Transcranial magnet stimulation of deep brain targets
First Claim
1. A Transcranial Magnetic Stimulation (TMS) method for stimulating a brain region deep within a patient'"'"'s brain, the method comprising:
- positioning a first TMS electromagnet outside of a patient'"'"'s head;
determining the distance between a target deep brain region and a sulcus, wherein the sulcus is within the range of a magnetic field emitted by the first TMS electromagnet;
determining the direction of a pathway through the sulcus to the target deep brain region;
determining stimulation parameters for the first TMS electromagnet based on the distance between the target brain region and the sulcus and based on the direction of the pathway through the sulcus to the target deep brain region; and
applying energy to the first TMS electromagnet at the determined stimulation parameters.
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Abstract
The treatment of specific neurological and psychiatric illnesses using Transcranial Magnetic Stimulation (TMS) requires that specific neuroanatomical structures are targeted using specific pulse parameters. Described herein are methods of positioning and powering TMS electromagnets to selectively stimulate a deep brain target region while minimizing the impact on non-target regions between the TMS electromagnet and the target. Use of these configurations may involve a combination of physical, spatial and/or temporal summation. Specific approaches to achieving temporal summation are detailed.
122 Citations
32 Claims
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1. A Transcranial Magnetic Stimulation (TMS) method for stimulating a brain region deep within a patient'"'"'s brain, the method comprising:
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positioning a first TMS electromagnet outside of a patient'"'"'s head; determining the distance between a target deep brain region and a sulcus, wherein the sulcus is within the range of a magnetic field emitted by the first TMS electromagnet; determining the direction of a pathway through the sulcus to the target deep brain region; determining stimulation parameters for the first TMS electromagnet based on the distance between the target brain region and the sulcus and based on the direction of the pathway through the sulcus to the target deep brain region; and applying energy to the first TMS electromagnet at the determined stimulation parameters. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A Transcranial Magnetic Stimulation (TMS) method for stimulating a brain region deep within a patient'"'"'s brain, the method comprising:
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positioning a plurality of TMS electromagnets outside of a patient'"'"'s head; aligning the plurality of TMS electromagnets so that the direction of the maximal current flow within the TMS electromagnets is aligned with a fiber bundle of a target deep brain region; determining stimulation parameters for each TMS electromagnet so that the target deep brain region is stimulated by activation of the TMS electromagnets more than non-target cortical surface regions; and applying energy to each of the plurality of TMS electromagnets at the determined stimulation parameters. - View Dependent Claims (16)
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17. A Transcranial Magnetic Stimulation (TMS) method for stimulating a cingulate region of a patient'"'"'s brain while leaving the outer cortex relatively undisturbed, the method comprising:
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aiming a plurality of independently powerable TMS electromagnets at the cingulate region tracts of the patient'"'"'s brain; determining stimulation parameters for each TMS electromagnet so that the power of the field emitted by each TMS electromagnet at the cortical surface is below the motor threshold; and triggering pulses from the TMS electromagnets at phase-complementary angles, wherein pulses from two or more TMS electromagnets are triggered within a membrane time constant of the target cingulate region. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24)
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25. A Transcranial Magnetic Stimulation (TMS) method for stimulating an insula region of a patient'"'"'s brain while leaving the outer cortex relatively undisturbed, the method comprising:
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positioning a plurality of independently powerable TMS electromagnets outside of the patient'"'"'s head; aiming the plurality of independently powerable TMS electromagnets at the insula region of the patient'"'"'s brain; determining stimulation parameters for each TMS electromagnet so that the power of the field emitted by each TMS electromagnet at the cortical surface is below the motor threshold; and triggering pulses from the TMS electromagnets at phase-complementary angles, wherein pulses from two or more TMS electromagnets are triggered within the membrane time constant of the target insula region. - View Dependent Claims (26, 27, 28, 29, 30)
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31. A Transcranial Magnetic Stimulation (TMS) method for stimulating a cingulate region of a patient'"'"'s brain while leaving the outer cortex relatively undisturbed, the method comprising:
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aiming a plurality of independently powerable TMS electromagnets at the cingulate region tracts of the patient'"'"'s brain; determining stimulation parameters for each TMS electromagnet so that stimulation at the target deep brain region from the plurality of TMS electromagnets is greater than the stimulation at a cortical surface; and triggering pulses from the TMS electromagnets at phase-complementary angles, wherein pulses from two or more TMS electromagnets are triggered within a membrane time constant of the target cingulate region.
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32. A Transcranial Magnetic Stimulation (TMS) method for stimulating a brain region deep within a patient'"'"'s brain, the method comprising:
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positioning a plurality of TMS electromagnets outside of a patient'"'"'s head; aligning the plurality of TMS electromagnets with a direction of a fiber bundle of a target deep brain region; determining stimulation parameters for each TMS electromagnet so that stimulation at the target deep brain region from the plurality of TMS electromagnets is greater than the stimulation at a cortical surface due to a magnetic field emitted by each TMS electromagnet; and applying energy to each of the plurality of TMS electromagnets at the determined stimulation parameters.
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Specification