Transcranial magnetic stimulation (2024)最新文献

{"title":"Stochastic Approximator of Motor Threshold (SAMT) for Transcranial Magnetic Stimulation: Online Software and Its Performance in Clinical Studies.","authors":"Boshuo Wang, Vedarsh U Shah, Lari M Koponen, Andrada D Neacsiu, Zafiris J Daskalakis, Paul B Fitzgerald, Lawrence G Appelbaum, Jessica Y Choi, Nimesha Gerlus, Yiru Li, Itay Hadas, Yinming Sun, Mohsen Poorganji, Hadley Daniels, Katie Rodriguez, Efstathia Stephanie Gotsis, Neil W Bailey, Jeydhurga Raveendran, Shona K Brinley, Alexander T Gallo, Stefan M Goetz, Angel V Peterchev","doi":"10.1016/j.transm.2026.100312","DOIUrl":"10.1016/j.transm.2026.100312","url":null,"abstract":"<p><strong>Background: </strong>The motor threshold (MT) plays a central role in probing brain excitability and individualizing transcranial magnetic stimulation (TMS). Previously, we proposed stochastic approximation (SA) as a new method for determining TMS MT and demonstrated its excellent speed and accuracy via simulations. SA also has low computational requirements and is theoretically robust to potential model flaws.</p><p><strong>Objective: </strong>This project aimed to develop a practical SA thresholding method and assess its performance in clinical studies.</p><p><strong>Methods: </strong>The SA thresholding method was implemented as an online software application-SAMT (Stochastic Approximator of MT)-that incorporates features for warning against likely inaccurate MT estimates. Two clinical studies used SAMT and collected 365 small hand muscle MTs from 179 participants to date. SAMT's misestimation warning method marked MTs of 7 thresholding trials as likely inaccurate, and SAMT's performance in the remaining 358 trials was assessed by comparing the MT at each step to the threshold estimated by fitting a sigmoidal probability distribution to the complete muscle response data from the session using maximum likelihood estimation (MLE).</p><p><strong>Results: </strong>By the 25^th TMS pulse, 99% of the SAMT MTs differed by less than 3.0% (relative) and 1.3% of maximum stimulator output (absolute) from the corresponding fitted MLE sigmoid thresholds and were within the 95% confidence intervals of the MLE thresholds.</p><p><strong>Conclusions: </strong>We provide the TMS community with a new thresholding tool, SAMT. Combined with the prior simulation results, the experimental assessment presented here supports the practicality and accuracy of the SA thresholding method and the SAMT software.</p>","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"7 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic caffeine consumption on clinical TMS outcomes: A naturalistic retrospective analysis.","authors":"Jamie Kweon, Prem Ganesh, Joshua C Brown","doi":"10.1016/j.transm.2025.100199","DOIUrl":"10.1016/j.transm.2025.100199","url":null,"abstract":"<p><p>Health and behavioral factors likely influence repetitive transcranial magnetic stimulation (rTMS) effectiveness, though clear support is lacking. Since habitual caffeine use has been found to impair corticomotor plasticity, we hypothesized that clinical benefits may likewise be impaired. We performed a retrospective analysis (n = 179) from the McLean Hospital TMS Clinic to explore the effect of self-reported caffeine use on TMS clinical outcomes. Self-report depression and anxiety scales from caffeine users and non-users were compared with Wilcoxon-rank-sum test and response and remission rates with chi-square; Spearman's was used to correlate correlation caffeine quantity with degree of clinical change. Both groups experienced a significant reduction in depressive symptoms as expected. Contrary to our hypothesis, however, we found no differences between caffeine users and non-users in total symptom reduction or response and remission rates, nor did we find a relationship between caffeine quantity and clinical change. This naturalistic analysis suggests that chronic caffeine consumption does not influence treatment outcomes in clinical rTMS for depression.</p>","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"5 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing synaptic mechanisms of iTBS and 10-Hz rTMS corticomotor plasticity.","authors":"Prem Ganesh, Jamie Kweon, Shan H Siddiqi, Linda L Carpenter, Joshua C Brown","doi":"10.1016/j.transm.2025.100191","DOIUrl":"10.1016/j.transm.2025.100191","url":null,"abstract":"<p><strong>Introduction: </strong>Intermittent theta burst stimulation (iTBS) and 10-Hz repetitive transcranial magnetic stimulation (rTMS) appear clinically equivalent for the treatment of depression, but whether they share the same mechanism of action at the synaptic level is unknown.</p><p><strong>Methods: </strong>In this randomized, double-blind, placebo-controlled, eight-arm crossover study, we directly compared the influence of N-methyl-D-aspartate receptor (NMDAR) and gamma-aminobutyric acid receptor (GABAR) activity on iTBS and 10-Hz rTMS induced corticomotor plasticity in six healthy subjects using both permutation analysis and a linear mixed model with repeated measures of motor-evoked potentials (MEPs).</p><p><strong>Results: </strong>iTBS and 10-Hz produced nearly identical corticomotor plasticity in the placebo condition (p = 1.0), consistent with clinical equivalency. However, 10-Hz rTMS benefitted from NMDAR agonism with d-cycloserine (DCS) more than iTBS (β = 0.516, p < 0.001), which was partially attenuated by adding NMDAR antagonist dextromethorphan (DXM) to DCS. To test whether GABAR removal contributes to enhanced MEP excitability, as suggested by animal studies with 10-Hz, we reasoned that inhibition induced by GABAR agonism via lorazepam (LZP) would be less than at baseline, after GABAR removal by TMS. Instead, we found that neither protocol increased MEPs, but rather, MEPs were reduced in both protocols immediately (β = -0.172, p = 0.027) and 30 min after TMS (β = -0.183, p = 0.019).</p><p><strong>Discussion: </strong>Our exploratory pilot study is preliminary and requires replication to make any conclusions. Nevertheless, it is the first to compare the synaptic-level mechanisms of iTBS and 10-Hz rTMS, suggesting both iTBS and 10-Hz act predominantly through NMDAR-dependent LTP-like mechanisms rather than GABAergic mechanisms. The differential effects between protocols (i.e., 10-Hz produced more facilitation with DCS and more inhibition with LZP) could be accounted for by iTBS producing occlusion with DCS and compensatory facilitation with LZP, but this is speculative and requires preclinical work to confirm.</p>","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"5 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of Motor Evoked Potential Identification in Pediatric Populations.","authors":"Cameron P Casey, Hung-Shao Cheng, Kellie M Collins, Ellen N Sutter, Abrar Majeedi, Arun Karumattu Manattu, Samuel T Nemanich, Ryan M McAdams, Bernadette T Gillick","doi":"10.1016/j.transm.2025.100194","DOIUrl":"10.1016/j.transm.2025.100194","url":null,"abstract":"<p><strong>Background: </strong>Motor evoked potentials (MEPs) elicited through transcranial magnetic stimulation (TMS) may provide valuable insights into neuromotor development in pediatric populations. However, the reliability of identifying MEPs using rater-based approaches, particularly in infants, remains poorly defined. This study addresses this gap by evaluating interrater reliability (IRR) and consensus rates for MEP identification in adolescents and infants.</p><p><strong>Methods: </strong>Three experienced TMS researchers independently scored 5,738 electromyography (EMG) trials from 18 adolescents and 5,086 trials from 20 infants using a 5-point confidence scale. Scores reflected the raters' confidence in MEP presence, guided by predefined electrophysiological criteria. IRR, measured by intraclass correlation coefficients (ICC), and scoring consensus were compared across age groups, and signal characteristics were analyzed to identify predictors of disagreement.</p><p><strong>Results: </strong>IRR for adolescent MEP scores was excellent, ICC(C,3) = 0.973, 95% confidence interval (CI) [0.972, 0.974], while infant MEPs showed good IRR, ICC(C,3) = 0.784, 95% CI [0.773, 0.794]. Consensus rates were significantly lower for infant data (76.8%) compared to adolescent data (89.1%) (p < 0.001). Greater baseline EMG variability and lower post-stimulation peak-to-peak amplitudes were strongly associated with reduced consensus (p < 0.001 for both).</p><p><strong>Conclusions: </strong>MEP identification using a rater-based scoring protocol is feasible in pediatric cohorts but presents greater challenges in infants due to distinct neurophysiological and behavioral factors. Despite these difficulties, good reliability can still be achieved when multiple trained raters independently score EMG trials. These findings support the need for consensus-driven best practices to guide MEP identification in early developmental research.</p>","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"5 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a reverse translational model of low-intensity rTMS in alcohol use disorder: The influence of theta burst stimulation protocols on binge alcohol drinking in mice.","authors":"Akriti Dhungana, Daniel M McCalley, Alesha M Heath, Eric P Kraybill, Fatemeh S Mojabi, Jairelisse Morales Morales, Allison R Morningstar, Allyson K Davis, Claudia B Padula, William J Giardino, M Windy McNerney","doi":"10.1016/j.transm.2025.100098","DOIUrl":"10.1016/j.transm.2025.100098","url":null,"abstract":"<p><strong>Background: </strong>Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising treatment tool for Alcohol Use Disorder (AUD). A challenge facing the field is that the optimal TMS parameters to reduce drinking are unknown. There are now rodent TMS coils which can be adapted to evaluate rTMS-induced changes in alcohol consumption in a rapid, cost-effective manner.</p><p><strong>Objective: </strong>Develop a preclinical model of rTMS in alcohol consuming rodents and collect pilot data to evaluate the influence rTMS parameters (here, theta burst pattern) on change in alcohol consumption and biochemistry.</p><p><strong>Methods: </strong>66 C57BL/6 J mice (32 F) received sham, intermittent Theta Burst Stimulation (iTBS), or continuous Theta Burst Stimulation (cTBS) (14 sessions, 2 sessions/day, low intensity 16mT stimulation). Alcohol consumption and preference were evaluated before and after rTMS using a two-bottle choice, Drinking in the Dark (DID) paradigm. Cortical brain tissue was assayed for BDNF gene expression via qPCR. During DID sessions, control mice (n = 31) were given access to water only.</p><p><strong>Results: </strong>Relative to sham, iTBS increased alcohol consumption (d=0.72) and preference (d=0.44), however these results were not statistically significant. Female mice receiving iTBS, experienced a significant, large increase in alcohol consumption (p = 0.02, d=1.5). Among water only mice, iTBS (d=-1.01) and cTBS (d=-1.03) significantly reduced BDNF expression.</p><p><strong>Conclusions: </strong>This preclinical model is a feasible method to evaluate rTMS-induced changes in alcohol consumption. This pilot analysis warrants future work evaluating the influence of rTMS parameters and sex on changes in drinking or drug-seeking behaviors.</p>","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12201979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing TMS for PTSD - From networks to individuals.","authors":"Patlapa Sompolpong, Sanne J H van Rooij","doi":"10.1016/j.transm.2025.100178","DOIUrl":"10.1016/j.transm.2025.100178","url":null,"abstract":"","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12499369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rewiring recovery: Patient-centered neuromodulation interventions for substance use disorders that meet people where they are.","authors":"Heather Burrell Ward, Sophia H Blyth, Kristopher Kast","doi":"10.1016/j.transm.2025.100179","DOIUrl":"10.1016/j.transm.2025.100179","url":null,"abstract":"","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying patients with non-response for an extension of TMS treatments for depression: A retrospective analysis of clinical response conversion.","authors":"Brandon J Lew, Eric Tirrell, Andrew M Fukuda, Nimalan Murugan, Carissa Perez, Wenricka Griffith, Linda L Carpenter","doi":"10.1016/j.transm.2025.100092","DOIUrl":"10.1016/j.transm.2025.100092","url":null,"abstract":"<p><strong>Introduction: </strong>Transcranial Magnetic Stimulation (TMS) is an FDA-approved treatment for Major Depressive Disorder (MDD) which traditionally consists of 30 sessions of daily treatment followed by a taper phase of 6 sessions. Generally, over 50 % show a significant improvement in MDD symptoms; however, there are many patients who show a trend of improvement but have not have yet crossed that threshold defining meaningful clinical response. Extending the acute course with more sessions may optimize outcomes for the treatment course, however little data exist to inform which patients would benefit from treatment extension. In a retrospective analysis of naturalistic treatment data, we examined variables association with \"conversion\" of patients from nonresponder to responder status following extension of the acute course by at least 5 sessions.</p><p><strong>Methods: </strong>Response was defined as ≥ 50 % reduction from baseline score on the Inventory of Depressive Symptomatology-Self Report (IDS-SR). Of 485 treatment courses reviewed, we identified 40 patient series where a course extension (≥41 treatments) was given to patients who had not achieved response at treatment 30. In 21 treatment series, the patient \"converted\" to responder status by end of the course. Mixed model ANOVAs of IDSSR scores were used to compare the groups and identify features associated with conversion to response with additional sessions.</p><p><strong>Results: </strong>In 21 treatment series (representing 17 unique individuals), patients converted from nonresponse to response with additional treatment sessions beyond 30. Greater degree of IDS-SR improvement from baseline to treatment 30 was significantly associated with conversion to responder status. A 26 % reduction in IDS-SR total by treatment 30 showed 77.5 % accuracy in classifying whether or not a patient would ultimately respond to a 10-session course extension.</p><p><strong>Conclusion: </strong>Extension of the acute TMS course beyond 30 sessions is effective in converting a subset of nonresponding patients into treatment responders. The patients that were most likely to benefit from extension were those that improved the most by treatment 30. While these data may begin to inform extension criteria research, further study is needed to determine a clinically reliable threshold for selection of patients for an extension.</p>","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and tolerability of dual-site accelerated transcranial magnetic stimulation treatment for obsessive-compulsive disorder and major depressive disorder.","authors":"Carolina Jimenez, Jungho Cha, Zarghona Imtiaz, Sonia Olson, Shannon O'Neill, Ki Sueng Choi, Martijn Figee, Andrew H Smith","doi":"10.1016/j.transm.2025.100182","DOIUrl":"10.1016/j.transm.2025.100182","url":null,"abstract":"","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A feasibility study of sequenced TMS and TBS dosing in adolescents with major depressive disorder.","authors":"Cicek N Bakir, Paul A Nakonezny, Dicle Buyuktaskin, Lucero Sangster-Carrasco, Irem Azamet, Jennifer Vande Voort, Paul E Croarkin","doi":"10.1016/j.transm.2025.100093","DOIUrl":"10.1016/j.transm.2025.100093","url":null,"abstract":"<p><p>This feasibility study focused on a staged approach to transcranial magnetic stimulation (TMS) interventions for adolescents with depression. Adolescents (N = 6) who did not respond to standard TMS were offered a two-week course of either continuous or intermittent theta burst stimulation (TBS) based on an intracortical facilitation - (ICF) biomarker. A within-subjects linear mixed model analysis of repeated measures was conducted to assess changes in depressive symptoms using the Children's Depression Rating Scale-Revised (CDRS-R). The analysis revealed a significant overall improvement in depressive symptoms from baseline to 6-month follow-up (p = 0.02; d=0.82). Significant pairwise comparisons were observed between baseline and week 2 [LSM decrease = -5.83 (SE = 2.`21), adjusted p = 0.04], and between baseline and 6-month follow-up [LSM decrease = -18.39 (SE = 7.05), adjusted p = 0.04]. There is a theoretical rationale for the use of ICF to guide dosing of TBS and this study suggests feasibility. While this study does not provide evidence to support the utility of the ICF biomarker, it may provide a template for future studies.</p>","PeriodicalId":520872,"journal":{"name":"Transcranial magnetic stimulation (2024)","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}