Using Brain Imaging to Improve Spatial Targeting of Transcranial Magnetic Stimulation for Depression

FH Robin Cash; Anne Weigand; Andrew Zalesky; H Shan Siddiqi; Jonathan Downar; B Paul Fitzgerald; D Michael Fox

Journal article

Using Brain Imaging to Improve Spatial Targeting of Transcranial Magnetic Stimulation for Depression

FH Robin Cash, Anne Weigand, Andrew Zalesky, H Shan Siddiqi, Jonathan Downar, B Paul Fitzgerald, D Michael Fox

BIOLOGICAL PSYCHIATRY | ELSEVIER SCIENCE INC | Published : 2021

DOI: 10.1016/j.biopsych.2020.05.033

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Abstract

Transcranial magnetic stimulation (TMS) is an effective treatment for depression but is limited in that the optimal therapeutic target remains unknown. Early TMS trials lacked a focal target and thus positioned the TMS coil over the prefrontal cortex using scalp measurements. Over time, it became clear that this method leads to variation in the stimulation site and that this could contribute to heterogeneity in antidepressant response. Newer methods allow for precise positioning of the TMS coil over a specific brain location, but leveraging these precise methods requires a more precise therapeutic target. We review how neuroimaging is being used to identify a more focal therapeutic target fo..

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University of Melbourne Researchers

Robin Cash Author Biomedical Engineering

Andrew Zalesky Author Psychiatry

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Grants

Awarded by Australian Research Council

Awarded by National Institute of Mental Health

Awarded by Australian National Health and Medical Research Council

Funding Acknowledgements

This work was supported by the Australian Research Council (Grant No. DE200101708 [to RFHC] ) , National Institute of Mental Health (Grant Nos. R01MH113929 and R01MH115949 [to MDF] ) , Nancy Lurie Marks Foundation (to MDF) , Mathers Foundation (to MDF) , Australian National Health and Medical Research Council Senior Research Fellowship B (Grant No. 1136649 [to AZ] ) and Practitioner Fellowship (Grant No. 1078567 [to PBF] ) , Arrell Family Foundation (to JD) , Buchan Family Foundation (to JD) , Brain Canada (to JD) , Canadian Biomarker Integration Network in Depression (to JD) , Canadian Institutes of Health Research (to JD) , Klarman Family Foundation (to JD) , National Institutes of Health (to JD) , Ontario Brain Institute (to JD) , Toronto General and Western Hospital Foundation (to JD) , Weston Family Foundation (to JD) , Sidney R. Baer Foundation (to SHS) , and Brain & Behavior Research Foundation (to SHS) . We thank all participants, funding bodies, researchers, nurses, and other staff who have made this research possible. MDF has intellectual property on using brain connectivity to guide brain stimulation therapies. JD has received travel stipends from Lundbeck and ANT Neuro and in-kind equipment support for investigator-initiated studies from MagVenture; he has served as an advisor for BrainCheck, Restorative Brain Clinic, and Salience TMS Neuro Solutions. PBF has received equipment for research from MagVenture, Medtronic, Neuronetics, and Brains-Way and funding for research from Neuronetics. He is on scientific advisory boards for Bionomics and LivaNova and is a founder of TMS Clinics Australia. SHS serves as a scientific consultant for SigNeuro, has intellectual property on the use of brain network mapping to target neuromodulation, and has received investigator-initiated research support from Neuronetics. All other authors report no biomedical financial interests or potential conflicts of interest.