MODular and EXpandable multi-locus Transcranial Magnetic Stimulation

Introduction

We aim to develop and validate a versatile and affordable transcranial magnetic stimulation (TMS) system that can perform adaptive and automated brain stimulation.

Background

TMS is performed routinely in thousands of hospitals worldwide for various purposes, including:

• Diagnostics (e.g., to measure corticospinal excitability)
• Presurgical planning (to locate eloquent brain areas that should not be harmed)
• Treating severe depression and neuropathic pain

Unfortunately, only about 50% of patients benefit from the treatment, and the treatments are also very time-consuming.

Current Challenges

Current TMS protocols are:

• User-dependent
• Non-personalized
• Capable of stimulating only one brain target at a time

Furthermore, target searches can take up to 10 minutes. When only one cortical node is stimulated, networks are difficult to modulate. Therefore, we need stimulus sequences that activate precise cortical nodes in specific networks involved in different disorders such as depression, addiction, or neuropathic pain.

Proposed Solution

This can be achieved with so-called multi-locus TMS (mTMS), which we have developed in the ongoing ERC Synergy project ConnectToBrain. However, the barrier to users purchasing mTMS is often the high cost.

In this project, we will introduce a minimum viable prototype: an affordable 3-channel entry system for mTMS that enables efficient clinical protocols. This system will provide:

• Operator independence
• Time savings in patient care
• The potential to improve clinical outcomes

Goals

We aim to demonstrate the viability and value of this 3-channel device, which can later be expanded to a larger one simply by adding electronic modules and new coil sets.

We intend to:

1. Demonstrate the speeding up of motor cortex hotspot search by a factor of 5–10.
2. Show experimentally that the new multi-locus technology will markedly improve the efficacy of inducing plastic changes in the target network.