NeuroImage: DTI引导TMS可有效靶向深部大脑结构

2022-01-22 影像小生 MedSci原创

TMS-fMRI结合的方法可以利用网络属性帮助克服深度限制,并实现非侵入性脑刺激影响深层大脑结构的可能性。

经颅磁刺激(TMS)已经成为探索皮质功能的有力工具,而且在各种精神病学和神经系统疾病的治疗中,也已经证明了这一点。不幸的是,由于TMS的直接影响,大部分的结论认为仅限于在头皮下几厘米的区域, 然而,更遥远的区域可能会受到结构上相连的刺激点的影响。

Bruce Luber等在NeuroImage杂志发表研究文章,在这项研究中,他们试图研发一种新范式,个体化放置TMS线圈,以实现无创地激活与治疗精神疾病相关的特定脑深部目标。

在10个受试者中,使用结构扩散成像纤维示踪数据在右额极识别一个可接近的皮质目标,该目标显示与BA25的解剖和功能连接。一系列单一交错TMS脉冲应用于右侧额极,强度为从80%到140%的运动阈值的四个等级。

用于功能分析的四个感兴趣区。红色:刺激位点;紫色:背侧控制位点;绿色:R-BA25纤维束确定区域;蓝色:L-BA25纤维束确定区域。

10个受试者中的9个, TMS刺激个性化额极位点导致了BA25的BOLD活动随TMS强度增加呈线性增高。

组纤维束结果。用于纤维束分析的BA25种子点ROI显示为黄色。

fMRI活动的刺激依赖差异。a) 120%MT vs 80%MT, B) 140%MT vs 80%MT。

激活中的群体水平刺激效应。

结构-连接基础(A)和功能-连接基础(B)目标的有效性。

DTI引导的TMS的初步应用表明,这是一种扩展非侵入性刺激效用的新工具,使研究人员能够瞄准以前被认为无法触及的大脑深层区域。此处的深层目标是BA25,它被认为是抑郁症神经系统的一个关键节点。BA25以剂量依赖的方式成功激活,表明了无论靶向目标位于大脑的哪个位置,使用DTI引导的TMS是进行无创治疗的第一步,

BA25在剂量依赖性上的可靠激活表明TMS-fMRI结合的方法可以利用网络属性帮助克服深度限制,并实现非侵入性脑刺激影响深层大脑结构的可能性。

 原文出处

Using diffusion tensor imaging to effectively target TMS to deep brain structures

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    2022-05-15 360611850
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    2022-08-05 whlxd
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    2022-01-20 wmr116

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