Neuromodulation最新文献

{"title":"Magnetic Resonance Imaging Monitoring of the Safety of Repeated Low-Intensity Focused Ultrasound Exposure at Three Brain Locations","authors":"M. Anthony Phipps PhD ,&nbsp;Arabinda Mishra PhD ,&nbsp;Cooper L. Donovan ,&nbsp;Allen T. Newton PhD ,&nbsp;Colin D. McKnight MD ,&nbsp;Allison Q. Dockum MS ,&nbsp;Michelle K. Sigona PhD ,&nbsp;Pai-Feng Yang PhD ,&nbsp;Charles F. Caskey PhD ,&nbsp;Li Min Chen MD, PhD","doi":"10.1016/j.neurom.2025.09.313","DOIUrl":"10.1016/j.neurom.2025.09.313","url":null,"abstract":"<div><h3>Objectives</h3><div>Transcranial focused ultrasound stimulation (FUS) integrated with magnetic resonance (MR) acoustic radiation force imaging (ARFI) enables real-time localization of the FUS beam, a highly desirable feature for neuromodulation. Because MR-ARFI requires higher acoustic pressure, it is essential to establish the safety of repeated sonication during both ARFI and FUS procedures.</div></div><div><h3>Materials and Methods</h3><div>Six macaque monkeys underwent repeated neuromodulation studies targeting three brain regions: the thalamic ventroposterior lateral (VPL) nucleus, anterior cingulate cortex (ACC), and periaqueductal gray (PAG). Susceptibility-weighted imaging (SWI) and fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) sequences, sensitive to microbleeds, edema, and lesions, were acquired during each session. MRI signals from target regions were quantified and compared with control regions of interest with similar tissue properties. Signal variability within two SDs was considered negative, indicating no detectable damage. Data acquisition intervals ranged from two weeks to &gt;one year. Histologic analysis with Hematoxylin and Eosin and glial fibrillary acidic protein stains was performed on one PAG target.</div></div><div><h3>Results</h3><div>No evidence of tissue damage was detected at any of the three targeted brain regions on SWI or FLAIR imaging. Signal variability for all targets remained within two SDs. Histologic evaluation revealed evenly distributed staining with no signs of tissue damage or neuroinflammation. These findings apply to both neuromodulation pulses delivered within current guidelines and MR-ARFI pulses exceeding current guideline limits.</div></div><div><h3>Conclusions</h3><div>Repeated sonication of cortical, deep brain, and brainstem regions caused no detectable tissue damage, supporting a preliminary safety profile for clinical applications using similar MR-guided FUS protocols.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 243-254"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Modulation of Cortical Excitability by Repeated Anodal Transcranial Direct Current Stimulation Highlights Neurobiological Constraints in a Neurodevelopmental Disorder Model","authors":"Bhanumita Agrawal MSc ,&nbsp;Roaa Abu Zeid MSc ,&nbsp;Hanoch Kaphzan MD, PhD, MPH","doi":"10.1016/j.neurom.2025.10.058","DOIUrl":"10.1016/j.neurom.2025.10.058","url":null,"abstract":"<div><h3>Introduction</h3><div>Transcranial direct current stimulation (tDCS) modulates neuronal excitability, but its long-term effects on intrinsic and synaptic properties remain largely underinvestigated, as are its effects in the case of a malfunctioning brain, such as in neurodevelopmental disorders.</div></div><div><h3>Materials and Methods</h3><div>We applied a repeated sham or anodal tDCS for five consecutive days to wild-type (WT) and Angelman syndrome (AS) model mice over the parietal cortex. Behavioral assessments began on the third day of stimulation. Ninety minutes after the final fifth session, we extracted the brains and measured the intrinsic and synaptic neuronal properties of layer-V pyramidal neurons in the cortical area under the stimulating electrode.</div></div><div><h3>Results</h3><div>Anodal tDCS did not improve spatial memory performance in the object location memory task but altered exploratory behavior. Moreover, it differentially modulated neuronal excitability in WT and AS mice, inducing an enhanced excitability, especially in AS neurons. In addition, we observed complementary differential effects of anodal tDCS on the intrinsic properties of WT and AS neurons. Although WT neurons showed homeostatic regulatory modulation of intrinsic and synaptic properties that mitigated the enhanced excitability to some extent, AS neurons showed a dysregulated increase in excitability, with impaired compensatory mechanisms at both intrinsic and synaptic levels.</div></div><div><h3>Discussion</h3><div>These findings reveal that tDCS modulates excitability by inducing long-term modulation of intrinsic and synaptic properties. Moreover, these findings emphasize that the neurophysiologic response to tDCS is shaped by the underlying neurobiological context, differing markedly between healthy and diseased brains.</div></div><div><h3>Conclusions</h3><div>Although tDCS can induce long-term excitability changes, its effects depend on intact regulatory mechanisms, highlighting the need for tailored approaches in neurodevelopmental disorders such as AS.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 227-242"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized Beta Frequency Intermittent Theta Burst Stimulation Enhances Corticospinal Plasticity in Healthy Adults","authors":"Daisuke Kudo PhD ,&nbsp;Mitsuhiro Nito PhD ,&nbsp;Akio Kikuchi PhD, MD ,&nbsp;Shigeo Tanabe PhD ,&nbsp;Tomofumi Yamaguchi PhD","doi":"10.1016/j.neurom.2025.10.069","DOIUrl":"10.1016/j.neurom.2025.10.069","url":null,"abstract":"<div><h3>Background</h3><div>Intermittent theta burst stimulation (iTBS) can alter cortical excitability by modulating dendritic plasticity and spine density; however, its efficacy exhibits high interindividual variability. Recent findings suggest that noninvasive brain stimulation with individualized beta-band frequency improves cortical plasticity. This study investigated whether iTBS applied at an individualized beta-band frequency could increase specific cortical excitability (ie, L2/3 interneurons and L5 pyramidal neurons), prolonging effects and reducing variability.</div></div><div><h3>Materials and Methods</h3><div>In total, 30 healthy individuals participated in two experiments using a randomized, cross-over design with three conditions: individualized beta-band frequency iTBS (individualized iTBS), conventional iTBS, and sham stimulation. Each intervention was applied for 190 seconds over the left primary motor cortex (M1). For individualized iTBS, the standard 50-Hz burst frequency was replaced with each participant’s peak beta-band corticomuscular coherence between electroencephalography over the left M1 and electromyography from the right first dorsal interosseous muscle. In experiment 1, we evaluated the immediate effects of each intervention on motor-evoked potentials (MEPs) elicited by transcranial magnetic stimulation in posterior–anterior (PA) and lateral–medial (LM) orientations. In experiment 2, we assessed the duration of changes in corticospinal excitability at 10-minute intervals up to 60 minutes after stimulation.</div></div><div><h3>Results</h3><div>Individualized iTBS immediately increased PA-MEPs and LM-MEPs, and sustained improvement of corticospinal excitability for up to 50 minutes. Conversely, conventional iTBS induced an immediate increase only in PA-MEPs but failed to produce sustained improvement. Sham iTBS induced no significant changes in either PA-MEPs or LM-MEPs and did not elicit any lasting effects. Furthermore, in experiment 2, responders were defined as individuals with a Post0-to-Pre-MEP ratio &gt;1.15, and the responder rate was higher with individualized iTBS (62.5%) than with conventional iTBS (37.5%).</div></div><div><h3>Conclusions</h3><div>These findings suggest that individualized beta-band frequency iTBS improves the duration of corticospinal excitability and reduces interindividual variability, possibly through improved specific cortical excitability.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 298-305"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Resolution Computational Modeling of Transcranial Photobiomodulation: Light Propagation and Thermal Effects","authors":"Alexander R. Guillen MS ,&nbsp;Dennis Q. Truong PhD ,&nbsp;Paula Cristina Faria PhD ,&nbsp;Brian Pryor PhD ,&nbsp;Luis de Taboada MSEE ,&nbsp;Abhishek Datta PhD","doi":"10.1016/j.neurom.2025.06.003","DOIUrl":"10.1016/j.neurom.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Transcranial photobiomodulation (tPBM) is the noninvasive application of light to modulate underlying brain activity. There is increasing interest in evaluating tPBM as a therapeutic option. The typical technological questions are extent of light penetration and associated tissue temperature increases. Limited computational efforts to quantify these aspects are restricted to simplified models.</div></div><div><h3>Materials and Methods</h3><div>We considered a three-dimensional high-resolution (1 mm) anatomically realistic head model to simulate tPBM with the light source targeting the F3 region at 800 nm wavelength. Power densities spanning three decades (10, 100, and 1000) mW/cm² were investigated. We also tested time-variant application at 100 mW/cm² for up to 20 minutes. Finally, tissue temperature increases for the American National Standards Institute safety limit of 330 mW/cm² also were determined at a test case.</div></div><div><h3>Results</h3><div>Our predictions reveal that the induced cortical irradiance is largely focal, demarcated by the shape and extent of the source. Approximately 1% of the injected irradiance reaches the gray matter. Aligned with previous efforts, the scalp accounts for the greatest loss (∼65%). The irradiance reduces to a hundredth of the value from gray matter at an approximately 113-mm perpendicular distance from its surface. There is a growing halo-like effect at the level of cerebrospinal fluid (CSF), which is extended down to the underlying cortex. The CSF was found to be mainly responsible for this effect. We observe scalp temperature increases of 0.38 °C and 3.76 °C for 100 and 1000 mW/cm² power density, respectively. The corresponding brain temperature increases are predicted to be 0.06 °C and 0.57 °C. As expected, irradiance absorption is linear with applied power density. Although the maximum induced scalp temperature increases linearly with power density, maximum brain temperature increases less slowly with power density. Transient analysis at 100 mW/cm² power density indicates expected scalp temperature increase with increasing stimulation duration. Temperature increases asymptote in approximately 10 minutes.</div></div><div><h3>Conclusions</h3><div>tPBM presents unique potential to directly impose a desired spatial profile using simple alteration of the shape and size of the source. Usage of power density of 1000 mW/cm² exceeds scalp and brain temperature safety limits. Contrary to prior reports, light penetration can exceed &gt;10 cm from gray matter surface.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 267-280"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repetitive Transcranial Magnetic Stimulation for Refractory and Super-refractory Status Epilepticus: A Systematic Review","authors":"Chloé Algoet MD ,&nbsp;Kato Van Rooy MD ,&nbsp;Paul Boon MD, PhD ,&nbsp;Evelien Carrette PhD ,&nbsp;Sofie Carrette MD ,&nbsp;Mathieu Sprengers MD, PhD ,&nbsp;Robrecht Raedt PhD ,&nbsp;Ann Mertens MD, PhD ,&nbsp;Alfred Meurs MD, PhD ,&nbsp;Kristl Vonck MD, PhD","doi":"10.1016/j.neurom.2025.02.001","DOIUrl":"10.1016/j.neurom.2025.02.001","url":null,"abstract":"<div><h3>Rationale</h3><div>Off-label treatments are often considered to treat refractory status epilepticus (RSE) and superrefractory status epilepticus (SRSE). To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) as a treatment for (S)RSE, we performed a systematic review.</div></div><div><h3>Materials and Methods</h3><div>Cessation of (S)RSE after rTMS was extracted as the primary end point from manuscripts describing patients with (S)RSE treated with rTMS. Data relevant to epilepsy history, (S)RSE type and etiology, prior treatment for (S)RSE, prior duration of (S)RSE, rTMS parameters, number of treatment sessions, duration of rTMS protocols, latency to (S)RSE cessation, recurrence rate, adverse events, and long-term outcome were collected as secondary end points.</div></div><div><h3>Results</h3><div>We identified 33 patients; 17 of 33 had epilepsia partialis continua; 7 of 33 had new onset RSE. Data were incomplete in 3 of 33 regarding classification and etiology; 18 of 30 had focal motor status epilepticus (SE), 9 of 30 nonconvulsive SE, and 3 of 30 convulsive SE. The most frequent etiologies were cortical malformation (8/31), stroke (5/31), and genetic mutations (5/31). Median duration of (S)RSE before rTMS was 70 days (range: two–7300, interquartile range = 148, Q1 = 32, Q3 = 180). In 25 of 33 patients (75.8%), rTMS caused cessation of (S)RSE after zero to four days. (S)RSE recurred in eight of 17 patients (47%), for whom follow-up was available. Three deaths occurred from the underlying disease.</div></div><div><h3>Conclusion</h3><div>rTMS caused cessation in 75.8% of patients with (S)RSE within four days, with recurrence in 47%. To determine the therapeutic potential of rTMS for patients with (S)RSE, further studies are required given the present findings stem from level IV studies and may have reporting bias.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 205-218"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shape of the Pulse: Pulse Width and Current Direction Effects on Motor Evoked Potentials Using a Cobot-assisted Controllable Transcranial Magnetic Stimulation Device","authors":"Mirja Osnabruegge MSc ,&nbsp;Florian Schwitzgebel PhD ,&nbsp;Carolina Kanig MSc ,&nbsp;Hannah Franke ,&nbsp;Katharina Kerkel MSc ,&nbsp;Andreas Reissmann PhD ,&nbsp;Berthold Langguth MD ,&nbsp;Wolfgang Mack PhD ,&nbsp;Martin Schecklmann PhD ,&nbsp;Stefan Schoisswohl PhD","doi":"10.1016/j.neurom.2025.08.418","DOIUrl":"10.1016/j.neurom.2025.08.418","url":null,"abstract":"<div><h3>Background</h3><div>Transcranial magnetic stimulation (TMS) is a noninvasive technique for stimulating the cerebral cortex. The purpose of the study is to investigate the effect of current direction and pulse width on motor evoked potentials (MEPs), using a controllable TMS (cTMS) stimulator in combination with cobot-assisted neuronavigation. The setup allows a modulation of pulse width and current direction within one TMS system while precise and reliable coil placement motor cortex is ensured.</div></div><div><h3>Materials and Methods</h3><div>In 30 healthy participants, MEPs were recorded from the first dorsal interosseous muscle. Biphasic pulses with different initial phase durations (280 and 160 μs) and current directions (posterior-anterior [PA] and anterior-posterior [AP] in second phase) were used both for determining resting motor threshold (RMT) and MEPs. To assess MEPs, 100 pulses were applied with an intensity of 110% RMT in three conditions (PA_280μs, AP_280μs, PA_160μs).</div></div><div><h3>Results</h3><div>Stimulation with the cTMS device was well tolerated, with no serious adverse events or uncommon side effects. The RMT differed significantly among pulse widths, indicating an inversely proportional relationship of pulse width and stimulation intensity. Differences in RMT and MEP readout show sensitivity of the motor cortex and indicate AP-PA currents as more effective than PA-AP currents when adjusted to threshold. For pulse width, no differences were found for electromyography readout, indicating shorter pulses as more efficient given they produce the same level of electrophysiologic response but with less energy loss.</div></div><div><h3>Discussion</h3><div>This study emphasizes that TMS outcomes depend on the current direction and pulse width of stimulation parameters. The finding that shorter pulses achieve equivalent responses with lower energy use suggests more efficient stimulation protocols, whereas the sensitivity to current direction underlines the need for parameter optimization to improve reliability and comparability across studies and devices. These insights support the improvement of TMS protocols in both research and clinical applications.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 289-297"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review of Mechanistic Effects of Low-Intensity Focused Ultrasound","authors":"Pravarakhya Puppalla BA ,&nbsp;Ugur Kilic MD, PhD ,&nbsp;Derek D. George MD ,&nbsp;AnneLeigh Twer ,&nbsp;Minza Haque MBBS ,&nbsp;Lotanna Ojukwu BS ,&nbsp;Julie G. Pilitsis MD, PhD, MBA","doi":"10.1016/j.neurom.2025.07.006","DOIUrl":"10.1016/j.neurom.2025.07.006","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>Low-intensity focused ultrasound (LIFU) has become increasingly used in neuromodulation. However, its mechanisms of action are less well understood. Here, we provide a scoping review of the effects of LIFU on nervous system tissue.</div></div><div><h3>Materials and Methods</h3><div>We evaluated the PubMed, SCOPUS, and Web of Science data bases for articles using the keywords related to LIFU and neuromodulation; 3970 articles were retrieved and titles screened by two authors (AT and MH) with conflicts resolved by one author (PP). The abstract review included 837 articles, and full-text review included 371 articles; 157 articles were included in the final manuscript.</div></div><div><h3>Results</h3><div>The mechanisms of action of LIFU for neuromodulation have been studied in vitro, in preclinical models, and in humans. LIFU exerts both excitatory and inhibitory modulatory effects through ion channel activation, changes in neurotransmission, and certain gene expression pathways. These changes cause localized and distributed effects in brain tissue and in behavioral modification in human trials and nonhuman models, depending on stimulation parameters and region targeted. Most LIFU research focuses on cerebral neuromodulation whereas some data exist for spinal cord and peripheral nerve neuromodulation.</div></div><div><h3>Conclusion</h3><div>Considerable growth in research evaluating LIFU’s ability to modulate the nervous system has occurred. Although safety and efficacy have been indicated, heterogeneity in LIFU operating parameters may cause nuanced differential effects on target tissue. By further elucidating the mechanisms of LIFU neuromodulation, future research will advance treatments for chronic neurologic diseases.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 163-186"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145302484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2026 Calendar of Events","authors":"","doi":"10.1016/S1094-7159(25)01223-1","DOIUrl":"10.1016/S1094-7159(25)01223-1","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Page 342"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146098874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Theta-Burst Stimulation of the Right Temporoparietal Junction and Implicit Theory of Mind in Autism","authors":"Amir-Homayun Hallajian MSc ,&nbsp;Fateme Dehghani-Arani PhD ,&nbsp;Sepehr Sima MSc ,&nbsp;Amirmahdi Heydari BSc ,&nbsp;Kiomars Sharifi MSc ,&nbsp;Yasamin Rahmati MSc ,&nbsp;Reza Rostami MD ,&nbsp;Zahra Vaziri PhD ,&nbsp;Mohammad Ali Salehinejad PhD","doi":"10.1016/j.neurom.2025.04.005","DOIUrl":"10.1016/j.neurom.2025.04.005","url":null,"abstract":"<div><h3>Objectives</h3><div>Theory of mind (ToM), or mentalizing, is the ability to attribute mental states to oneself and others and is altered in individuals with autism spectrum disorder (ASD). Recent evidence suggests that <em>impli</em><em>cit</em> rather than explicit ToM is impaired in individuals with ASD. The right temporoparietal junction (rTPJ), which plays a crucial role in ToM, has altered activity in ASD and is a potential terget by noninvasive brain stimulation.</div></div><div><h3>Materials and Methods</h3><div>In a randomized single-blind placebo-controlled study, we investigated, for what we believe is the first time, the effects of theta-burst stimulation of the rTPJ on implicit ToM and egocentric bias in 17 adolescents with ASD. Participants (mean age = 13.84 ± 3.32 years) were randomly assigned to three sessions of continuous theta-burst stimulation (cTBS), intermittent theta-burst stimulation (iTBS), and sham stimulation in a counterbalanced order. Stimulation intensity was set to 80% of the active motor threshold during cTBS and iTBS, with the coil centered on the rTPJ (CP6). Immediately after each stimulation, cognitive correlates of ToM, including <em>implicit</em> mentalizing and egocentric bias, were evaluated using the computerized Buzz-lightyear task.</div></div><div><h3>Results</h3><div>Both cTBS and iTBS significantly improved <em>implicit</em> ToM compared with sham stimulation, with cTBS yielding a numerically larger effect (379.2 milliseconds) than did iTBS (191.3 milliseconds), although this difference was not statistically significant. No effect was found on the egocentric bias index.</div></div><div><h3>Conclusions</h3><div>These findings show a causal link between the rTPJ activation and implicit mentalizing in ASD, suggesting that theta-burst stimulation of this region can be used to enhance ToM in ASD. Targeting the rTPJ may improve implicit mentalizing in ASD and other disorders with impaired ToM.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 306-315"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144160696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cingulo-Opercular Connectivity Enhances the Repeatability of Transcranial Magnetic Stimulation Target Maps","authors":"Emma Komulainen MD, PhD ,&nbsp;Annu-Sinikka Salminen MD ,&nbsp;Dogu Baran Aydogan PhD ,&nbsp;Siina Pamilo DSC (Tech) ,&nbsp;Tuukka T. Raij MD, PhD","doi":"10.1016/j.neurom.2025.09.316","DOIUrl":"10.1016/j.neurom.2025.09.316","url":null,"abstract":"<div><h3>Introduction</h3><div>The effectiveness of transcranial magnetic stimulation (TMS) in the treatment of major depressive disorder (MDD) may be enhanced through individualized targeting in the dorsolateral prefrontal cortex (DLPFC). Recent clinical trials have used TMS targeting based on the subgenual anterior cingulate cortex (sgACC) or right anterior insula (rAI) functional connectivity. However, the repeatability of such individual targeting may present significant challenges for feasibility.</div><div>We aimed to compare the repeatability of the novel depression core network model-based (CNM) target maps with the sgACC functional connectivity-based and the rAI effective connectivity-based target maps. We further tested whether using a movie stimulus increases the feasibility of individualized functional connectivity-based targeting.</div></div><div><h3>Materials and Methods</h3><div>In a final sample of 31 patients with treatment-resistant MDD, the repeatability of the target maps was computed as the within-subject spatial correlation among imaging sessions in the DLPFC. Repeatability was compared across the connectivity models. Furthermore, repeatability, head movement, and subjective alertness and comfortableness during functional magnetic resonance imaging (fMRI) were compared between movie and resting-state acquisition.</div></div><div><h3>Results</h3><div>The CNM functional connectivity-based DLPFC target maps were more repeatable than the sgACC- or rAI-based target maps when using a movie stimulus. In particular, the cingulo-opercular seeds from the CNM produced target maps with high repeatability in both resting-state and movie stimulus conditions. Compared with the resting-state, the movie stimulus reduced head movement during fMRI but did not enhance repeatability at a statistically significant level.</div></div><div><h3>Conclusions</h3><div>Our findings support future investigations of multiseed functional connectivity targeting methods, including those focused on the cingulo-opercular regions. These findings also encourage further research on the use of engaging naturalistic stimuli to enhance the feasibility of individualized TMS targeting.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"29 2","pages":"Pages 316-325"},"PeriodicalIF":3.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}