bends created preferred sites of activation that were not found in gyral crowns. The model agreed with the well-known coil orientation sensitivity of motor cortex, and also suggested unexpected activation distributions emerging from the E-field and tract configurations. We further propose a novel method for computing the optimal coil location and orientation to maximally stimulate a pre-determined axonal bundle.

CONCLUSIONS:

Diffusion MRI tractography with electromagnetic modeling may improve spatial specificity and efficacy of TMS.

Copyright © 2013 Elsevier Inc. All rights reserved.

KEYWORDS:

Coil orientation, DTI, Diffusion MRI tractography, Electromagnetic modeling, MRI, Navigation, TMS, Transcranial magnetic stimulation, diffusion tensor imaging, magnetic resonance imaging, transcranial magnetic stimulation



PMID: 24220599