Robotically Delivered fMRI-Guided Personalized Transcranial Magnetic Stimulation Therapy for Treatment-Resistant...

Area of Science:

• Neuroscience
• Psychiatry
• Medical Technology

Background:

• Treatment-resistant depression (TRD) has limited therapeutic options.
• Transcranial magnetic stimulation (TMS) efficacy can be improved by personalized targeting.
• Robotic delivery enhances precision in TMS therapy.

Purpose of the Study:

• To describe the clinical protocol for personalized, robotically delivered, fMRI-guided TMS for TRD.
• To detail the workflow for implementing this advanced TMS protocol.
• To establish a framework for precise dose delivery in TRD treatment.

Main Methods:

• Patients with TRD undergo anatomical and resting-state MRI scans.
• fMRI data are used to identify optimal TMS targets in the left dorsolateral prefrontal cortex (DLPFC) based on functional connectivity with the subgenual cingulate cortex (SGC).
• A robotic arm with neuronavigation guides TMS coil placement for precise, consistent stimulation.

Main Results:

• The protocol enables precise targeting of the DLPFC using fMRI-derived functional connectivity.
• Robotic delivery ensures accurate and repeatable coil positioning across TMS sessions.
• The described workflow facilitates clinical implementation of personalized TMS for TRD.

Conclusions:

• Robotically delivered, fMRI-guided personalized TMS offers a precise approach for TRD.
• This protocol demonstrates the feasibility and workflow for advanced TMS implementation.
• Personalized targeting and precise delivery are key to optimizing TMS outcomes in TRD.