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Real-Time Tractography-Assisted Neuronavigation for Transcranial Magnetic Stimulation.

作者信息

Aydogan Dogu Baran, Souza Victor H, Matsuda Renan H, Lioumis Pantelis, Ilmoniemi Risto J

机构信息

A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland.

Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Finland.

出版信息

Hum Brain Mapp. 2025 Jan;46(1):e70122. doi: 10.1002/hbm.70122.


DOI:10.1002/hbm.70122
PMID:39737576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11685379/
Abstract

State-of-the-art navigated transcranial magnetic stimulation (nTMS) systems can display the TMS coil position relative to the structural magnetic resonance image (MRI) of the subject's brain and calculate the induced electric field. However, the local effect of TMS propagates via the white-matter network to different areas of the brain, and currently there is no commercial or research neuronavigation system that can highlight in real time the brain's structural connections during TMS. This lack of real-time visualization may overlook critical inter-individual differences in brain connectivity and does not provide the opportunity to target brain networks. In contrast, real-time tractography enables on-the-fly parameter tuning and detailed exploration of connections, which is computationally inefficient and limited with offline methods. To target structural brain connections, particularly in network-based treatments like major depressive disorder, a real-time tractography-based neuronavigation solution is needed to account for each individual's unique brain connectivity. The objective of this work is to develop a real-time tractography-assisted TMS neuronavigation system and investigate its feasibility. We propose a modular framework that seamlessly integrates offline (preparatory) analysis of diffusion MRI data with online (real-time) probabilistic tractography using the parallel transport approach. For tractography and neuronavigation, we combine our open source software Trekker and InVesalius, respectively. We evaluate our system using synthetic data and MRI scans of four healthy volunteers obtained using a multi-shell high-angular resolution diffusion imaging protocol. The feasibility of our online approach is assessed by studying four major TMS targets via comparing streamline count and overlap against offline tractography results based on filtering of one hundred million streamlines. Our development of a real-time tractography-assisted TMS neuronavigation system showcases advanced tractography techniques, with interactive parameter tuning and real-time visualization of thousands of streamlines via an innovative uncertainty visualization method. Our analysis reveals considerable variability among subjects and TMS targets in the streamline count, for example, while 15,000 streamlines were observed for the TMS target on the visual cortex (V1) of subject #4, in the case of subject #3's V1, no streamlines were obtained. Overlap analysis against offline tractograms demonstrated that real-time tractography can quickly cover a substantial part of the target areas' connectivity, often surpassing the coverage of offline approaches within seconds. For instance, significant portions of Broca's area and the primary motor cortex were effectively visualized after generating tens of thousands of streamlines, highlighting the system's efficiency and feasibility in capturing brain connectivity in real-time. Overall, our work shows that real-time tractography-assisted TMS neuronavigation is feasible. With our system, it is possible to target specific brain regions based on their structural connectivity, and to aim for the fiber tracts that make up the brain's networks. Real-time tractography provides new opportunities for TMS targeting through novel visualization techniques without compromising structural connectivity estimates when compared to the offline approach.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/f4f77a846e60/HBM-46-e70122-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/77bfd13312a0/HBM-46-e70122-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/cedd42d6ddfd/HBM-46-e70122-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/8666385c25a4/HBM-46-e70122-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/1fd9e1c322cf/HBM-46-e70122-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/aa271478d4d6/HBM-46-e70122-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/da1f74cdaf56/HBM-46-e70122-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/f4f77a846e60/HBM-46-e70122-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/77bfd13312a0/HBM-46-e70122-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/cedd42d6ddfd/HBM-46-e70122-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/8666385c25a4/HBM-46-e70122-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/1fd9e1c322cf/HBM-46-e70122-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/aa271478d4d6/HBM-46-e70122-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/da1f74cdaf56/HBM-46-e70122-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f1e/11685379/f4f77a846e60/HBM-46-e70122-g006.jpg

相似文献

[1]
Real-Time Tractography-Assisted Neuronavigation for Transcranial Magnetic Stimulation.

Hum Brain Mapp. 2025-1

[2]
Language pathway tracking: comparing nTMS-based DTI fiber tracking with a cubic ROIs-based protocol.

J Neurosurg. 2016-5-27

[3]
Modeling transcranial magnetic stimulation from the induced electric fields to the membrane potentials along tractography-based white matter fiber tracts.

J Neural Eng. 2016-4

[4]
A new approach for corticospinal tract reconstruction based on navigated transcranial stimulation and standardized fractional anisotropy values.

Neuroimage. 2012-5-29

[5]
Development and characterization of the InVesalius Navigator software for navigated transcranial magnetic stimulation.

J Neurosci Methods. 2018-8-24

[6]
Associations between clinical outcome and navigated transcranial magnetic stimulation characteristics in patients with motor-eloquent brain lesions: a combined navigated transcranial magnetic stimulation-diffusion tensor imaging fiber tracking approach.

J Neurosurg. 2017-3-31

[7]
SIFT2: Enabling dense quantitative assessment of brain white matter connectivity using streamlines tractography.

Neuroimage. 2015-10-1

[8]
Navigated transcranial magnetic stimulation for "somatotopic" tractography of the corticospinal tract.

Neurosurgery. 2014-12

[9]
When imaging meets neurophysiology: the value of navigated transcranial magnetic stimulation for preoperative neurophysiological mapping prior to brain tumor surgery.

Neurosurg Focus. 2019-12-1

[10]
TAP: targeting and analysis pipeline for optimization and verification of coil placement in transcranial magnetic stimulation.

J Neural Eng. 2022-4-21

引用本文的文献

[1]
State-Dependent Transcranial Magnetic Stimulation Synchronized with Electroencephalography: Mechanisms, Applications, and Future Directions.

Brain Sci. 2025-7-8

[2]
Design, construction, and deployment of a multi-locus transcranial magnetic stimulation system for clinical use.

Biomed Eng Online. 2025-5-18

[3]
Optimization of TMS target engagement: current state and future perspectives.

Front Neurosci. 2025-1-29

本文引用的文献

[1]
Significance of navigated transcranial magnetic stimulation and tractography to preserve motor function in patients undergoing surgery for motor eloquent gliomas.

Heliyon. 2024-3-16

[2]
Electric Field Modeling in Personalizing Transcranial Magnetic Stimulation Interventions.

Biol Psychiatry. 2024-3-15

[3]
Study Design for Navigated Repetitive Transcranial Magnetic Stimulation for Speech Cortical Mapping.

J Vis Exp. 2023-3-24

[4]
Targeted Modulation of Human Brain Interregional Effective Connectivity With Spike-Timing Dependent Plasticity.

Neuromodulation. 2023-6

[5]
Applications of diffusion tensor imaging integrated with neuronavigation to prevent visual damage during tumor resection in the optic radiation area.

Front Oncol. 2022-8-16

[6]
Transcranial magnetic stimulation of the brain: What is stimulated? - A consensus and critical position paper.

Clin Neurophysiol. 2022-8

[7]
Insights from the IronTract challenge: Optimal methods for mapping brain pathways from multi-shell diffusion MRI.

Neuroimage. 2022-8-15

[8]
Post mortem mapping of connectional anatomy for the validation of diffusion MRI.

Neuroimage. 2022-8-1

[9]
Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback.

Brain Stimul. 2022

[10]
TMS with fast and accurate electronic control: Measuring the orientation sensitivity of corticomotor pathways.

Brain Stimul. 2022

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