Identification of reproducible individualized targets for treatment of depression with TMS based on intrinsic connectivity
By Michael D. Fox, Hesheng Liu, Alvaro Pascual-Leone. NeuroImage, 2012
371 citations recorded by the source corpus.
Transcranial magnetic stimulation (TMS) to the left dorsolateral prefrontal cortex (DLPFC) is used clinically for the treatment of depression however outcomes vary greatly between patients. We have shown that average clinical efficacy of different left DLPFC TMS sites is related to intrinsic functional connectivity with remote regions including the subgenual cingulate and suggested that functional connectivity with these remote regions might be used to identify optimized left DLPFC targets for TMS. However it remains unclear if and how this connectivity-based targeting approach should be applied at the single-subject level to potentially individualize therapy to specific patients. In this article we show that individual differences in DLPFC connectivity are large, reproducible across sessions, and can be used to generate individualized DLPFC TMS targets that may prove clinically superior to those selected on the basis of group-average connectivity. Factors likely to improve individualized targeting including the use of seed maps and the focality of stimulation are investigated and discussed. The techniques presented here may be applicable to individualized targeting of focal brain stimulation across a range of diseases and stimulation modalities and can be experimentally tested in clinical trials.
Subfields: Cognitive Neuroscience, Neurology
View Paper: https://www.semanticscholar.org/paper/e9cc8504f809e1e7ea062fce191a952f5e319d6d
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Citations in the corpus
- Safety and recommendations for TMS use in healthy subjects and patient populations, with updates on training, ethical and regulatory issues: Expert Guidelines (2020, positive): “As these neuroanatomical targets become clearer (Fitzgerald et al., 2009; Fox et al., 2013; Weigand et al., 2018), neuroimaging is likely to take a stable place for therapeutic TMS applications.”
- Individual Variability in Functional Connectivity Architecture of the Human Brain (2013, neutral): “be guided by differences in connectivity (Fox et al., 2012).”
- Quantifying and reporting the precision of transcranial magnetic stimulation targeting. (2024, unknown): “…2019; Hermiller, 2020; Freed-berg, 2020; Hermiller, 2022), amygdala (Oathes, 2021; Sydnor, 2022), as well as to perform cross-network connectivity analyses (Fox, 2012; Fox et al., 2013; Cash, 2021; Cash, 2019; Weigand, 2018) to identify cortical stimulation targets in networks of interest.”