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用于神经精神疾病治疗的临床深度经颅磁刺激在解剖头部模型中的电场估计

Electric field estimation of deep transcranial magnetic stimulation clinically used for the treatment of neuropsychiatric disorders in anatomical head models.

作者信息

Parazzini Marta, Fiocchi Serena, Chiaramello Emma, Roth Yiftach, Zangen Abraham, Ravazzani Paolo

机构信息

Consiglio Nazionale delle Ricerche - Istituto di Elettronica e di Ingegneria dell'Informazione e delle Telecomunicazioni, Piazza Leonardo da Vinci 32 - 20133 Milano, Italy.

Consiglio Nazionale delle Ricerche - Istituto di Elettronica e di Ingegneria dell'Informazione e delle Telecomunicazioni, Piazza Leonardo da Vinci 32 - 20133 Milano, Italy.

出版信息

Med Eng Phys. 2017 May;43:30-38. doi: 10.1016/j.medengphy.2017.02.003. Epub 2017 Feb 21.

Abstract

Literature studies showed the ability to treat neuropsychiatric disorders using H1 coil, developed for the deep Transcranial Magnetic Stimulation (dTMS). Despite the positive results of the clinical studies, the electric field (E) distributions inside the brain induced by this coil when it is positioned on the scalp according to the clinical studies themselves are not yet precisely estimated. This study aims to characterize the E distributions due to the H1 coil in the brain of two realistic human models by computational electromagnetic techniques and to compare them with the ones due to the figure-of-8 coil, traditionally used in TMS and positioned as such to simulate the clinical experiments. Despite inter-individual differences, our results show that the dorsolateral prefrontal cortex is the region preferentially stimulated by both H1 and figure-of-8 coil when they are placed in the position on the scalp according to the clinical studies, with a more broad and non-focal distribution in the case of H1 coil. Moreover, the H1 coil spreads more than the figure-of-8 coil both in the prefrontal cortex and medial prefrontal cortex and towards some deeper brain structures and it is characterized by a higher penetration depth in the frontal lobe. This work highlights the importance of the knowledge of the electric field distribution in the brain tissues to interpret the outcomes of the experimental studies and to optimize the treatments.

摘要

文献研究表明,用于深部经颅磁刺激(dTMS)的H1线圈具有治疗神经精神疾病的能力。尽管临床研究取得了积极成果,但根据临床研究本身,当该线圈放置在头皮上时,其在脑内诱发的电场(E)分布尚未得到精确估计。本研究旨在通过计算电磁技术表征两种真实人体模型大脑中H1线圈引起的电场分布,并将其与传统用于经颅磁刺激(TMS)且按此放置以模拟临床实验的8字形线圈引起的电场分布进行比较。尽管存在个体差异,但我们的结果表明,根据临床研究将H1线圈和8字形线圈放置在头皮上的位置时,背外侧前额叶皮质是它们优先刺激的区域,H1线圈的刺激分布更广泛且不集中。此外,H1线圈在前额叶皮质和内侧前额叶皮质中的分布范围比8字形线圈更广,并且向一些更深的脑结构扩散,其特征是在额叶中的穿透深度更高。这项工作强调了了解脑组织中电场分布对于解释实验研究结果和优化治疗的重要性。

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