BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation
Volume 2, Issue 3 , Pages 123-131, July 2009

A triangulation-based magnetic resonance image-guided method for transcranial magnetic stimulation coil positioning

  • Jamila Andoh, PhD

      Affiliations

    • Inserm, U797 Research Unit “Neuroimaging and Psychiatry”, IFR49, Orsay, France
    • CEA, “Neuroimaging and Psychiatry” U797 Unit, Hospital Department Frédéric Joliot and Neurospin, I2BM, Orsay, France
    • Univ Paris-Sud, UMR U797, Orsay; and University Paris Descartes, UMR U797, Paris; France
    • Brain and Body Centre, University of Nottingham, Nottingham, UK
    • ,
  • Denis Riviere, PhD

      Affiliations

    • Image Analysis and Structural Anatomy Group, Neurospin, IFR 49, Atomic Energy Commission, Gif/Yvette, France
    • ,
  • Jean-François Mangin, PhD

      Affiliations

    • Inserm, U797 Research Unit “Neuroimaging and Psychiatry”, IFR49, Orsay, France
    • CEA, “Neuroimaging and Psychiatry” U797 Unit, Hospital Department Frédéric Joliot and Neurospin, I2BM, Orsay, France
    • Univ Paris-Sud, UMR U797, Orsay; and University Paris Descartes, UMR U797, Paris; France
    • Image Analysis and Structural Anatomy Group, Neurospin, IFR 49, Atomic Energy Commission, Gif/Yvette, France
    • ,
  • Eric Artiges, PhD

      Affiliations

    • Inserm, U797 Research Unit “Neuroimaging and Psychiatry”, IFR49, Orsay, France
    • CEA, “Neuroimaging and Psychiatry” U797 Unit, Hospital Department Frédéric Joliot and Neurospin, I2BM, Orsay, France
    • Univ Paris-Sud, UMR U797, Orsay; and University Paris Descartes, UMR U797, Paris; France
    • Psychiatry Department, 91G16, Orsay Hospital, Orsay, France
    • ,
  • Yann Cointepas, PhD

      Affiliations

    • Image Analysis and Structural Anatomy Group, Neurospin, IFR 49, Atomic Energy Commission, Gif/Yvette, France
    • ,
  • David Grevent, MD

      Affiliations

    • Inserm, U797 Research Unit “Neuroimaging and Psychiatry”, IFR49, Orsay, France
    • CEA, “Neuroimaging and Psychiatry” U797 Unit, Hospital Department Frédéric Joliot and Neurospin, I2BM, Orsay, France
    • Univ Paris-Sud, UMR U797, Orsay; and University Paris Descartes, UMR U797, Paris; France
    • ,
  • Marie-Laure Paillère-Martinot, MD, PhD

      Affiliations

    • Inserm, U797 Research Unit “Neuroimaging and Psychiatry”, IFR49, Orsay, France
    • CEA, “Neuroimaging and Psychiatry” U797 Unit, Hospital Department Frédéric Joliot and Neurospin, I2BM, Orsay, France
    • Univ Paris-Sud, UMR U797, Orsay; and University Paris Descartes, UMR U797, Paris; France
    • AP-HP, Department of Adolescent Medicine, Maison de Solenn, Cochin Hospital, Paris, France
    • ,
  • Jean-Luc Martinot, MD, PhD

      Affiliations

    • Inserm, U797 Research Unit “Neuroimaging and Psychiatry”, IFR49, Orsay, France
    • CEA, “Neuroimaging and Psychiatry” U797 Unit, Hospital Department Frédéric Joliot and Neurospin, I2BM, Orsay, France
    • Univ Paris-Sud, UMR U797, Orsay; and University Paris Descartes, UMR U797, Paris; France
    • Corresponding Author InformationCorrespondence: Dr. Jean-Luc Martinot, U797 INSERM-CEA, Service Hospitalier Frédéric Joliot, CEA, 4, place du Général Leclerc, 91401 Orsay, France.
    • ,
  • Arnaud Cachia, PhD

      Affiliations

    • Inserm, U797 Research Unit “Neuroimaging and Psychiatry”, IFR49, Orsay, France
    • CEA, “Neuroimaging and Psychiatry” U797 Unit, Hospital Department Frédéric Joliot and Neurospin, I2BM, Orsay, France
    • Univ Paris-Sud, UMR U797, Orsay; and University Paris Descartes, UMR U797, Paris; France

Received 30 October 2007; received in revised form 29 October 2008; accepted 30 October 2008. published online 04 March 2009.

Transcranial magnetic stimulation (TMS) is currently used for cognitive studies and investigated as a treatment for psychiatric disorders. Because of the cortex variability, the coil positioning stage is difficult and should be improved by using individual neuroimaging data. Sophisticated and expensive neuronavigation systems have been developed to guide the coil to selected regions on the patient's magnetic resonance images (MRI). Our objective was to develop a triangulation-based MRI-guided method to position manually the TMS coil over the subject's head, using a cortical target derived from individual MR data. We evaluated both the spatial accuracy and the reproducibility of the method using functional MR activations of two different targets in the motor and parietal cortices. The accuracy of the MRI-guided method, assessed from the Euclidean distance (Dm) between the thumb motor target and the coil position eliciting reproducible thumb motor-evoked potentials with TMS, was Dm = 10 ± 3 mm. The reproducibility of the method, evaluated across two different operators, was Dm = 6.7 ± 1.4 mm for the repositioning in the motor cortex and Dm = 6.0 ± 3.2 mm in the parietal cortex. This novel method could be used clinically to assist positioning of the TMS coil.

Keywords: transcranial magnetic stimulation, functional magnetic resonance imaging, coil positioning, motor cortex

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 This study was funded in part by a grant from the “Programme Hospitalier de Recherche Clinique”, “Délégation à la Recherche Clinique de l'Assistance Publique-Hôpitaux de Paris (AP-HP) (PHRC AOM 98099)” and by an INSERM-PROGRESS grant and an APHP/INSERM interface grant to ML Paillère-Martinot. This study was also supported in part by a grant (APV05137LSA) from the National Agency for Research.

 Jamila Andoh was supported by a PhD grant from the “Fondation pour la Recherche Médicale.” Arnaud Cachia was supported by grants from INSERM and from the “Electricité de France - EDF Foundation.”

PII: S1935-861X(08)00358-6

doi:10.1016/j.brs.2008.10.002

BRAIN STIMULATION: Basic, Translational, and Clinical Research in Neuromodulation
Volume 2, Issue 3 , Pages 123-131, July 2009

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