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Causal Connectivity Maps Derived from Single-Pulse Interleaved TMS/fMRI
Lison Bossus1, Jess Dickson1, Camille Blaine1
1University of Pennsylvania.
Research Square
|August 20, 2025
Summary
This study used transcranial magnetic stimulation with fMRI to create causal brain activation maps. Image-guided TMS successfully engaged targeted brain regions and networks, supporting its use in neuromodulation.
Area of Science:
- Neuroscience
- Cognitive Neuroscience
- Neuromodulation
Background:
- Understanding brain circuit function is crucial for developing effective neuromodulation therapies.
- Previous methods lacked causal evidence for TMS-induced network engagement.
- Personalized targeting approaches are needed to optimize TMS efficacy.
Purpose of the Study:
- To generate causal activation maps using interleaved single-pulse transcranial magnetic stimulation with functional MRI (spTMS/fMRI).
- To investigate TMS-evoked brain responses in the left hemisphere using personalized connectivity targeting.
- To validate image-guided TMS for causally engaging distributed brain regions and networks.
Main Methods:
- Employed interleaved spTMS/fMRI in over 80 participants.
- Utilized personalized resting-state connectivity targeting approaches.
- Quantified TMS-evoked BOLD responses using voxelwise event-related fMRI, controlling for confounds.
Main Results:
- Stimulation of frontal and ventrolateral targets induced specific BOLD responses in targeted and distributed regions.
- Subgenual anterior cingulate cortex (sgACC) and amygdala stimulation modulated widespread cortical and subcortical networks.
- No significant group differences in evoked responses were found between depressed and healthy control participants.
Conclusions:
- Image-guided TMS can causally engage distributed brain networks, validating its utility for circuit-based neuromodulation.
- The generated causal connectivity maps can guide future research linking brain circuits with outcomes.
- This approach offers a powerful tool for understanding and modulating brain function.

