Concurrent TMS/fMRI reveals individual DLPFC dose-response pattern
Background: TMS is a valuable tool in both research and clinical settings, playing a crucial role in understanding brain-behavior relationships and providing treatment for various neurological and psychiatric conditions. Importantly, TMS over left DLPFC is an FDA approved treatment for MDD. Despite...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-11-01
|
| Series: | NeuroImage |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1053811923005451 |
| _version_ | 1797647921800282112 |
|---|---|
| author | Martin Tik Maria Vasileiadi Michael Woletz David Linhardt Anna-Lisa Schuler Nolan Williams Christian Windischberger |
| author_facet | Martin Tik Maria Vasileiadi Michael Woletz David Linhardt Anna-Lisa Schuler Nolan Williams Christian Windischberger |
| author_sort | Martin Tik |
| collection | DOAJ |
| description | Background: TMS is a valuable tool in both research and clinical settings, playing a crucial role in understanding brain-behavior relationships and providing treatment for various neurological and psychiatric conditions. Importantly, TMS over left DLPFC is an FDA approved treatment for MDD. Despite its potential, response variability to TMS remains a challenge, with stimulation parameters, particularly the stimulation intensity, being a primary contributor to these differences. Objective: The objective of this study was to establish dose-response relationships of TMS stimulation in DLPFC by means of concurrent TMS/fMRI. Methods: Here, we stimulated 15 subjects at different stimulation intensities of 80, 90, 100 and 110 % relative to the motor threshold during concurrent TMS/fMRI. The experiment comprised two sessions: one session to collect anatomical data in order to perform neuronavigation and one session dedicated to dose-response mapping. We calculated GLMs for each intensity level and each subject, as well as at a group-level per intensity. Results: On a group level, we show that the strongest BOLD-response was at 100 % stimulation. However, investigating individual dose response-relationships showed differences in response patterns across the group: subjects that responded to subthreshold stimulation, subjects that required above threshold stimulation in order to show a significant BOLD-response and atypical responders. Conclusions: We observed qualitative inter-subject variability in terms of dose-response relationship to TMS over left DLPFC, which hints towards the motor threshold not being directly transferable to the excitability of the DLPFC. Concurrent TMS/fMRI might have the potential to improve response rates to rTMS applications. As such, it may be valuable in the future to consider implementing this approach prior to clinical TMS or validating more cost-effective methods to determine dose and target with respect to changes in clinical symptoms. |
| first_indexed | 2024-03-11T15:24:38Z |
| format | Article |
| id | doaj.art-d8da55a8bb5c41e997741a66251689ee |
| institution | Directory Open Access Journal |
| issn | 1095-9572 |
| language | English |
| last_indexed | 2024-03-11T15:24:38Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage |
| spelling | doaj.art-d8da55a8bb5c41e997741a66251689ee2023-10-28T05:06:47ZengElsevierNeuroImage1095-95722023-11-01282120394Concurrent TMS/fMRI reveals individual DLPFC dose-response patternMartin Tik0Maria Vasileiadi1Michael Woletz2David Linhardt3Anna-Lisa Schuler4Nolan Williams5Christian Windischberger6MR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, Austria; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USAMR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, AustriaMR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, AustriaMR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, AustriaMR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, AustriaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USAMR Center of Excellence, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Lazarettgasse 14, Vienna 1090, Austria; Corresponding author.Background: TMS is a valuable tool in both research and clinical settings, playing a crucial role in understanding brain-behavior relationships and providing treatment for various neurological and psychiatric conditions. Importantly, TMS over left DLPFC is an FDA approved treatment for MDD. Despite its potential, response variability to TMS remains a challenge, with stimulation parameters, particularly the stimulation intensity, being a primary contributor to these differences. Objective: The objective of this study was to establish dose-response relationships of TMS stimulation in DLPFC by means of concurrent TMS/fMRI. Methods: Here, we stimulated 15 subjects at different stimulation intensities of 80, 90, 100 and 110 % relative to the motor threshold during concurrent TMS/fMRI. The experiment comprised two sessions: one session to collect anatomical data in order to perform neuronavigation and one session dedicated to dose-response mapping. We calculated GLMs for each intensity level and each subject, as well as at a group-level per intensity. Results: On a group level, we show that the strongest BOLD-response was at 100 % stimulation. However, investigating individual dose response-relationships showed differences in response patterns across the group: subjects that responded to subthreshold stimulation, subjects that required above threshold stimulation in order to show a significant BOLD-response and atypical responders. Conclusions: We observed qualitative inter-subject variability in terms of dose-response relationship to TMS over left DLPFC, which hints towards the motor threshold not being directly transferable to the excitability of the DLPFC. Concurrent TMS/fMRI might have the potential to improve response rates to rTMS applications. As such, it may be valuable in the future to consider implementing this approach prior to clinical TMS or validating more cost-effective methods to determine dose and target with respect to changes in clinical symptoms.http://www.sciencedirect.com/science/article/pii/S1053811923005451Dose responseTranscranial magnetic stimulationTMS-fMRIExcitabilityThreshold |
| spellingShingle | Martin Tik Maria Vasileiadi Michael Woletz David Linhardt Anna-Lisa Schuler Nolan Williams Christian Windischberger Concurrent TMS/fMRI reveals individual DLPFC dose-response pattern NeuroImage Dose response Transcranial magnetic stimulation TMS-fMRI Excitability Threshold |
| title | Concurrent TMS/fMRI reveals individual DLPFC dose-response pattern |
| title_full | Concurrent TMS/fMRI reveals individual DLPFC dose-response pattern |
| title_fullStr | Concurrent TMS/fMRI reveals individual DLPFC dose-response pattern |
| title_full_unstemmed | Concurrent TMS/fMRI reveals individual DLPFC dose-response pattern |
| title_short | Concurrent TMS/fMRI reveals individual DLPFC dose-response pattern |
| title_sort | concurrent tms fmri reveals individual dlpfc dose response pattern |
| topic | Dose response Transcranial magnetic stimulation TMS-fMRI Excitability Threshold |
| url | http://www.sciencedirect.com/science/article/pii/S1053811923005451 |
| work_keys_str_mv | AT martintik concurrenttmsfmrirevealsindividualdlpfcdoseresponsepattern AT mariavasileiadi concurrenttmsfmrirevealsindividualdlpfcdoseresponsepattern AT michaelwoletz concurrenttmsfmrirevealsindividualdlpfcdoseresponsepattern AT davidlinhardt concurrenttmsfmrirevealsindividualdlpfcdoseresponsepattern AT annalisaschuler concurrenttmsfmrirevealsindividualdlpfcdoseresponsepattern AT nolanwilliams concurrenttmsfmrirevealsindividualdlpfcdoseresponsepattern AT christianwindischberger concurrenttmsfmrirevealsindividualdlpfcdoseresponsepattern |