Virtual Neuronavigation for Parcel-guided TMS.

Area of Science:

• Neuroscience
• Medical Imaging
• Biomedical Engineering

Background:

• Repetitive transcranial magnetic stimulation (rTMS) for depression shows limited efficacy due to non-individualized coil positioning.
• Current scalp-based methods fail to account for individual anatomy, leading to suboptimal brain target activation.
• Previous studies show high response rates when rTMS targets specific brain regions like parcel 46 (p46) using neuronavigation.

Purpose of the Study:

• To develop a cost-effective virtual neuronavigation system using individualized 3D printed headgear for precise rTMS targeting.
• To determine the accuracy and reproducibility of 3D printed headgear for targeting specific brain parcels.

Main Methods:

• A virtual neuronavigation system processed MRI data to identify p46.
• Individualized 3D printed headgear with anatomical markings was developed using iterative CAD modeling and printing.
• Headgear accuracy was verified by comparing its alignment with neuronavigation-determined targets on the scalp and brain.

Main Results:

• Individualized headgear demonstrated accuracy within 8.31±4.93 mm on the scalp and 7.94±4.99 mm on the brain.
• Within-subject reproducibility was high, with distances of 1.21 ± 0.84 mm.
• The system was tested on 16 subjects for accuracy and 8 subjects for reproducibility.

Conclusions:

• Individualized 3D printed headgear offers a practical solution for implementing advanced rTMS targeting.
• This method allows clinical practices to utilize state-of-the-art targeting without the need for expensive neuronavigation hardware.
• The developed system enhances the precision of rTMS for conditions like depression.