Department of Electrical and Electronic Engineering, Hanyang University, Ansan, 15588, Republic of Korea.
Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 21431, Republic of Korea.
Sci Rep. 2023 Aug 28;13(1):14074. doi: 10.1038/s41598-023-41044-1.
There has been an increasing demand for robotic coil positioning during repetitive transcranial magnetic stimulation (rTMS) treatment. Accurate coil positioning is crucial because rTMS generally targets specific brain regions for both research and clinical application with other reasons such as safety, consistency and reliability and individual variablity. Some previous studies have employed industrial robots or co-robots and showed they can more precisely stimulate the target cortical regions than traditional manual methods. In this study, we not only developed a custom-TMS robot for better TMS coil placement but also analyzed the therapeutic effects on depression. Treatment effects were evaluated by measuring regional cerebral blood flow (rCBF) using single-photon emission computed tomography and depression severity before and after rTMS for the two positioning methods. The rTMS preparation time with our robotic coil placement was reduced by 53% compared with that of the manual method. The position and orientation errors were also significantly reduced from 11.17 mm and 4.06° to 0.94 mm and 0.11°, respectively, confirming the superiority of robotic positioning. The results from clinical and neuroimaging assessments indicated comparable improvements in depression severity and rCBF in the left dorsolateral prefrontal cortex between the robotic and manual rTMS groups. A questionnaire was used to determine the patients' feelings about the robotic system, including the safety and preparation time. A high safety score indicated good acceptability of robotic rTMS at the clinical site.
在重复经颅磁刺激（rTMS）治疗中，对机器人线圈定位的需求日益增加。准确的线圈定位至关重要，因为 rTMS 通常针对特定的大脑区域进行研究和临床应用，其原因还包括安全性、一致性和可靠性以及个体差异等。一些先前的研究已经采用了工业机器人或协作机器人，并表明它们可以比传统的手动方法更精确地刺激目标皮质区域。在这项研究中，我们不仅开发了一种定制的 TMS 机器人，用于更好地放置 TMS 线圈，还分析了其在治疗抑郁症方面的效果。通过单光子发射计算机断层扫描测量 rCBF，并比较两种定位方法在 rTMS 前后的区域脑血流（rCBF）和抑郁严重程度，来评估 rTMS 的治疗效果。与手动方法相比，我们的机器人线圈放置方法将 rTMS 的准备时间减少了 53%。位置和方向误差也从 11.17 毫米和 4.06 度分别显著降低到 0.94 毫米和 0.11 度，证实了机器人定位的优越性。临床和神经影像学评估的结果表明，机器人和手动 rTMS 组在左背外侧前额叶皮质的抑郁严重程度和 rCBF 方面均有可比的改善。通过问卷调查确定了患者对机器人系统的感受，包括安全性和准备时间。高安全性评分表明机器人 rTMS 在临床场所具有良好的可接受性。
