Standalone Augmented Reality Neuronavigation System for Accurate Pulse Delivery in Transcranial Magnetic Stimulation.

Area of Science:

• Neuroscience
• Biomedical Engineering
• Medical Technology

Background:

• Transcranial magnetic stimulation (TMS) is a noninvasive technique for modulating neural activity, primarily used for major depressive disorder.
• Effective TMS treatment necessitates precise targeting and multiple sessions, posing challenges with current neuronavigation systems.
• Existing neuronavigation systems are costly and require time-intensive setups for repeated TMS sessions.

Purpose of the Study:

• To introduce and evaluate an augmented reality neuronavigation system (AR-NS) for TMS.
• To compare the functional targeting accuracy of the AR-NS with a commercial neuronavigation system (Localite TMSNavigator).
• To assess the potential of AR-NS to provide more accessible and less cognitively demanding TMS delivery.

Main Methods:

• Developed a TMS phantom with embedded Hall effect sensors to measure magnetic pulse responses.
• Utilized co-registered X-ray computed tomography and structured light scans for precise coil placement.
• Compared AR-NS and Localite TMSNavigator by firing a MagVenture C-B60 coil 30 times at each of four sensor sites in a randomized order.

Main Results:

• The AR-NS showed functional targeting accuracy comparable to the Localite TMSNavigator across most tested sites.
• A non-inferiority test with a 5 mT margin confirmed similar performance between the two systems.
• The AR interface reduced cognitive load and hand-eye coordination demands compared to traditional 2D navigation.

Conclusions:

• Augmented reality neuronavigation systems offer a viable alternative for TMS delivery.
• AR-NS provides comparable functional accuracy to commercial systems, potentially increasing accessibility.
• This technology may streamline TMS procedures, making them more efficient for recurring treatments.