Personalised Transcranial Magnetic Stimulation (TMS)

TMS needs to be delivered with accuracy and reliability

To ensure that brain activity normalises, TMS needs to be given multiple times every day for several weeks. Standard treatments require between 20 and 40 TMS sessions in total. The aim of each treatment session is to train the brain regions to communicate normally. This requires accurate and reliable stimulation.1 

‘Standard’ TMS has some limitations

‘Standard’ TMS refers to the traditional practice of delivering TMS to a brain region based on surface landmarks on the scalp. This is the most common practice of TMS.

Using surface landmarks on the scalp to localise the DLPFC may be inaccurate and unreliable

At best, this approach roughly estimates the location of the brain region to stimulate. Of course, everyone has a unique brain size and shape, and this one-size-fits-all approach may not be optimal for all people. The DLPFC is a large brain region, and targeting it using surface markers on the scalp may be inaccurate and unreliable.

For example, research shows that in ‘standard’ TMS, different sites within the DLPFC are stimulated across sessions, and at times the wrong brain region is stimulated. 2, 3

Personalised TMS at Queensland Neurostimulation Centre improves accuracy and reliability

Personalised TMS accounts for an individual’s brain variability through the use of an MRI brain scan.

Explanation of personalised TMS at QNC

In ‘standard’ TMS for treatment resistant depression, accuracy and reliability is lower

  • Uses surface markers on the scalp of the head to target the DLPFC
  • Does not account for head movement
  • Does not account for individual variability in the person’s brain
  • More likely to treat different sites within the DLPFC, or may miss the DLPFC across sessions
  • Operator error is more probable
diagram of how standard TMS is delivered

In personalised TMS for treatment resistant depression, accuracy and reliability improves

  • Accurate and reliable targeting of DLPFC site through use of MRI
  • TMS robot accounts for head movement
  • The individual’s brain variability is accounted for
  • Accurate and reliable across all sessions
  • TMS robot reduces possibility of operator error
Diagram describing how personalised TMS works

This personalised approach is what sets Queensland Neurostimulation Centre apart nationally and internationally as TMS providers.

References

  1. Fitzgerald, Paul B., et al. “A randomized trial of rTMS targeted with MRI based neuro-navigation in treatment-resistant depression.” Neuropsychopharmacology 34.5 (2009): 1255-1262. 
  2. Herwig, Uwe, et al. “Transcranial magnetic stimulation in therapy studies: examination of the reliability of “standard” coil positioning by neuronavigation.” Biological psychiatry 50.1 (2001): 58-61. 
  3. Opitz, Alexander, et al. “An integrated framework for targeting functional networks via transcranial magnetic stimulation.” Neuroimage 127 (2016): 86-96. 
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