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Optimal coil orientation for transcranial magnetic stimulation.

Lars Richter1, Gunnar Neumann, Stephen Oung

  • 1Institute for Robotics and Cognitive Systems, University of Lübeck, Lübeck, Germany. richter@rob.uni-luebeck.de

Plos One
|April 18, 2013
PubMed
Summary

Optimal coil orientation for transcranial magnetic stimulation (TMS) of the foot was determined. Adjusting coil orientation significantly reduced the motor threshold, improving stimulation efficiency.

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Area of Science:

  • Neuroscience
  • Biomedical Engineering
  • Electrophysiology

Background:

  • Transcranial magnetic stimulation (TMS) coil orientation is critical for effective cortical stimulation.
  • Standard coil orientations may not be optimal for stimulating specific peripheral nerves, such as those controlling foot muscles.
  • Understanding optimal coil orientation can enhance the precision and efficacy of TMS applications.

Purpose of the Study:

  • To investigate the impact of varying coil orientation on the motor threshold (MT) for foot muscle stimulation.
  • To identify and present an optimal coil orientation for stimulating the abductor hallucis muscle.
  • To compare experimental findings with predictive models based on electrodynamic properties and cellular orientation.

Main Methods:

  • Utilized a robotized TMS system for precise coil placement and orientation adjustments.

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  • Recorded motor-evoked potentials from the abductor hallucis muscle in 8 healthy subjects.
  • Systematically rotated the TMS coil from a standard lateral orientation, measuring MT at each step, complemented by structural MRI for anatomical correlation.

    • Main Results:

    • An optimal coil orientation was found to be 33.1 ± 18.3° anteriorly relative to the standard lateral orientation.
    • Stimulation at the optimal orientation resulted in a significantly lower motor threshold (54 ± 18% maximum stimulator output) compared to the standard orientation (8.0 ± 5.9% difference).
    • Optimal coil orientations showed a significant correlation with the direction perpendicular to the postcentral gyrus.

    Conclusions:

    • Robotized TMS enables precise coil positioning to detect subtle variations in MT with coil orientation.
    • The identified optimal coil orientation significantly improves stimulation efficiency for the foot.
    • Observed deviations in optimal orientation align better with models of field propagation than with pyramidal cell orientation models.