Whole-Brain TMS Targeting With Personalized Connectivity Mapping
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Solution Overview
Problem
Current transcranial magnetic stimulation (TMS) treatments for neuropsychiatric disorders, particularly for treatment-resistant depression, lack precise targeting, resulting in suboptimal response and remission rates due to non-specific stimulation of the left dorsolateral prefrontal cortex (DLPFC) without differentiation among its subregions.
Innovation Solution
A personalized TMS treatment approach using functional and structural connectivity analysis, including fMRI and dMRI, to identify multiple target regions and networks within the brain for precise stimulation, utilizing resting-state functional connectivity and blood oxygenation level-dependent imaging to determine optimal treatment locations based on individual patient characteristics.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional TMS treatment uses a standardized protocol targeting the left DLPFC based on approximate anatomical landmarks, then the treatment procedure is simple and easy to implement, but the targeting precision is insufficient and cannot differentiate among DLPFC subregions
Solution Approach 1:
The patent applies preliminary action by performing functional connectivity MRI (fcMRI) and diffusion MRI (dMRI) scanning before TMS treatment to map individual patient brain connectivity patterns. This pre-treatment mapping identifies specific target regions and networks, allowing personalized stimulation protocols to be designed in advance based on each patient's unique brain circuitry, thereby improving targeting precision without requiring complex real-time adjustments during treatment.
Solution Approach 2:
The patent implements local quality by transitioning from standardized anatomical landmarks to personalized functional connectivity-based targeting. By identifying specific brain regions and networks with abnormal connectivity patterns using fcMRI and dMRI, the treatment targets locally specific dysfunctional circuits rather than applying uniform stimulation across the entire DLPFC, thereby enhancing therapeutic precision for individual patients.
2Reliability
If TMS treatment uses standardized anatomical landmarks for coil placement, then the treatment protocol is easy to operate, but the response and remission rates remain suboptimal at 41.2% and 35.3%
Solution Approach 1:
The patent applies feedback by using fcMRI and dMRI to assess each patient's baseline brain connectivity patterns and treatment response. The imaging data provides feedback on which brain networks are dysfunctional, allowing clinicians to adjust stimulation parameters and target selection based on individual patient responses, thereby improving treatment efficacy through personalized, data-driven decision-making.
Solution Approach 2:
The patent implements parameter changes by moving from fixed anatomical landmark-based coil placement to dynamic, patient-specific target selection based on functional connectivity parameters. Treatment parameters such as stimulation frequency, intensity, and duration are customized according to individual brain imaging findings, transforming the standardized protocol into a personalized treatment plan that adapts to each patient's neurological profile.
3Adaptability or versatility
If conventional TMS uses a single standardized target location, then the treatment procedure is straightforward, but it fails to address multiple dysfunctional brain networks involved in neuropsychiatric disorders
Solution Approach 1:
The patent applies segmentation by dividing the brain into distinct functional networks and regions based on fcMRI and dMRI data. Instead of treating the DLPFC as a single homogeneous target, the methodology identifies and segments multiple dysfunctional circuits and networks, allowing selective stimulation of specific pathological pathways while sparing healthy brain regions, thereby enabling personalized multi-target treatment plans.
Solution Approach 2:
The patent implements another dimension by adding the functional connectivity dimension to traditional anatomical targeting. Rather than relying solely on three-dimensional anatomical coordinates, the methodology incorporates functional network architecture as an additional dimension for target selection, allowing identification of distributed brain regions that form dysfunctional circuits, thereby enabling comprehensive multi-network treatment approaches.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enhances treatment efficacy by improving response and remission rates through personalized targeting of brain regions and networks, providing a more precise and effective TMS treatment for neuropsychiatric disorders.
Implementation Method 1
TMS uses short, magnetic field pulses to induce electrical currents in underlying cortical tissue. Through electromagnetic induction, the TMS coil induce an electric current inside the brain at pre-determined targets when a magnetic pulse is delivered to the coil that is placed on top of the patient's skull.
Implementation Method 2
The comparisons of brain regions and networks are made based on covariation of the variations of the spontaneous blood oxygenation level over time. Embodiments herein may use resting-stated functional connectivity to assess brain activity. The resting-state functional connectivity may be based on changes in the blood oxygenation level of the brain over time. Embodiments herein may use blood oxygenation level dependent (BOLD) imaging to generate images in functional magnetic resonance imaging (fMRI).
Data Source
AI summary
Targeted and individualized methods are provided herein for determining specific treatment sites based on an individual patient. Embodiments described herein may use functional and/or structural connections to create brain mapping of the patient and/or control groups having the same metrics as the patient, and combinations thereof in determining target locations for stimulation treatment.