Personalized Brain Stimulation: Advances and Challenges

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Neuroscience and Neural Engineering".

Deadline for manuscript submissions: closed (23 December 2022) | Viewed by 7383

Special Issue Editors


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Guest Editor
Department of Clinical Neurophysiology, Kuopio University Hospital, 70210 Kuopio, Finland
Interests: brain stimulation; clinical neurophysiology; developmental neurophysiology; ageing

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Guest Editor
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Interests: brain stimulation; neurophysiology; neuroscience; biomarkers; therapeutics

Special Issue Information

Dear Colleagues,

This Special Issue is devoted to the personalized applications of brain stimulation, including transcranial magnetic stimulation, repetitive transcranial magnetic stimulation, magnetic seizure therapy, electroconvulsive therapy, transcranial electrical stimulation, deep brain stimulation, photobiomodulation, vagus nerve stimulation, and ultrasound stimulation. Each article should include discussion on the advances or challenges associated with personalizing the application. Both therapeutic and non-therapeutic applications and original research, non-experimental studies (method/technology development), case reports, and critical reviews are welcome. The authors should demonstrate that brain stimulation is somehow personalized to the neural characteristics of the study participants, either based on baseline or online measurement or on other factors, such as sex, age, pathology, etc. As in some brain stimulation applications, such as transcranial magnetic stimulation, conventional applications already personalize the stimulation to excitability threshold; this Special Issue seeks novel approaches beyond these well-established protocols. Studies showing the need/lack of need for personalized applications, i.e., those showing that the study participants react differently/similarly to brain stimulation, are also welcome. Potential topics in non-experimental studies include but are not limited to methods and technology that could facilitate personalizing brain stimulation applications and simulations and mathematical models that provide a theoretical framework for personalizing applications.

Dr. Sara Määttä
Dr. Elisa Kallioniemi
Guest Editors

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Published Papers (4 papers)

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Research

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12 pages, 2582 KiB  
Article
Auditory Fine-Tuned Suppressor of TMS-Clicks (TMS-Click AFTS): A Novel, Perceptually Driven/Tuned Approach for the Reduction in AEP Artifacts in TMS-EEG Studies
by Konstantinos Pastiadis, Ioannis Vlachos, Evangelia Chatzikyriakou, Yiftach Roth, Samuel Zibman, Abraham Zangen, Dimitris Kugiumtzis and Vasilios K. Kimiskidis
Appl. Sci. 2023, 13(2), 1047; https://doi.org/10.3390/app13021047 - 12 Jan 2023
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Abstract
TMS contaminates concurrent EEG recordings with Auditory Evoked Potentials (AEPs), which are caused by the perceived impulsive acoustic noise of the TMS coils. We hereby introduce a novel and perceptually motivated/tuned method for the suppression of auditory evoked EEG artifacts of rTMS under [...] Read more.
TMS contaminates concurrent EEG recordings with Auditory Evoked Potentials (AEPs), which are caused by the perceived impulsive acoustic noise of the TMS coils. We hereby introduce a novel and perceptually motivated/tuned method for the suppression of auditory evoked EEG artifacts of rTMS under the name of “Auditory Fine-Tuned Suppressor of TMS-Clicks” (TMS-click AFTS). The proposed method is based on the deployment of a psychophysically-matched wide-band noise (WBN) masking stimulus, whose parametric synthesis and presentation are based upon adaptive psychophysical optimization. The masking stimulus is constructed individually for each patient/subject, thus facilitating aspects of precision medicine. A specially designed automation software is used for the realization of an adaptive procedure for optimal parameterization of masking noise level, optimizing both the subject’s comfort and the degree of AEP reduction. The proposed adaptive procedure also takes into account the combined effect of TMS intensity level and can as well account for any possibly available subject’s hearing acuity data. To assess the efficacy of the proposed method in reducing the acoustic effects of TMS, we performed TMS-EEG recordings with a 60 channel TMS-compatible EEG system in a cohort of healthy subjects (n = 10) and patients with epilepsy (n = 10) under four conditions (i.e., resting EEG with and without acoustic mask and sham TMS-EEG with and without acoustic mask at various stimulus intensity levels). The proposed approach shows promising results in terms of efficiency of AEP suppression and subject’s comfort and warrants further investigation in research and clinical settings. Full article
(This article belongs to the Special Issue Personalized Brain Stimulation: Advances and Challenges)
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14 pages, 4390 KiB  
Article
The Relation between Induced Electric Field and TMS-Evoked Potentials: A Deep TMS-EEG Study
by Ioannis Vlachos, Marietta Tzirini, Evangelia Chatzikyriakou, Ioannis Markakis, Maria Anastasia Rouni, Theodoros Samaras, Yiftach Roth, Abraham Zangen, Alexander Rotenberg, Dimitris Kugiumtzis and Vasilios K. Kimiskidis
Appl. Sci. 2022, 12(15), 7437; https://doi.org/10.3390/app12157437 - 24 Jul 2022
Cited by 1 | Viewed by 1666
Abstract
Transcranial magnetic stimulation (TMS) in humans induces electric fields (E-fields, EF) that perturb and modulate the brain’s endogenous neuronal activity and result in the generation of TMS-evoked potentials (TEPs). The exact relation of the characteristics of the induced E-field and the intensity of [...] Read more.
Transcranial magnetic stimulation (TMS) in humans induces electric fields (E-fields, EF) that perturb and modulate the brain’s endogenous neuronal activity and result in the generation of TMS-evoked potentials (TEPs). The exact relation of the characteristics of the induced E-field and the intensity of the brains’ response, as measured by electroencephalography (EEG), is presently unclear. In this pilot study, conducted on three healthy subjects and two patients with generalized epilepsy (total: 3 males, 2 females, mean age of 26 years; healthy: 2 males, 1 female, mean age of 25.7 years; patients: 1 male, 1 female, mean age of 26.5 years), we investigated the temporal and spatial relations of the E-field, induced by single-pulse stimuli, and the brain’s response to TMS. Brain stimulation was performed with a deep TMS device (BrainsWay Ltd., Jerusalem, Israel) and an H7 coil placed over the central area. The induced EF was computed on personalized anatomical models of the subjects through magneto quasi-static simulations. We identified specific time instances and brain regions that exhibit high positive or negative associations of the E-field with brain activity. In addition, we identified significant correlations of the brain’s response intensity with the strength of the induced E-field and finally prove that TEPs are better correlated with E-field characteristics than with the stimulator’s output. These observations provide further insight in the relation between E-field and the ensuing cortical activation, validate in a clinically relevant manner the results of E-field modeling and reinforce the view that personalized approaches should be adopted in the field of non-invasive brain stimulation. Full article
(This article belongs to the Special Issue Personalized Brain Stimulation: Advances and Challenges)
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21 pages, 7290 KiB  
Article
Electric Field Distribution Induced by TMS: Differences Due to Anatomical Variation
by Marietta Tzirini, Evangelia Chatzikyriakou, Konstantinos Kouskouras, Nikolaos Foroglou, Theodoros Samaras and Vasilios K. Kimiskidis
Appl. Sci. 2022, 12(9), 4509; https://doi.org/10.3390/app12094509 - 29 Apr 2022
Cited by 3 | Viewed by 1425
Abstract
Transcranial magnetic stimulation (TMS) is a well-established technique for the diagnosis and treatment of neuropsychiatric diseases. The numerical calculation of the induced electric field (EF) distribution in the brain increases the efficacy of stimulation and improves clinical outcomes. However, unique anatomical features, which [...] Read more.
Transcranial magnetic stimulation (TMS) is a well-established technique for the diagnosis and treatment of neuropsychiatric diseases. The numerical calculation of the induced electric field (EF) distribution in the brain increases the efficacy of stimulation and improves clinical outcomes. However, unique anatomical features, which distinguish each subject, suggest that personalized models should be preferentially used. The objective of the present study was to assess how anatomy affects the EF distribution and to determine to what extent personalized models are useful for clinical studies. The head models of nineteen healthy volunteers were automatically segmented. Two versions of each head model, a homogeneous and a five-tissue anatomical, were stimulated by the model of a Hesed coil (H-coil), employing magnetic quasi-static simulations. The H-coil was placed at two standard stimulating positions per model, over the frontal and central areas. The results show small, but indisputable, variations in the EFs for the homogeneous and anatomical models. The interquartile ranges in the anatomical versions were higher compared to the homogeneous ones, indicating that individual anatomical features may affect the prediction of stimulation volumes. It is concluded that personalized models provide complementary information and should be preferably employed in the context of diagnostic and therapeutic TMS studies. Full article
(This article belongs to the Special Issue Personalized Brain Stimulation: Advances and Challenges)
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9 pages, 475 KiB  
Case Report
Transcranial Direct Current Stimulation (tDCS) Combined with Therapeutic Exercise and Cognitive Rehabilitation to Treat a Case of Burning Mouth Syndrome (BMS) Related Pain
by Francisco José Sánchez-Cuesta, Yeray González-Zamorano, Aida Arroyo-Ferrer, Martín Avellanal, Josué Fernández-Carnero and Juan Pablo Romero
Appl. Sci. 2021, 11(23), 11538; https://doi.org/10.3390/app112311538 - 06 Dec 2021
Cited by 1 | Viewed by 1777
Abstract
Burning Mouth Syndrome (BMS) is a multifactorial, chronic pain condition with neuropathic and psychogenic mechanisms. Cortical activation as well as sustained attention and executive functions have proven to be affected by chronic pain. The main objectives of this work were to test the [...] Read more.
Burning Mouth Syndrome (BMS) is a multifactorial, chronic pain condition with neuropathic and psychogenic mechanisms. Cortical activation as well as sustained attention and executive functions have proven to be affected by chronic pain. The main objectives of this work were to test the efficacy of a multidimensional personalized pain treatment protocol and to investigate if the effects are based on psychophysical pain processing changes or cognitive effects. A 74-year-old female with 2 years of BMS received 10 sessions of a combined protocol of anodal left dorsolateral prefrontal cortex tDCS, cognitive therapy, and therapeutic exercise. The subjective perception of pain decreased by 47% after treatment but returned to the baseline at 45 days. No changes were found in objective pain measurements apart from a transient worsening of conditioned pain modulation. A large effect size was found in all functional scales, processing speed and executive control as well as sustained attention that persisted during follow-up. No changes in anxiety and depression were found. A multimodal therapeutic approach combining TDCS, cognitive rehabilitation and therapeutic exercise produces improved quality of life, disability and pain perception correlated with improvements in processing speed, executive control and sustained attention but independent of changes in psychophysical pain processing. Full article
(This article belongs to the Special Issue Personalized Brain Stimulation: Advances and Challenges)
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