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Magnetic Resonance Imaging-Guided Neuronavigation for Transcranial Magnetic Stimulation in Mood Disorders: Technical
Ilya Demchenko1,2,3,4, Huda F Al-Shamali1, Alice Rueda1,3
1Interventional Psychiatry Program, St. Michael's Hospital-Unity Health Toronto, Toronto, Ontario, Canada.
Human Brain Mapping
|November 28, 2025
Summary
Magnetic resonance imaging (MRI)-guided transcranial magnetic stimulation (TMS) precisely targets brain circuits for mood disorders. Advanced neuronavigation improves accuracy and outcomes, with connectivity-based MRI offering promising network targeting.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Transcranial magnetic stimulation (TMS) guided by magnetic resonance imaging (MRI) enhances mood disorder treatment by enabling precise targeting of relevant brain circuits.
- Neuronavigation systems using real-time MRI improve spatial accuracy, individualization, and therapeutic outcomes in TMS.
Purpose of the Study:
- To review technological and methodological advancements in MRI-guided neuronavigation for TMS in treating mood disorders.
- To critically examine challenges and discuss emerging innovations in this field.
Main Methods:
- Review of anatomical MRI, functional MRI (fMRI) (task-based and resting-state), and connectivity-based MRI for neuronavigation.
- Analysis of progress in image acquisition, co-registration, and artifact mitigation.
Main Results:
- Anatomical MRI offers structural guidance, while fMRI enhances target selection through neural activity and connectivity patterns.
- Connectivity-based MRI neuronavigation shows promise for targeting disrupted neural networks.
Conclusions:
- MRI-guided TMS neuronavigation has advanced mood disorder treatment, but challenges in image quality and clinical integration remain.
- Future innovations aim to enhance precision, clinical adoption, and therapeutic outcomes in interventional psychiatry.
