Application Of Transcranial Magnetic Stimulation Research Articles

Impact of Titanium Skull Plate on Transcranial Magnetic Stimulation: Analysis of Induced Electric Fields

Background: Implanted titanium skull plates (TSPs) in cranioplasty are used to replace or reconstruct areas of the skull that have been damaged or removed due to trauma, surgery, or other medical conditions. However, the presence of a TSP in the head may influence the distribution of the electric field induced during transcranial magnetic stimulation (TMS) procedures. The purpose of this study was to determine how the presence of TSP would interfere with TMS-induced cortical electric fields. Methods: The TMS with a figure-of-eight coil was applied to a realistic head model with TSPs. The distribution of the induced electric field in head tissues was calculated by employing the impedance method, and the results were compared with that of a normal head without TSP. Results: Simulation results show that the distribution of the induced electric field has changed greatly for the head model with TSP. The maximum value of the induced electric field in head tissues was present under one of the circular coil wings rather than in the tissues beneath the junction of the two wings of the Fo8 coil. Conclusions: The induced electric field in deep brain regions was increased for the head model with TSP, which could potentially lead to deep brain stimulation. Since the presence of metallic TSP can greatly influence the distribution of the induced electric field in TMS applications, it is important to adjust the treatment scheme when considering TMS for individuals with cranial titanium plates.

Pilot study with randomised control of dual site theta burst transcranial magnetic stimulation (TMS) for methamphetamine use disorder: a protocol for the TARTAN study

BackgroundTranscranial magnetic stimulation (TMS) (including the theta burst stimulation (TBS) form of TMS used in this study) is a non-invasive means to stimulate nerve cells in superficial areas of the brain. In recent years, there has been a growth in the application of TMS to investigate the modulation of neural networks involved in substance use disorders. This study examines the feasibility of novel TMS protocols for the treatment of methamphetamine (MA) use disorder in an ambulatory drug and alcohol treatment setting.MethodsThirty participants meeting the criteria for moderate to severe MA use disorder will be recruited in community drug and alcohol treatment settings and randomised to receive active TMS or sham (control) intervention. The treatment is intermittent TBS (iTBS) applied to the left dorsolateral prefrontal cortex (DLPFC), then continuous TBS (cTBS) to the left orbitofrontal cortex (OFC). Twelve sessions are administered over 4 weeks with opt-in weekly standardized cognitive behaviour therapy (CBT) counselling and a neuroimaging sub-study offered to participants. Primary outcomes are feasibility measures including recruitment, retention and acceptability of the intervention. Secondary outcomes include monitoring of safety and preliminary efficacy data including changes in substance use, cravings (cue reactivity) and cognition (response inhibition).DiscussionThis study examines shorter TBS protocols of TMS for MA use disorder in real-world drug and alcohol outpatient settings where withdrawal and abstinence from MA, or other substances, are not eligibility requirements. TMS is a relatively affordable treatment and staff of ambulatory health settings can be trained to administer TMS. It is a potentially scalable and translatable treatment for existing drug and alcohol clinical settings. TMS has the potential to provide a much-needed adjuvant treatment to existing psychosocial interventions for MA use disorder. A limitation of this protocol is that the feasibility of follow-up is only examined at the end of treatment (4 weeks).Trial registrationAustralia New Zealand Clinical Trial Registry ACTRN12622000762752. Registered on May 27, 2022, and retrospectively registered (first participant enrolled) on May 23, 2022, with protocol version 7 on February 24, 2023.

Investigational applications of transcranial magnetic stimulation (TMS) in Mood Disorders: Studies from a tertiary care center in India

The investigational potential of TMS in psychiatry is largely underutilized. In the current article, we present the results of five studies with similar TMS protocols that looked at the investigative applications of TMS via measuring cortical reactivity as potential biomarkers in mood disorders. The first two studies, evaluate potential of TMS parameters and Motor neuron system (MNS) as state or trait markers of BD. Third and fourth studies evaluate these as endophenotypic markers of BD. The fifth study which is an RCT evaluating add-on yoga in UD, evaluates if markers of CI can index the therapeutic response of yoga. In study one MT1 was significantly greater in the SM (symptomatic-mania) group compared to HC (healthy-control) (P=0.032). The cortical inhibition measures SICI was reduced in SM(P=0.021) and BD (remitted Bipolar) (P=0.023) groups compared to HC. LICI was increased in the SM(0.021) and BD(P=0.06) groups compared to HC. In study two, a significant group x time interaction effect was observed indicating higher putative MNS-activity mediation in patients compared to HC on SlCl(P=0.024), LlCl(P=0.033). There were no significant group differences noted in the endophenotype studies. The fifth study showed a significant time X group interaction for CSP, favoring improvement in YG (yoga-group) (p<0.01).No significant change was observed for LICI(p=0.2), SICI(p=0.5). Limitations of these studies notwithstanding, we conclude that cortical reactivity measured using TMS is a potential biomarker across the course of mood disorders, starting from state and trait markers to understanding the therapeutic mechanism of a particular treatment modality in these disorders.

A review of algorithms and software for real-time electric field modeling techniques for transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) is a device-based neuromodulation technique increasingly used to treat brain diseases. Electric field (E-field) modeling is an important technique in several TMS clinical applications, including the precision stimulation of brain targets with accurate stimulation density for the treatment of mental disorders and the localization of brain function areas for neurosurgical planning. Classical methods for E-field modeling usually take a long computation time. Fast algorithms are usually developed with significantly lower spatial resolutions that reduce the prediction accuracy and limit their usage in real-time or near real-time TMS applications. This review paper discusses several modern algorithms for real-time or near real-time TMS E-field modeling and their advantages and limitations. The reviewed methods include techniques such as basis representation techniques and deep neural-network-based methods. This paper also provides a review of software tools that can integrate E-field modeling with navigated TMS, including a recent software for real-time navigated E-field mapping based on deep neural-network models.

Application of Transcranial Magnetic Stimulation for the Treatment of Residual Catatonia

Catatonia is a common syndrome among psychiatric patients, diagnosed in 20-43% of cases. Treatment methods for patients with catatonia are limited to the use of benzodiazepines and ECT in the acute period, and the problem of anti-relapse and maintenance therapy remains one of the most difficult. Currently, transcranial magnetic stimulation is a promising approach in the treatment of catatonia. The purpose of the study was to evaluate the possibility of using the method of transcranial magnetic stimulation of the brain in patients with schizophrenia in remission with residual catatonic symptoms. Material and methods. 50 patients diagnosed with schizophrenia and residual catatonic symptoms were examined by clinical and psychometric methods and divided into 2 groups (therapeutic and comparison groups) to prospectively evaluate the effectiveness of transcranial magnetic stimulation for 4 weeks. Results. Transcranial magnetic stimulation of the DLPFC on the left in patients with residual catatonia TMS turned out to be effective and safe a tendency was revealed to reduce psychomotor impairments that made up the clinical picture before the start of stimulation, along with an improvement in basic cognitive functions. Conclusions. Augmentation of standard psychopharmacotherapy protocols with TMS is effective for the correction of psychomotor symptoms.

Knowledge and attitude toward transcranial magnetic stimulation among rehabilitation specialists in Saudi Arabia.

Research has demonstrated the benefits of transcranial magnetic stimulation (TMS) in rehabilitation. TMS has been widely used in clinical and research settings for individuals with and without neurological dysfunctions. Therefore, understanding the knowledge and attitudes of rehabilitation specialists regarding TMS is crucial for its application. To our knowledge, no such studies have previously been conducted in the rehabilitation field. Therefore, this study is the first to assess rehabilitation specialists' knowledge of and attitudes toward TMS. An observational cross-sectional study using a self-administered online survey was conducted among 102 rehabilitation specialists to assess their knowledge and attitudes regarding TMS application in rehabilitation sciences. Descriptive and inferential statistics were used to describe the knowledge and attitudes of rehabilitation specialists toward TMS and examine the impact of different factors such as gender, education level, acceptability, and practice on these outcomes. Rehabilitation specialists who participated in this study showed a limited level of general knowledge of TMS in rehabilitation (7.81 ± 6.20, 37.19%). However, a significant association between educational levels and knowledge was found. Higher knowledge scores were observed for specialists with post-graduate degrees compared to those with only a bachelor's degree. Moreover, knowledge level, experience, and availability of TMS equipment in the workplace led to a positive attitude toward TMS among rehabilitation specialists. A low knowledge level among rehabilitation specialists was attributed to their level of education. Nevertheless, specialists showed an overall positive attitude toward TMS. Therefore, customized medical education is necessary to incorporate TMS theory and applications into neuroscience and rehabilitation courses for rehabilitation specialists as it holds significant promise as a therapeutic tool.

The Use of Transcranial Magnetic Stimulation in Attention Optimization Research: A Review from Basic Theory to Findings in Attention-Deficit/Hyperactivity Disorder and Depression.

This review explores the pivotal role of attention in everyday life, emphasizing the significance of studying attention-related brain functions. We delve into the development of methodologies for investigating attention and highlight the crucial role of brain neuroimaging and transcranial magnetic stimulation (TMS) in advancing attention research. Attention optimization theory is introduced to elucidate the neural basis of attention, identifying key brain regions and neural circuits involved in attention processes. The theory further explores neuroplasticity, shedding light on how the brain dynamically adapts and changes to optimize attention. A comprehensive overview of TMS is provided, elucidating the principles and applications of this technique in affecting brain activity through magnetic field stimulation. The application of TMS in attention research is discussed, outlining how it can be employed to regulate attention networks. The clinical applications of TMS are explored in attention-deficit/hyperactivity disorder (ADHD) and depression. TMS emerges as an effective clinical treatment for ADHD, showcasing its potential in addressing attention-related disorders. Additionally, the paper emphasizes the efficacy of TMS technology as a method for regulating depression, further underlining the versatility and therapeutic potential of TMS in clinical settings. In conclusion, this review underscores the interdisciplinary approach to attention research, integrating neuroimaging, neuroplasticity, and TMS. The presented findings contribute to our understanding of attention mechanisms and highlight the promising clinical applications of TMS in addressing attention-related disorders. This synthesis of theoretical and practical insights aims to propel further advancements in attention research and its therapeutic applications.

Transcranial Magnetic Stimulation to Treat Neuropathic Pain: A Bibliometric Analysis.

Neuropathic pain is caused by a lesion or disease of the somatosensory system and is one of the most incapacitating pain types, representing a significant non-met medical need. Due to the increase in research in the field and since innovative therapeutic strategies are required, namely in intractable neuropathic pain, neurostimulation has been used. Within this approach, transcranial magnetic stimulation (TMS) that uses a transient magnetic field to produce electrical currents over the cortex emerges as a popular method in the literature. Since this is an area in expansion and due to the putative role of TMS, we performed a bibliometric analysis in Scopus with the primary objective of identifying the scientific production related to the use of TMS to manage neuropathic pain. The research had no restrictions, and the analysis focused on the characteristics of the literature retrieved, scientific collaboration and main research topics from inception to 6 July 2023. A total of 474 articles were collected. A biggest co-occurrence between the terms "neuropathic pain" and "transcranial magnetic stimulation" was obtained. The journal "Clinical Neurophysiology" leads the Top 5 most productive sources. The United States is the most productive country, with 50% of US documents being "review articles", followed by France, with 56% of French documents being "original articles". Lefaucheur, JP and Saitoh, Y are the two most influential authors. The most frequent type of document was "original article". Most of the studies (34%) that identified the neuropathic pain type focused on traumatic neuropathic pain, although a large proportion (38%) did not report the neuropathic pain type. This study allows us to provide a general overview of the field of TMS application for neuropathic pain and is useful for establishing future directions of research in this field.

Transcranial magnetic stimulation in the rehabilitation complex for patients with cervical spine hernia

The purpose of the study is to analyze the results of using TMS in patients in the early period after removal of herniated discs of the cervical spine. Material and methods. The study was based on the analysis of 51 patients with cervical spine hernias (30 (58.8 %) men, 21 (41.2 %) women aged 23–72 years, with mean age of 42.8 years). All patients underwent discectomy of the cervical spine in the self-supporting department of the National Center for Rehabilitation and Prosthetics of the Disabled during the period of 2018–2022. The patients were divided into two groups. The first group consisted of 31 (60.7 %) patients who underwent discectomy of cervical hernias followed by TMS in the early postoperative period. The second group included 20 (39.3 %) patients who underwent discectomy without using TMS. Results and discussion. The results of open surgical interventions were assessed in two groups, according to the surgical intervention performed and the use of TMS. The first (study) group of 31 (60.7 %) patients underwent «discectomy with decompression of the spinal cord and subsequent stabilization with an improved cylindrical cage and the use of TMS in the early postoperative period». The second group of the patients underwent discectomy using cylindrical cages, laminectomy from the posterior approach, and laminectomy using transpedicular or transarticular stabilization without subsequent TMS. Conclusions. The use of an improved cylindrical cage for herniated cervical spine is justified and timely; the application of transcranial magnetic stimulation in the early postoperative stage in patients with a herniated disc of the cervical spine restores neurological deficits and awakens long-lost functions of a group of muscles and, in some cases, of entire organs.

Novel multi-magnetic material transcranial magnetic stimulation coils for small animals application

Transcranial magnetic stimulation (TMS) is a non-invasive therapeutic approach with proven efficacy in treating certain psychiatric and neurological disorders. To broaden the application of TMS to a wider range of neurological disorders, the induced electric field (e-field) must be able to more focally target specific regions of the brain. Animal coil designs are promising for studying TMS effects and developing new procedures for treating various neurological and psychiatric disorders. However, investigations have mostly used coil designs intended for humans, and, as such, have failed to scale down for small animal sizes. Currently available coil systems have been limited by not adequately incorporating ideal soft magnetic materials as coil cores and not advancing the coil shapes for small animals as is necessary to achieve highly focused e-field concentration. In this study, we used multi-magnetic materials in TMS coils for the first time to our knowledge. We also considered the non-linear, hysteretic behavior of the cores in our FEM simulations of induced e-field and magnetic field in the brain models of the rat. Our study involved a comprehensive assessment of the distribution and intensity of the e-field across various coil configurations using our customized anatomically accurate rat head model. Iron-cobalt-vanadium (Permendur) alloy known for its high relative permeability, high saturation magnetization and low coercivity was used as the core material for all simulations. To enhance coil focality and concentration of the e-field, while avoiding stimulation of adjacent regions, we introduced a shape-conforming, flexible, diamagnetic pyrolytic graphite with susceptibility of -4.5×10-4 for our top performing coil. Simulation results were validated by comparing the simulated magnetic field results with experimental measurements obtained from the v-tip coil with a carbon steel AISI-1010 core at varying tip distances. This thorough study advances our knowledge of TMS coil designs and their optimization, particularly for small animal applications.

Identifying Locations for Transcranial Magnetic Stimulation Coil Placement For Deep Brain Structures

Stimulation of deep brain structures with transcranial magnetic stimulation (TMS) is the premier mode of non-invasive brain stimulation (NIBS). Currently, there is little support for the application of TMS in modulating deeper brain structures. This study validates the use of TMS for a set of 8 deep brain structures shown to alleviate symptoms of certain conditions when stimulated. 200 sets of T1-weighted and T2-weighted MRIs were processed using the SimNIBS headreco pipeline. Then, 200 TMS optimization simulations were run for each brain structure, which generated 200 3D coordinates for each structure representing the best TMS coil placement locations on the scalp for stimulation. This data was analyzed using K-means and agglomerative clustering methods to find the overall best coil placement locations. Overall, this study validates the use of TMS to stimulate these brain structures and finds the optimal parameters for stimulation.

Transcranial Magnetic Stimulation Application in Children with Severe Traumatic Brain Injury: a Randomized Prospective Study

INTRODUCTION. Today, severe traumatic brain injury (STBI) poses a serious threat to the life and health of affected children, which requires long-term expensive treatment and long-term rehabilitation. Improving the diagnosis, resuscitation and neurosurgical care for children with STBI leads to an increase in the percentage of surviving patients, which necessitates the development and implementation of individual early rehabilitation programs. One of the tasks of early rehabilitation is to reduce the spasticity of the extremities, in connection with which transcranial magnetic stimulation (TMS) is used in our hospital. The experience of using the TCMS method in the first month of STBI in children is given, due to which the dynamics of the restoration of lost functions improves.&#x0D; AIM. Evaluation of the effectiveness of the use of the method of transcranial magnetic stimulation in children in the acute period of STBI with inclusion in the program of early medical rehabilitation.&#x0D; MATERIAL AND METHODS. 40 patients with STBI who were treated at the GAUZ СRCH MH RT, Kazan were taken for curation. The main group was selected by the randomization method, which included 20 (50 %) patients who received the procedure of transcranial magnetic stimulation in the individual program of medical rehabilitation and the control group — 20 (50 %) patients who received only the standard individual program of early rehabilitation. Patients of the main group on the 10th day after receiving a severe traumatic brain injury were initiated to undergo TKMS in addition to the program of individual early rehabilitation.&#x0D; RESULTS AND DISCUSSION. As a result of the course of therapy with the inclusion of TMS in the rehabilitation measures, an increase in the motor activity of the affected limb was observed, which led to an improvement in the patient’s self-care.&#x0D; CONCLUSION. The inclusion of transcranial magnetic stimulation in the program of early rehabilitation of children with severe traumatic brain injury creates suitable conditions for the course of compensatory-regenerative processes in the brain due to the depolarization of the membrane of cortical neurons. In this group of patients, there was a clear increase in muscle strength and a decrease in spasticity.

An Overview of Transcranial Magnetic Stimulation and Its Application in Multiple Sclerosis

Transcranial magnetic stimulation (TMS) is a flexible, non-invasive technique that involves the production of a brief magnetic field to stimulate the conductive structures of the brain. When TMS is specifically employed as a single- or paired-pulse over the motor cortex, the function and integrity of the descending motor pathways can be assessed through the generation of a motor evoked potential (MEP). Important MEP-derived measures include the motor threshold, MEP amplitude and latency, central motor conduction time, silent period, intracortical inhibition, and intracortical facilitation. These functional measures may have use in individuals with multiple sclerosis (MS), a common chronic autoimmune disorder of the central nervous system, due to their useful diagnostic and prognostic implications. As a representation of excitability and conductivity, TMS measures may have the potential to serve as objective markers of corticospinal tract integrity, which is a major aspect of clinical disability in MS. Additionally, TMS may be employed to help monitor and provide insight on the effects of therapies for patients with MS over a longitudinal timeframe. In this review, we focus on the application of TMS in the context of MS, with an emphasis on the relationship between TMS measures and widely used clinical assessment measures used for patients with MS.

Combined transcranial magnetic stimulation and electroencephalography reveals alterations in cortical excitability during pain.

Transcranial magnetic stimulation (TMS) has been used to examine inhibitory and facilitatory circuits during experimental pain and in chronic pain populations. However, current applications of TMS to pain have been restricted to measurements of motor evoked potentials (MEPs) from peripheral muscles. Here, TMS was combined with electroencephalography (EEG) to determine whether experimental pain could induce alterations in cortical inhibitory/facilitatory activity observed in TMS-evoked potentials (TEPs). In Experiment 1 (n=29), multiple sustained thermal stimuli were administered to the forearm, with the first, second, and third block of thermal stimuli consisting of warm but non-painful (pre-pain block), painful (pain block) and warm but non-painful (post-pain block) temperatures, respectively. During each stimulus, TMS pulses were delivered while EEG (64 channels) was simultaneously recorded. Verbal pain ratings were collected between TMS pulses. Relative to pre-pain warm stimuli, painful stimuli led to an increase in the amplitude of the frontocentral negative peak ~45 ms post-TMS (N45), with a larger increase associated with higher pain ratings. Experiments 2 and 3 (n=10 in each) showed that the increase in the N45 in response to pain was not due to changes in sensory potentials associated with TMS, or a result of stronger reafferent muscle feedback during pain. This is the first study to use combined TMS-EEG to examine alterations in cortical excitability in response to pain. These results suggest that the N45 TEP peak, which indexes GABAergic neurotransmission, is implicated in pain perception and is a potential marker of individual differences in pain sensitivity.

High-frequency repetitive transcranial magnetic stimulation promotes neural stem cell proliferation after ischemic stroke.

JOURNAL/nrgr/04.03/01300535-202408000-00031/figure1/v/2023-12-16T180322Z/r/image-tiff Proliferation of neural stem cells is crucial for promoting neuronal regeneration and repairing cerebral infarction damage. Transcranial magnetic stimulation (TMS) has recently emerged as a tool for inducing endogenous neural stem cell regeneration, but its underlying mechanisms remain unclear. In this study, we found that repetitive TMS effectively promotes the proliferation of oxygen-glucose deprived neural stem cells. Additionally, repetitive TMS reduced the volume of cerebral infarction in a rat model of ischemic stroke caused by middle cerebral artery occlusion, improved rat cognitive function, and promoted the proliferation of neural stem cells in the ischemic penumbra. RNA-sequencing found that repetitive TMS activated the Wnt signaling pathway in the ischemic penumbra of rats with cerebral ischemia. Furthermore, PCR analysis revealed that repetitive TMS promoted AKT phosphorylation, leading to an increase in mRNA levels of cell cycle-related proteins such as Cdk2 and Cdk4. This effect was also associated with activation of the glycogen synthase kinase 3β/β-catenin signaling pathway, which ultimately promotes the proliferation of neural stem cells. Subsequently, we validated the effect of repetitive TMS on AKT phosphorylation. We found that repetitive TMS promoted Ca2+ influx into neural stem cells by activating the P2 calcium channel/calmodulin pathway, thereby promoting AKT phosphorylation and activating the glycogen synthase kinase 3β/β-catenin pathway. These findings indicate that repetitive TMS can promote the proliferation of endogenous neural stem cells through a Ca2+ influx-dependent phosphorylated AKT/glycogen synthase kinase 3β/β-catenin signaling pathway. This study has produced pioneering results on the intrinsic mechanism of repetitive TMS to promote neural function recovery after ischemic stroke. These results provide a strong scientific foundation for the clinical application of repetitive TMS. Moreover, repetitive TMS treatment may not only be an efficient and potential approach to support neurogenesis for further therapeutic applications, but also provide an effective platform for the expansion of neural stem cells.

Exploring research trends and focal points in the application of transcranial magnetic stimulation for enhancing motor function in post-stroke patients: A bibliometric and content analytical approach

BackgroundMotor impairment is a significant health concern among post-stroke patients. Transcranial magnetic stimulation (TMS) is considered as an emerging rehabilitation therapy for various neurological conditions, and the effects of excitatory TMS on post-stroke have received much attention in past decade. However, the future hotspots and content analysis on the growth trends have not been studied. This bibliometric and content analysis aimed to study the global developmental history and current status of TMS for motor function of post-stroke from January 2004 to July 2023. MethodsLiterature published on Scopus database from January 2004 to July 2023 were searched. Extracted data was analysed using the R studio and VOS viewer for author's publication, institutions, sources, keyword co-occurrence and world network analysis. Keyword cluster analysis, co-citation analysis for references and content analysis were also performed. We screened top 10 most cited or collaborative areas for publications, institutions and sources in the field of TMS associated with motor function of post-stroke. ResultsIn this study, a comprehensive analysis of 267 publications was conducted, revealing a substantial surge in research output throughout 2022. China emerged as the leading contributor, with 409 publications, followed by the United States with 211 publications. Notably, Harvard Medical School stood out as one of the most prolific institutions, accounting for 34 publications (13.12 %). Among researchers, Abo M garnered the highest publication count, with 9 articles (14.5 %). The Word cloud showed that motor function, repetitive transcranial magnetic stimulation (rTMS) and upper limb have been the focus of recent attention. Burst keywords on thematic evolution and topic trend shows that quality of life scale, network parameters, cognition, lower limb motor function are the future trends. ConclusionThis bibliometric study describes that TMS has shown promising results in improving motor function of upper extremity in stroke patients, the long-term effects and durability of these improvements are still being investigated. Future research might focus on understanding the optimal duration and frequency of TMS sessions for sustained motor recovery and exploring strategies to maintain gains achieved through TMS over extended periods of time. Future studies can investigate the changes in the lower limb motor function.

Three novel methods for determining motor threshold with transcranial magnetic stimulation outperform conventional procedures.

Objective. Thresholding of neural responses is central to many applications of transcranial magnetic stimulation (TMS), but the stochastic aspect of neuronal activity and motor evoked potentials (MEPs) challenges thresholding techniques. We analyzed existing methods for obtaining TMS motor threshold and their variations, introduced new methods from other fields, and compared their accuracy and speed.Approach. In addition to existing relative-frequency methods, such as the five-out-of-ten method, we examined adaptive methods based on a probabilistic motor threshold model using maximum-likelihood (ML) or maximuma-posteriori(MAP) estimation. To improve the performance of these adaptive estimation methods, we explored variations in the estimation procedure and inclusion of population-level prior information. We adapted a Bayesian estimation method which iteratively incorporated information of the TMS responses into the probability density function. A family of non-parametric stochastic root-finding methods with different convergence criteria and stepping rules were explored as well. The performance of the thresholding methods was evaluated with an independent stochastic MEP model.Main Results. The conventional relative-frequency methods required a large number of stimuli, were inherently biased on the population level, and had wide error distributions for individual subjects. The parametric estimation methods obtained the thresholds much faster and their accuracy depended on the estimation method, with performance significantly improved when population-level prior information was included. Stochastic root-finding methods were comparable to adaptive estimation methods but were much simpler to implement and did not rely on a potentially inaccurate underlying estimation model.Significance. Two-parameter MAP estimation, Bayesian estimation, and stochastic root-finding methods have better error convergence compared to conventional single-parameter ML estimation, and all these methods require significantly fewer TMS pulses for accurate estimation than conventional relative-frequency methods. Stochastic root-finding appears particularly attractive due to the low computational requirements, simplicity of the algorithmic implementation, and independence from potential model flaws in the parametric estimators.

The Physics, Mechanism, and Application of Transcranial Magnetic Stimulation (TMS)

The Physics, Mechanism, and Application of Transcranial Magnetic Stimulation (TMS)

Advancements in Transcranial Magnetic Stimulation Research and the Path to Precision.

Transcranial magnetic stimulation (TMS) has become increasingly popular in clinical practice in recent years, and there have been significant advances in the principles and stimulation modes of TMS. With the development of multi-mode and precise stimulation technology, it is crucial to have a comprehensive understanding of TMS. The neuroregulatory effects of TMS can vary depending on the specific mode of stimulation, highlighting the importance of exploring these effects through multimodal application. Additionally, the use of precise TMS therapy can help enhance our understanding of the neural mechanisms underlying these effects, providing us with a more comprehensive perspective. This article aims to review the mechanism of action, stimulation mode, multimodal application, and precision of TMS.

Research progress on the application of transcranial magnetic stimulation in spinal cord injury rehabilitation: a narrative review.

Traumatic or non-traumatic spinal cord injury (SCI) can lead to severe disability and complications. The incidence of SCI is high, and the rehabilitation cycle is long, which increases the economic burden on patients and the health care system. However, there is no practical method of SCI treatment. Recently, transcranial magnetic stimulation (TMS), a non-invasive brain stimulation technique, has been shown to induce changes in plasticity in specific areas of the brain by regulating the activity of neurons in the stimulation site and its functionally connected networks. TMS is a new potential method for the rehabilitation of SCI and its complications. In addition, TMS can detect the activity of neural circuits in the central nervous system and supplement the physiological evaluation of SCI severity. This review describes the pathophysiology of SCI as well as the basic principles and classification of TMS. We mainly focused on the latest research progress of TMS in the physiological evaluation of SCI as well as the treatment of motor dysfunction, neuropathic pain, spasticity, neurogenic bladder, respiratory dysfunction, and other complications. This review provides new ideas and future directions for SCI assessment and treatment.