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Updated: Jan 12, 2026

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

A Multimodal Imaging- and Stimulation-based Method of Evaluating Connectivity-related Brain Excitability in Patients with Epilepsy

Published on: November 13, 2016

Cingulo-Opercular Connectivity Enhances the Repeatability of Transcranial Magnetic Stimulation Target Maps.

Emma Komulainen¹, Annu-Sinikka Salminen¹, Dogu Baran Aydogan²

¹Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Neuromodulation : Journal of the International Neuromodulation Society

|November 7, 2025

Summary

This summary is machine-generated.

This study found that depression core network model (CNM) targeting for transcranial magnetic stimulation (TMS) is more repeatable than other methods. Using a movie stimulus reduced movement but did not significantly improve targeting repeatability for major depressive disorder (MDD).

Keywords:

Functional connectivity major depressive disorder repeatability targeting transcranial magnetic stimulation

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Area of Science:

Neuroscience
Psychiatry
Medical Imaging

Background:

Transcranial magnetic stimulation (TMS) effectiveness for major depressive disorder (MDD) may improve with individualized dorsolateral prefrontal cortex (DLPFC) targeting.
Current methods using subgenual anterior cingulate cortex (sgACC) or right anterior insula (rAI) connectivity show potential but face repeatability challenges.
Novel depression core network model (CNM) based targeting offers a new approach to enhance TMS precision.

Purpose of the Study:

To compare the repeatability of CNM-based DLPFC target maps against sgACC and rAI connectivity-based maps.
To evaluate if a movie stimulus enhances the feasibility of individualized functional connectivity-based TMS targeting.

Main Methods:

31 patients with treatment-resistant MDD underwent repeated functional magnetic resonance imaging (fMRI) sessions.
Repeatability of DLPFC target maps was assessed using within-subject spatial correlation.
fMRI acquisition was compared between resting-state and movie stimulus conditions, measuring repeatability, head movement, and participant comfort.

Main Results:

CNM functional connectivity-based DLPFC target maps demonstrated higher repeatability than sgACC or rAI-based maps, especially with a movie stimulus.
Cingulo-opercular seeds within the CNM yielded highly repeatable target maps in both resting-state and movie conditions.
The movie stimulus decreased head movement during fMRI but did not significantly improve targeting repeatability.

Conclusions:

Findings support further research into multi-seed functional connectivity targeting, particularly using cingulo-opercular regions.
Engaging naturalistic stimuli like movies warrant further investigation for improving individualized TMS targeting feasibility.