Neuroimaging-informed Transcranial Magnetic Stimulation (TMS)

Transcranial magnetic stimulation (TMS) is a form of noninvasive brain stimulation that is FDA-cleared in the United States for treatment of major depression, obsessive-compulsive disorder, and nicotine dependence. TMS uses electromagnetic fields to temporarily alter patterns of neuronal activity. Importantly, TMS exerts both local effects at the stimulation site and downstream effects across functionally connected networks. The overwhelming majority of TMS protocols used for clinical treatment use targets based on scalp landmarks, which are imprecise and may not be optimal. The use of MRI to identify TMS targets allows for greater precision and a wider array of targets. This talk will provide an overview of various MRI targeting methods, including both structural (T1, DTI) and functional (resting-state and task) methods. This talk will also discuss the use of personalized rTMS targets and will show examples of personalized network-targeting and traditional MNI-based targeting using neuronavigation software. We will also discuss how MRI can be used to measure TMS effects, including timing of post-TMS neuroimaging and the appropriate MRI modality. Participants will engage in small group discussions about their own study designs and potential neuroimaging-based targeting approaches.