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The effect of inaccurate targeting of the left dorsolateral prefrontal cortex on TMS response

Nele De Geeter (UGent) , Guillaume Crevecoeur (UGent) and Luc Dupré (UGent)
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Abstract
Transcranial magnetic stimulation (TMS) of the dorsolateral prefrontal cortex (DLPFC) is increasingly used as a non-invasive treatment for medication-resistant depression. However, this target site is commonly localized using an inaccurate standard procedure, which uses a fixed distance with respect to the motor cortical site for optimal stimulation of a hand muscle. Several studies have suggested this 5-cm distance is in average too short to reliably target the DLPFC, while others just found the opposite. Nevertheless, they all agree on the fact that the interindividual neuroanatomical variability cannot be neglected. We simulated the effect of this inaccurate targeting on the electromagnetic and neurophysiological response to TMS by displacing the stimulation coil to more rostral or dorsal areas with respect to the correct reference position. The induced electric field distribution in the brain and the spatio-temporal distribution of the membrane potentials along a traced nerve bundle, localized in the targeted brain region of interest, are computed. Our results show that the number of spikes initiated and propagating towards deeper limbic regions is highly variable, even for coil shifts of only 2 mm whereas the electric field changes are moderate. Moreover, they illustrate the increased (decreased) generation of spikes in case of targeting more dorsal (rostral) regions. This confirms that an accurate patient-specific determination of the stimulation target in combination with a neuronavigation system is mandatory to perform reliable TMS studies.
Keywords
TREATMENT-RESISTANT DEPRESSION, TRANSCRANIAL MAGNETIC STIMULATION, MODELS, VARIABILITY, TRIAL

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Citation

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MLA
De Geeter, Nele, Guillaume Crevecoeur, and Luc Dupré. “The Effect of Inaccurate Targeting of the Left Dorsolateral Prefrontal Cortex on TMS Response.” International IEEE EMBS Conference on Neural Engineering. IEEE, 2013. 819–822. Print.
APA
De Geeter, N., Crevecoeur, G., & Dupré, L. (2013). The effect of inaccurate targeting of the left dorsolateral prefrontal cortex on TMS response. International IEEE EMBS Conference on Neural Engineering (pp. 819–822). Presented at the 6th International IEEE EMBS Conference on Neural Engineering (NER), IEEE.
Chicago author-date
De Geeter, Nele, Guillaume Crevecoeur, and Luc Dupré. 2013. “The Effect of Inaccurate Targeting of the Left Dorsolateral Prefrontal Cortex on TMS Response.” In International IEEE EMBS Conference on Neural Engineering, 819–822. IEEE.
Chicago author-date (all authors)
De Geeter, Nele, Guillaume Crevecoeur, and Luc Dupré. 2013. “The Effect of Inaccurate Targeting of the Left Dorsolateral Prefrontal Cortex on TMS Response.” In International IEEE EMBS Conference on Neural Engineering, 819–822. IEEE.
Vancouver
1.
De Geeter N, Crevecoeur G, Dupré L. The effect of inaccurate targeting of the left dorsolateral prefrontal cortex on TMS response. International IEEE EMBS Conference on Neural Engineering. IEEE; 2013. p. 819–22.
IEEE
[1]
N. De Geeter, G. Crevecoeur, and L. Dupré, “The effect of inaccurate targeting of the left dorsolateral prefrontal cortex on TMS response,” in International IEEE EMBS Conference on Neural Engineering, San Diego, California, USA, 2013, pp. 819–822.
@inproceedings{4429318,
  abstract     = {Transcranial magnetic stimulation (TMS) of the dorsolateral prefrontal cortex (DLPFC) is increasingly used as a non-invasive treatment for medication-resistant depression. However, this target site is commonly localized using an inaccurate standard procedure, which uses a fixed distance with respect to the motor cortical site for optimal stimulation of a hand muscle. Several studies have suggested this 5-cm distance is in average too short to reliably target the DLPFC, while others just found the opposite. Nevertheless, they all agree on the fact that the interindividual neuroanatomical variability cannot be neglected. We simulated the effect of this inaccurate targeting on the electromagnetic and neurophysiological response to TMS by displacing the stimulation coil to more rostral or dorsal areas with respect to the correct reference position. The induced electric field distribution in the brain and the spatio-temporal distribution of the membrane potentials along a traced nerve bundle, localized in the targeted brain region of interest, are computed. Our results show that the number of spikes initiated and propagating towards deeper limbic regions is highly variable, even for coil shifts of only 2 mm whereas the electric field changes are moderate. Moreover, they illustrate the increased (decreased) generation of spikes in case of targeting more dorsal (rostral) regions. This confirms that an accurate patient-specific determination of the stimulation target in combination with a neuronavigation system is mandatory to perform reliable TMS studies.},
  author       = {De Geeter, Nele and Crevecoeur, Guillaume and Dupré, Luc},
  booktitle    = {International IEEE EMBS Conference on Neural Engineering},
  isbn         = {9781467319690},
  issn         = {1948-3546},
  keywords     = {TREATMENT-RESISTANT DEPRESSION,TRANSCRANIAL MAGNETIC STIMULATION,MODELS,VARIABILITY,TRIAL},
  language     = {eng},
  location     = {San Diego, California, USA},
  pages        = {819--822},
  publisher    = {IEEE},
  title        = {The effect of inaccurate targeting of the left dorsolateral prefrontal cortex on TMS response},
  year         = {2013},
}

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