Brain stimulation · 2025
Personalized models of Beam/F3 targeting in transcranial magnetic stimulation for depression: Implications for precision clinical translation.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rajasekharan Divya, Madore Michelle R, Holtzheimer Paul, Lim Kelvin O, Williams Leanne M, Philip Noah S
Аннотация
BACKGROUND: Clinical transcranial magnetic stimulation (TMS) for depression routinely relies on the scalp-based Beam/F3 targeting method to identify stimulation targets in the dorsolateral prefrontal cortex (dLPFC). Scalp-based targeting offers a low-cost and easily implemented method for TMS coil placement, enhancing treatment availability. However, limited anatomical and functional specificity of the Beam/F3 method may affect treatment outcomes, motivating assessment of the clinical standard.
METHODS: In a naturalistic clinical trial of TMS conduced at four Veterans Affairs hospitals, the authors evaluate the Beam/F3 method using neuroimaging incorporated before TMS, after five treatment sessions, and after all thirty sessions. Personalized anatomical and electric field (E-field) models were developed to assess target location and network engagement, as well as subsequent effects on clinical outcomes.
RESULTS: Anatomical models demonstrate that the Beam/F3 method produced reliable targets in the dLPFC across individuals and repeated treatment sessions. E-field models revealed that baseline anticorrelation between the stimulation center and the sgACC was associated with antidepressant symptom response after five TMS sessions (p=0.032,r2=0.100,N=46) and at the end of treatment (p=0.042,r2=0.107,N=39). Relatedly, E-field magnitude at the sgACC-anticorrelated peak in the prefrontal cortex correlated with symptom response throughout treatment (early treatment: p=0.001,r2=0.220,N=46; end of treatment: p=0.026,r2=0.127,N=39).
CONCLUSIONS: This work establishes that scalp-based targeting can produce reliable targets in the dLPFC and be successfully evaluated using a combination of neuroimaging and E-field modeling in pragmatic, multisite applications. Importantly, this investigation also found that significant network effects occur early in treatment and that Beam/F3 targets can engage functional mechanisms in TMS.
METHODS: In a naturalistic clinical trial of TMS conduced at four Veterans Affairs hospitals, the authors evaluate the Beam/F3 method using neuroimaging incorporated before TMS, after five treatment sessions, and after all thirty sessions. Personalized anatomical and electric field (E-field) models were developed to assess target location and network engagement, as well as subsequent effects on clinical outcomes.
RESULTS: Anatomical models demonstrate that the Beam/F3 method produced reliable targets in the dLPFC across individuals and repeated treatment sessions. E-field models revealed that baseline anticorrelation between the stimulation center and the sgACC was associated with antidepressant symptom response after five TMS sessions (p=0.032,r2=0.100,N=46) and at the end of treatment (p=0.042,r2=0.107,N=39). Relatedly, E-field magnitude at the sgACC-anticorrelated peak in the prefrontal cortex correlated with symptom response throughout treatment (early treatment: p=0.001,r2=0.220,N=46; end of treatment: p=0.026,r2=0.127,N=39).
CONCLUSIONS: This work establishes that scalp-based targeting can produce reliable targets in the dLPFC and be successfully evaluated using a combination of neuroimaging and E-field modeling in pragmatic, multisite applications. Importantly, this investigation also found that significant network effects occur early in treatment and that Beam/F3 targets can engage functional mechanisms in TMS.