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Mechanisms mediating dynamic changes in neural responses during deep brain stimulation 脑深部刺激过程中神经反应动态变化的调节机制。
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-10 DOI: 10.1016/j.brs.2025.103002
Jahrane A. Dale , Stephen L. Schmidt , Kyle T. Mitchell , Jennifer J. Peters , Dennis A. Turner , Warren M. Grill

Background

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) to treat Parkinson's disease (PD) generates local evoked potentials (DLEPs). DLEPs reflect neural activation by DBS, but the mechanisms underlying the dynamic changes in DLEPs during continuous DBS are not understood, and such knowledge is critical to using these signals for DBS programming and closed-loop control.

Methods

We first systematically incorporated short-term synaptic depletion into 4 different synapse types in a biophysically realistic computational model of DLEPs. We then recorded DLEPs in naïve and a virally transfected rat model. Lastly, we conducted a retrospective analysis correlating DLEP dynamics to motor symptom severity in 13 patients with PD.

Results

A bespoke biophysical model suggests that synaptic depression, through synaptic vesicle depletion of activated motor cortical synapses onto STN neurons, causes the dynamic changes in DLEP amplitude and latency during continuous DBS. Virally-driven overexpression of endophilin A1 or alpha-synuclein in rat motor cortex reduces the time constant of DLEP amplitude and latency, supporting a critical role of these synapses in mediating DLEP dynamics. Further, a correlation between the change in UPDRS-III scores with antiparkinsonian medications and the time constant of DLEP amplitude is observed in persons with PD, suggesting DLEP dynamics as a biomarker of PD progression.

Conclusions

Collectively, these results suggest short-term synaptic depression of cortical synapses onto STN neurons mediate DLEP dynamics in STN DBS.
背景:丘脑下核(STN)深部脑刺激(DBS)治疗帕金森病(PD)产生局部诱发电位(DLEPs)。DLEPs反映了DBS的神经激活,但DLEPs在连续DBS过程中动态变化的机制尚不清楚,这些知识对于使用这些信号进行DBS编程和闭环控制至关重要。方法:我们首先在DLEPs的生物物理现实计算模型中系统地将短期突触耗竭纳入4种不同的突触类型。然后我们在naïve和病毒转染的大鼠模型中记录DLEPs。最后,我们对13例PD患者的DLEP动力学与运动症状严重程度的相关性进行了回顾性分析。结果:定制的生物物理模型表明,突触抑制通过激活的运动皮质突触到STN神经元上的突触囊泡耗竭,导致连续DBS期间DLEP振幅和潜伏期的动态变化。病毒驱动的大鼠运动皮层内嗜内肽A1或α -突触核蛋白的过表达降低了DLEP振幅和潜伏期的时间常数,支持这些突触在介导DLEP动力学中的关键作用。此外,在PD患者中观察到UPDRS-III评分与抗帕金森药物的变化与DLEP振幅时间常数之间的相关性,表明DLEP动态是PD进展的生物标志物。结论:总的来说,这些结果表明皮层突触对STN神经元的短期突触抑制介导了STN DBS中的DLEP动力学。
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引用次数: 0
Letter to the editor: Precision-guided multi-site insular deep brain stimulation for refractory neuropathic pain 致编辑的信:精确引导的多点岛脑深部刺激治疗难治性神经性疼痛。
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-06 DOI: 10.1016/j.brs.2025.102999
A.R. Segerdahl , A. Deli , A.L.B. Raghu , R. Crockett , T. Denison , A.L. Green , I. Tracey
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引用次数: 0
Reducing target E-field variability in repetitive TMS through online motion compensation 通过在线运动补偿减少重复经颅磁刺激的靶电场变异性。
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-04 DOI: 10.1016/j.brs.2025.102990
Sarah Grosshagauer , Michael Woletz , Marlen Becher , Jonas Björklund , Frank Padberg , Daniel Keeser , Lucia Bulubas , Christian Windischberger

Introduction

Precise targeting and dosing are critical for neurophysiological effectivity of repetitive transcranial magnetic stimulation (rTMS), particularly in clinical applications such as treating major depressive disorder (MDD). While neuronavigation enables accurate, individualized coil positioning, even small deviations in coil placement, e.g. during extended stimulation protocols, can significantly alter the induced electric field (E-field). In this study, we use continuous neuronavigational monitoring during stimulation to quantify motion-induced E-field variability at the target and introduce a novel methodology for compensating it.

Methods

We analyzed coil-target movement parameters in a sample of 200 rTMS sessions conducted in 20 adults with MDD, evaluating position, rotation and main axes of movement. In addition, we simulated induced E-fields within a target-ROI and quantified variability within- and across-sessions. To mitigate movement-related variability, we developed an algorithm which enables real-time adjustment of stimulator output based on current coil position and interpolation of precomputed E-fields.

Results

Our results show that E-field variability in this sample was primarily driven by coil displacement along the scalp-normal and rotation. Lateral movement played a minor role. Using the new stimulation amplitude adjustment strongly reduced target E-field variability. Mean E-field coefficient of variation was reduced within-session by 41% (2.85%–1.67%) and across-sessions by 74% (6.77%–1.73%).

Discussion

This study presents the first quantitative analysis of motion during rTMS treatment sessions and a practical method to compensate for it. Given its low computational cost, the proposed approach is well suited for clinical implementation, potentially enhancing treatment reliability, particularly in individuals prone to motion.
精确的靶向和剂量对于重复经颅磁刺激(rTMS)的神经生理有效性至关重要,特别是在临床应用中,如治疗重度抑郁症(MDD)。虽然神经导航可以实现精确、个性化的线圈定位,但即使线圈放置的微小偏差,例如在长时间刺激方案中,也会显著改变感应电场(E-field)。在这项研究中,我们在刺激过程中使用连续的神经导航监测来量化目标运动引起的电场变化,并引入一种新的方法来补偿它。方法:我们分析了20例重度抑郁症成人200次rTMS的线圈靶运动参数,评估了运动的位置、旋转和主轴。此外,我们模拟了目标roi内的诱导电场,并量化了会话内和跨会话的变异性。为了减轻运动相关的可变性,我们开发了一种算法,可以根据当前线圈位置和预先计算的e场插值实时调整刺激器输出。结果:我们的结果表明,该样品中的电场变异性主要是由线圈沿头皮法向和旋转的位移驱动的。横向运动起了次要作用。利用新的刺激幅度调整,有效地降低了目标电场的变异性。平均e场变异系数组内降低41%(2.85% ~ 1.67%),组间降低74%(6.77% ~ 1.73%)。讨论:本研究首次提出了rTMS治疗过程中运动的定量分析和一种实用的补偿方法。鉴于其较低的计算成本,所提出的方法非常适合临床实施,潜在地提高了治疗的可靠性,特别是在易于运动的个体中。
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引用次数: 0
dsGrid: a dual-site TMS grid-search method for personalized targeting of motor network connectivity dsGrid:一种针对运动网络连通性个性化定位的双站点TMS网格搜索方法。
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-04 DOI: 10.1016/j.brs.2025.102998
Joseph A. Deluisi , Elana R. Goldenkoff , Taraz G. Lee , James A. Brissenden , Stephan F. Taylor , Thad A. Polk , George F. Wittenberg , Michael Vesia

Background

Brain targets for transcranial magnetic stimulation (TMS) are often derived from anatomical landmarks or group-level neuroimaging data, which lack precision or personalization, contributing to the variability in TMS responses. Personalized functional magnetic resonance imaging (fMRI) may improve accuracy but remains resource-intensive and not widely accessible.

Objective

To determine whether a new dual-site targeting method (dsGrid), based on dual-coil TMS mapping of motor connectivity, aligns with individual motor network connectivity derived from fMRI and validate its use.

Methods

Forty-seven participants underwent resting-state and task-based fMRI, followed by dual-coil TMS during a goal-directed action task. Motor network connectivity was quantified using fMRI, both resting-state and task-based connectivity, and task-evoked BOLD activity was also quantified. The strength of fMRI-derived motor features was assessed at the TMS target sites identified by dsGrid and compared with the strength of these measures at a conventional group-based target (e.g., the P3 electrode from a 10–20 EEG system) and registered to individual anatomy.

Results

Targets identified by dsGrid are more accurate in terms of individualized motor network connectivity and activation across all three fMRI modalities than group-based P3 coordinates mapped to individual MRI space.

Conclusion

dsGrid enables precise, individualized TMS targeting of functional motor circuits, supporting its use in both research and clinical neuromodulation.
背景:经颅磁刺激(TMS)的脑靶点通常来自解剖标志或群体水平的神经影像学数据,缺乏精确性或个性化,导致了TMS反应的变异性。个性化功能磁共振成像(fMRI)可以提高准确性,但仍然是资源密集型的,不能广泛使用。目的:确定一种新的基于双线圈TMS运动连通性映射的双位点靶向方法(dsGrid)是否与fMRI得出的单个运动网络连通性一致,并验证其使用。方法:47名参与者在进行目标导向的动作任务时,分别进行静息状态和任务型功能磁共振成像和双线圈经颅磁刺激。运动网络连通性使用fMRI进行量化,包括静息状态和基于任务的连通性,任务诱发的BOLD活动也被量化。在dsGrid识别的TMS靶点上评估fmri衍生的运动特征的强度,并与这些措施在传统的基于群体的靶点(例如,来自10-20 EEG系统的P3电极)上的强度进行比较,并记录到个体解剖。结果:dsGrid识别的目标在所有三种fMRI模式下的个体化运动网络连接和激活方面比基于组的P3坐标映射到个体MRI空间更准确。结论:dsGrid能够精确、个性化地针对功能性运动回路的经颅磁刺激,支持其在研究和临床神经调节中的应用。
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引用次数: 0
A novel interleaved TMS-MRS approach with standard MRI hardware 基于标准MRI硬件的新型交错TMS-MRS方法。
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-02 DOI: 10.1016/j.brs.2025.102997
Maria Vasileiadi , Christopher B. Pople , Peter Truong , Benjamin Davidson , Clement Hamani , Peter Giacobbe , Nir Lipsman , Martin Tik , Jamie Near , Sean M. Nestor

Objective

Interleaved TMS-fMRI has advanced understanding of network modulation but is limited to hemodynamic measures. We introduce a novel interleaved TMS-MRS platform, using standard MRI hardware, to assess real-time neurochemical changes and demonstrate feasibility in a clinical sample of patients with treatment-resistant depression (TRD).

Methods

Nine TRD participants (mean age 47.3 ± 13.9) underwent interleaved TMS-MRS on a 3T Siemens Prisma. A 20 mm3 voxel was placed over individualized left dlPFC targets. 1H-MRS spectra were acquired at baseline and during 10 Hz burst stimulation. Spectral quality and metabolite concentrations were compared across conditions.

Results

Spectral quality was preserved across conditions (FWHM baseline: 0.041 ± 0.005; active: 0.040 ± 0.005; p = 0.699) and signal-to-noise remained stable (baseline: 38.29 ± 5.38; active: 34.67 ± 9.12; p = 0.790). Two metabolites differed significantly: alanine increased during stimulation (0.58 ± 0.16 vs. 0.46 ± 0.14; p = 0.031), while NAA + NAAG decreased (9.07 ± 2.02 vs. 8.83 ± 0.99; p = 0.031). Exploratory analyses suggested associations between baseline and stimulation-induced metabolites (e.g., GSH, GABA, lactate) and clinical improvement following accelerated iTBS.

Conclusion

Interleaved TMS-MRS is feasible with standard MRI hardware in TRD patients, enabling in-vivo detection of acute neurochemical changes during stimulation. This method offers a new avenue for probing excitatory/inhibitory balance, neuronal metabolism, and treatment mechanisms.
目的:交错TMS-fMRI对网络调节有深入的了解,但仅限于血流动力学测量。我们介绍了一种新的交错TMS-MRS平台,使用标准的MRI硬件,来评估实时神经化学变化,并证明在治疗难治性抑郁症(TRD)患者的临床样本中的可行性。方法:9例TRD患者(平均年龄47.3±13.9岁)在3T Siemens Prisma上行交错TMS-MRS检查。在个性化的左dlPFC目标上放置一个20 mm3的体素。在基线和10hz脉冲刺激时获得1H-MRS谱。不同条件下光谱质量和代谢物浓度的比较。结果:不同条件下(FWHM基线:0.041±0.005,主动:0.040±0.005,p = 0.699)的光谱质量保持不变,信噪比保持稳定(基线:38.29±5.38,主动:34.67±9.12,p = 0.790)。两种代谢物差异显著:刺激时丙氨酸升高(0.58±0.16比0.46±0.14,p = 0.031), NAA+NAAG降低(9.07±2.02比8.83±0.99,p = 0.031)。探索性分析表明,基线和刺激诱导的代谢物(如谷胱甘肽、GABA、乳酸)与加速iTBS后的临床改善之间存在关联。结论:交叉TMS-MRS在标准MRI硬件下对TRD患者是可行的,可以在体内检测刺激时的急性神经化学变化。这种方法为探索兴奋/抑制平衡、神经元代谢和治疗机制提供了新的途径。
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引用次数: 0
Time-dependent effect of left posterolateral cerebellar TMS in facial emotional processing 左小脑后外侧经颅磁刺激在面部情绪加工中的时间依赖效应。
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 DOI: 10.1016/j.brs.2025.103000
Sonia Paternò , Andrea Ciricugno , Zaira Cattaneo , Chiara Ferrari
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引用次数: 0
Response to: Brain injury during focused ultrasound neuromodulation for substance use disorder 对药物使用障碍聚焦超声神经调节期间脑损伤的反应。
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 DOI: 10.1016/j.brs.2025.102989
Elsa Fouragnan
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引用次数: 0
Neurophysiological correlates of spaced transcranial direct current stimulation in treatment-resistant depression: A case report 间隔经颅直流电刺激治疗难治性抑郁症的神经生理学相关性:1例报告
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-27 DOI: 10.1016/j.brs.2025.102995
Mohsen Poorganji , Hadley Daniels , Liam Lochhead , Jordan Kohn , Xia Li , Yinming Sun , Cory R. Weissman , Lawrence G. Appelbaum , Zafiris J. Daskalakis , Jean-Philippe Miron
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引用次数: 0
Open letter on intervention regimes and adverse events in focused ultrasound for neuromodulation 聚焦超声治疗神经调节的干预方案和不良事件的公开信。
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-27 DOI: 10.1016/j.brs.2025.102994
Miriam C. Klein-Flugge , Raag D. Airan , David Attali , Jean-Francois Aubry , Ellen J. Bubrick , Charles F. Caskey , Robin O. Cleveland , Elsa F. Fouragnan , Ryan M. Jones , Tatiana D. Khokhlova , Jan Kubanek , Harriet Lea-Banks , Wynn Legon , Nathan McDannold , Keith R. Murphy , Takahiro Osada , Kim Butts Pauly , Samuel Pichardo , Jérôme Sallet , Lei Sun , Lennart Verhagen
{"title":"Open letter on intervention regimes and adverse events in focused ultrasound for neuromodulation","authors":"Miriam C. Klein-Flugge ,&nbsp;Raag D. Airan ,&nbsp;David Attali ,&nbsp;Jean-Francois Aubry ,&nbsp;Ellen J. Bubrick ,&nbsp;Charles F. Caskey ,&nbsp;Robin O. Cleveland ,&nbsp;Elsa F. Fouragnan ,&nbsp;Ryan M. Jones ,&nbsp;Tatiana D. Khokhlova ,&nbsp;Jan Kubanek ,&nbsp;Harriet Lea-Banks ,&nbsp;Wynn Legon ,&nbsp;Nathan McDannold ,&nbsp;Keith R. Murphy ,&nbsp;Takahiro Osada ,&nbsp;Kim Butts Pauly ,&nbsp;Samuel Pichardo ,&nbsp;Jérôme Sallet ,&nbsp;Lei Sun ,&nbsp;Lennart Verhagen","doi":"10.1016/j.brs.2025.102994","DOIUrl":"10.1016/j.brs.2025.102994","url":null,"abstract":"","PeriodicalId":9206,"journal":{"name":"Brain Stimulation","volume":"19 1","pages":"Article 102994"},"PeriodicalIF":8.4,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Modulation of emotional memory in depression: Concurrent fMRI-guided rTMS over OFA during sad face viewing 抑郁症中情绪记忆的调节:fmri引导下的rTMS在悲伤面孔观看期间通过OFA进行并发
IF 8.4 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-11-27 DOI: 10.1016/j.brs.2025.102996
Hanliang Wei , Qiandong Wang , Waxun Su , Peng Li , Kai Yuan , Jiahui Deng , Zhaohui Zhang , Peter Zwanzger , Xiao Lin , Lin Lu
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引用次数: 0
期刊
Brain Stimulation
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