Evaluating transcranial magnetic stimulation (TMS) induced electric fields in pediatric stroke.
Evaluating transcranial magnetic stimulation (TMS) induced electric fields in pediatric stroke.
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DOI：
10.1016/j.nicl.2021.102563
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Opitz A
中科院分区：
文献类型：
--
作者：
Mantell KE;Sutter EN;Shirinpour S;Nemanich ST;Lench DH;Gillick BT;Opitz A
在围产期中风病变周围进行了数值TMS模拟。脑损伤的存在局部地影响电场分布。脑损伤不会显著改变平均电场强度。模型驱动的方法可以为儿科卒中人群的TMS给药提供信息。经颅磁刺激（TMS）是一种越来越受欢迎的中风康复工具。因此，研究人员已经开始探索TMS在儿科卒中中的应用。然而，TMS在具有病理的发育中的大脑中的应用带来了一系列独特的挑战。TMS诱导的电场的影响尚未在儿童中风病变中进行探讨。在这里，我们使用有限元方法（FEM）建模来研究电场强度如何受到病变的影响。我们创建了个人逼真的头部模型，从MRI（n = 6）的单侧脑性瘫痪，由于围产期中风的儿童。我们进行了TMS电场模拟线圈的位置在病变和非病变的半球。我们发现，病变的存在可以强烈地影响电场分布。在组水平上，平均电场强度在病变和非病变半球之间没有差异，但在病变半球中表现出更大的变异性。其他因素，如线圈到皮层的距离，即使在存在病变的情况下，也会对TMS电场产生强烈影响。我们的研究对于TMS给药和线圈放置在患有脑损伤的儿童中提供TMS具有重要意义。
Numerical TMS simulations were performed over and around perinatal stroke lesions. The presence of brain lesions locally affects the electric field distribution. Brain lesions do not significantly change the mean electric field strength. Model driven approaches can inform TMS dosing in a pediatric stroke population. Transcranial magnetic stimulation (TMS) is an increasingly popular tool for stroke rehabilitation. Consequently, researchers have started to explore the use of TMS in pediatric stroke. However, the application of TMS in a developing brain with pathologies comes with a unique set of challenges. The effect of TMS-induced electric fields has not been explored in children with stroke lesions. Here, we used finite element method (FEM) modeling to study how the electric field strength is affected by the presence of a lesion. We created individual realistic head models from MRIs (n = 6) of children with unilateral cerebral palsy due to perinatal stroke. We conducted TMS electric field simulations for coil locations over lesioned and non-lesioned hemispheres. We found that the presence of a lesion can strongly affect the electric field distribution. On the group level, the mean electric field strength did not differ between lesioned and non-lesioned hemispheres but exhibited a greater variability in the lesioned hemisphere. Other factors such as coil-to-cortex distance have a strong influence on the TMS electric field even in the presence of lesions. Our study has important implications for the delivery of TMS in children with brain lesions with respect to TMS dosing and coil placement.
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