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Multi-locus transcranial magnetic stimulation with pulse-width modulation.

Heikki Sinisalo1, Mikael Laine1, Jaakko O Nieminen1

  • 1Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland.

Brain Stimulation
|April 16, 2025
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Summary
This summary is machine-generated.

Multi-locus TMS (mTMS) with pulse-width modulation (PWM) enables faster targeting. While effective with 2-3 coils, five coils showed some differences in motor responses, indicating feasibility for millisecond-scale control.

Keywords:
Electric field time courseMotor cortex stimulationMulti-coil TMSNeuronal depolarizationPulse-width modulationWaveform

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Area of Science:

  • Neuroscience
  • Biomedical Engineering

Background:

  • Transcranial magnetic stimulation (TMS) uses scalp coils to induce electric fields for neuronal activation.
  • Multi-locus TMS (mTMS) allows electronic control of stimulation location and orientation.
  • Current mTMS coil adjustments limit target changes to seconds.

Purpose of the Study:

  • Investigate microsecond-scale pulse-width modulation (PWM) for rapid multi-coil TMS targeting.
  • Assess PWM's efficacy in overcoming mTMS speed limitations.

Main Methods:

  • Developed a methodology for generating and driving PWM approximations of reference pulses.
  • Compared resting motor thresholds (RMTs) and motor evoked potentials (MEPs) between trapezoidal and PWM pulses.
  • Evaluated performance across various multi-coil targeting scenarios.

Main Results:

  • PWM pulses exhibited high temporal complexity.
  • No significant differences in RMT or MEPs were found for 2- or 3-coil combinations.
  • Five-coil PWM stimulation showed a 9% RMT increase (p=0.06) and 20% MEP amplitude decrease (p<0.05) at higher doses.

Conclusions:

  • PWM pulses with mTMS are feasible for millisecond-scale target control.
  • Motor responses were equivalent for trapezoidal and PWM pulses with 2-3 coils.
  • Further research is needed on neurophysiological effects with increased coil counts.