Evaluating the Safety Profile of Connectome-Based Repetitive Transcranial Magnetic Stimulation.

IF 2.6 4区医学 Q3 NEUROSCIENCES

Acta Neuropsychiatrica Pub Date : 2025-03-21 DOI:10.1017/neu.2025.9

Si Jie Tang, Jonas Holle, Emil Gabrielsson, Nicholas B Dadario, Mark Ryan, Maurice Sholas, Michael E Sughrue, Charles Teo, Jacky Yeung

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引用次数: 0

Abstract

Objective: New developments in neuro-navigation and machine learning have allowed for personalized approaches to repetitive transcranial magnetic stimulation (rTMS) to treat various neuropsychiatric disorders. One specific approach, known as the Cingulum Framework, identifies individualized brain parcellations from resting state fMRI based on a machine-learning algorithm. Theta burst stimulation, a more rapid form of rTMS, is then delivered for 25 sessions, 5 per day, over 5 days consecutively or spaced out over 10 days. Preliminary studies have documented this approach for various neurological and psychiatric ailments. However, the safety and tolerability of this approach is unclear.

Methods: We performed a retrospective study on 165 unique patients (202 Target Sets) treated with this personalized approach between January 2020 to December 2023.

Results: Common side effects included fatigue (102/202, 50%), local muscle twitching (89/202, 43%), headaches (49/202, 23%), and discomfort (31/202, 17%), all transient. The top 10 unique parcellations commonly found in the Target Sets included L8av (52%), LPGs (28%), LTe1m (21%), RTe1m (18%), LPFM (17%), Ls6-8 (13%), Rs6-8 (9%), L46 (7%), L1 (6%), and L6v (6%). Fatigue was most common in Target Sets that contained R6v (6/6, 100%) and L8c (5/5, 100%). Muscle twitches were most common in Target Sets that contained RTGv (5/5, 100%) and LTGv (4/4, 100%).

Conclusion: These side effects were all transient and well-tolerated. No serious side effects were recorded. Results suggested that individualized, connectome-guided rTMS is safe and contain side effect profiles similar to other TMS approaches reported in the literature.

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目的：神经导航和机器学习的新发展使得重复经颅磁刺激（rTMS）治疗各种神经精神疾病的个性化方法成为可能。其中一种具体方法被称为 "Cingulum 框架"，它基于机器学习算法，从静息状态 fMRI 中识别出个性化的脑区。Theta 脉冲串刺激是一种更快速的经颅磁刺激，可在连续 5 天或间隔 10 天内进行 25 次治疗，每天 5 次。初步研究表明，这种方法适用于各种神经和精神疾病。然而，这种方法的安全性和耐受性尚不明确：我们对 2020 年 1 月至 2023 年 12 月期间使用这种个性化方法治疗的 165 名患者（202 个目标组）进行了回顾性研究：常见副作用包括疲劳（102/202，50%）、局部肌肉抽搐（89/202，43%）、头痛（49/202，23%）和不适（31/202，17%），均为一过性。目标组中常见的前 10 个独特旁路包括 L8av（52%）、LPGs（28%）、LTe1m（21%）、RTe1m（18%）、LPFM（17%）、Ls6-8（13%）、Rs6-8（9%）、L46（7%）、L1（6%）和 L6v（6%）。疲劳在包含 R6v（6/6，100%）和 L8c（5/5，100%）的目标组中最为常见。肌肉抽搐在包含 RTGv（5/5，100%）和 LTGv（4/4，100%）的目标组中最为常见：结论：这些副作用都是短暂的，且耐受性良好。没有严重副作用的记录。结果表明，个体化的、由连接体引导的经颅磁刺激是安全的，其副作用与文献中报道的其他经颅磁刺激方法相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neuropsychiatrica NEUROSCIENCES-PSYCHIATRY

自引率

5.30%

发文量

期刊介绍： Acta Neuropsychiatrica is an international journal focussing on translational neuropsychiatry. It publishes high-quality original research papers and reviews. The Journal''s scope specifically highlights the pathway from discovery to clinical applications, healthcare and global health that can be viewed broadly as the spectrum of work that marks the pathway from discovery to global health.