A reexamination of motor and prefrontal TMS in tobacco use disorder: Time for personalized dosing based on electric field modeling?
A reexamination of motor and prefrontal TMS in tobacco use disorder: Time for personalized dosing based on electric field modeling?
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烟草使用障碍的运动和前额叶TMS的重新检查：基于电场建模的个性化给药时间？
DOI：
10.1016/j.clinph.2021.06.015
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
George MS
中科院分区：
文献类型：
--
作者：
Caulfield KA;Li X;George MS
在这项研究中，我们重新检查了使用120%静息运动阈值（rMT）剂量的经颅磁刺激（TMS）在左背外侧前额叶皮层（DLPFC）使用电场建模。我们计算了38名烟草使用障碍（TUD）参与者的电场模型，以比较在初级运动皮层（M1）上100%rMT时以及在DLPFC上100%和120%rMT时的8字形线圈感应电场。然后，我们计算了DLPFC处电机等效感应电场所需的rMT百分比，并对每个人的强度进行了建模。M1上100% rMT刺激的电场显著大于使用100% rMT（p < 0.001）和120% rMT刺激（p = 0.013）在DLPFC中建模的电场。平均而言，TMS需要以133.5% rMT（范围= 79.9至247.5%）输送，以在158.2V/m的DLPFC下产生电机等效感应电场。在这38例TUD患者中，必须在左侧DLPFC上以平均133.5% rMT施加TMS，以产生与M1上100% rMT刺激等效的电场。每个参与者的运动和前额叶电场之间的高度个体间变异性支持使用个性化的电场建模进行TMS给药，以确保每个参与者不会受到刺激不足或过度刺激。TUD数据中的这些电场建模表明，DLPFC上的120% rMT刺激在许多个体中（73.7%）提供了亚运动等效电场。通过进一步验证，电场建模可能是单独给药TMS的有效方法。
In this study, we reexamined the use of 120% resting motor threshold (rMT) dosing for transcranial magnetic stimulation (TMS) over the left dorsolateral prefrontal cortex (DLPFC) using electric field modeling. We computed electric field models in 38 tobacco use disorder (TUD) participants to compare figure-8 coil induced electric fields at 100% rMT over the primary motor cortex (M1), and 100% and 120% rMT over the DLPFC. We then calculated the percentage of rMT needed for motor-equivalent induced electric fields at the DLPFC and modeled this intensity for each person. Electric fields from 100% rMT stimulation over M1 were significantly larger than what was modeled in the DLPFC using 100% rMT (p < 0.001) and 120% rMT stimulation (p = 0.013). On average, TMS would need to be delivered at 133.5% rMT (range = 79.9 to 247.5%) to produce motor-equivalent induced electric fields at the DLPFC of 158.2V/m. TMS would have to be applied at an average of 133.5% rMT over the left DLPFC to produce equivalent electric fields to 100% rMT stimulation over M1 in these 38 TUD patients. The high interindividual variability between motor and prefrontal electric fields for each participant supports using personalized electric field modeling for TMS dosing to ensure that each participant is not under- or over-stimulated. These electric field modeling in TUD data suggest that 120% rMT stimulation over the DLPFC delivers sub-motor equivalent electric fields in many individuals (73.7%). With further validation, electric field modeling may be an impactful method of individually dosing TMS.
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