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

Objective. Transcranial magnetic stimulation (TMS) is a promising non-invasive tool for modulating the brain activity. Despite the widespread therapeutic and diagnostic use of TMS in neurology and psychiatry, its observed response remains hard to predict, limiting its further development and applications. Although the stimulation intensity is always maximum at the cortical surface near the coil, experiments reveal that TMS can affect deeper brain regions as well. Approach. The explanation of this spread might be found in the white matter fiber tracts, connecting cortical and subcortical structures. When applying an electric field on neurons, their membrane potential is altered. If this change is significant, more likely near the TMS coil, action potentials might be initiated and propagated along the fiber tracts towards deeper regions. In order to understand and apply TMS more effectively, it is important to capture and account for this interaction as accurately as possible. Therefore, we compute, next to the induced electric fields in the brain, the spatial distribution of the membrane potentials along the fiber tracts and its temporal dynamics. Main results. This paper introduces a computational TMS model in which electromagnetism and neurophysiology are combined. Realistic geometry and tissue anisotropy are included using magnetic resonance imaging and targeted white matter fiber tracts are traced using tractography based on diffusion tensor imaging. The position and orientation of the coil can directly be retrieved from the neuronavigation system. Incorporating these features warrants both patient- and case-specific results. Significance. The presented model gives insight in the activity propagation through the brain and can therefore explain the observed clinical responses to TMS and their inter- and/or intra-subject variability. We aspire to advance towards an accurate, flexible and personalized TMS model that helps to understand stimulation in the connected brain and to target more focused and deeper brain regions

Feasibility of simultaneous intracranial EEG-fMRI in humans: a safety study

In epilepsy patients who have electrodes implanted in their brains as part of their pre-surgical assessment, simultaneous intracranial EEG and fMRI (icEEG-fMRI) may provide important localising information and improve understanding of the underlying neuropathology. However, patient safety during icEEG-fMRI has not been addressed. Here the potential health hazards associated with icEEG-fMRI were evaluated theoretically and the main risks identified as: mechanical forces on electrodes from transient magnetic effects, tissue heating due to interaction with the pulsed RF fields and tissue stimulation due to interactions with the switched magnetic gradient fields. These potential hazards were examined experimentally in vitro on a Siemens 3 T Trio, 1.5 T Avanto and a GE 3 T Signa Excite scanner using a Brain Products MR compatible EEG system. No electrode flexion was observed. Temperature measurements demonstrated that heating well above guideline limits can occur. However heating could be kept within safe limits (< 1.0 °C) by using a head transmit RF coil, ensuring EEG cable placement to exit the RF coil along its central z-axis, using specific EEG cable lengths and limiting MRI sequence specific absorption rates (SARs). We found that the risk of tissue damage due to RF-induced heating is low provided implant and scanner specific SAR limits are observed with a safety margin used to account for uncertainties (e.g. in scanner-reported SAR). The observed scanner gradient switching induced current (0.08 mA) and charge density (0.2 μC/cm2) were well within safety limits (0.5 mA and 30 μC/cm2, respectively). Site-specific testing and a conservative approach to safety are required to avoid the risk of adverse events

Brain and Human Body Modelling 2021

This open access book describes modern applications of computational human modelling to advance neurology, cancer treatment, and radio-frequency studies including regulatory, safety, and wireless communication fields. Readers working on any application that may expose human subjects to electromagnetic radiation will benefit from this book’s coverage of the latest models and techniques available to assess a given technology’s safety and efficacy in a timely and efficient manner. This is an Open Access book

Wireless, Customizable Coaxially-shielded Coils for Magnetic Resonance Imaging

Anatomy-specific RF receive coil arrays routinely adopted in magnetic resonance imaging (MRI) for signal acquisition, are commonly burdened by their bulky, fixed, and rigid configurations, which may impose patient discomfort, bothersome positioning, and suboptimal sensitivity in certain situations. Herein, leveraging coaxial cables' inherent flexibility and electric field confining property, for the first time, we present wireless, ultra-lightweight, coaxially-shielded MRI coils achieving a signal-to-noise ratio (SNR) comparable to or surpassing that of commercially available cutting-edge receive coil arrays with the potential for improved patient comfort, ease of implementation, and significantly reduced costs. The proposed coils demonstrate versatility by functioning both independently in form-fitting configurations, closely adapting to relatively small anatomical sites, and collectively by inductively coupling together as metamaterials, allowing for extension of the field-of-view of their coverage to encompass larger anatomical regions without compromising coil sensitivity. The wireless, coaxially-shielded MRI coils reported herein pave the way toward next generation MRI coils

A Multi-Dimensional Analysis of a Novel Approach for Wireless Stimulation

The elimination of integrated batteries in biomedical implants holds great promise for improving health outcomes in patients with implantable devices. However, despite extensive research in wireless power transfer, achieving efficient power transfer and effective operational range have remained a hindering challenge within anatomical constraints. Objective : We hereby demonstrate an intravascular wireless and batteryless microscale stimulator, designed for (1) low power dissipation via intermittent transmission and (2) reduced fixation mechanical burden via deployment to the anterior cardiac vein (ACV, ∼3.8 mm in diameter). Methods : We introduced a unique coil design circumferentially confined to a 3 mm diameter hollow-cylinder that was driven by a novel transmitter-based control architecture with improved power efficiency. Results : We examined wireless capacity using heterogenous bovine tissue, demonstrating >5 V stimulation threshold with up to 20 mm transmitter-receiver displacement and 20° of misalignment. Feasibility for human use was validated using Finite Element Method (FEM) simulation of the cardiac cycle, guided by pacer phantom-integrated Magnetic Resonance Images (MRI). Conclusion : This system design thus enabled sufficient wireless power transfer in the face of extensive stimulator miniaturization. Significance : Our successful feasibility studies demonstrated the capacity for minimally invasive deployment and low-risk fixation

A Multi-Dimensional Analysis of a Novel Approach for Wireless Stimulation

The elimination of integrated batteries in biomedical implants holds great promise for improving health outcomes in patients with implantable devices. However, despite extensive research in wireless power transfer, achieving efficient power transfer and effective operational range have remained a hindering challenge within anatomical constraints. Objective : We hereby demonstrate an intravascular wireless and batteryless microscale stimulator, designed for (1) low power dissipation via intermittent transmission and (2) reduced fixation mechanical burden via deployment to the anterior cardiac vein (ACV, ∼3.8 mm in diameter). Methods : We introduced a unique coil design circumferentially confined to a 3 mm diameter hollow-cylinder that was driven by a novel transmitter-based control architecture with improved power efficiency. Results : We examined wireless capacity using heterogenous bovine tissue, demonstrating >5 V stimulation threshold with up to 20 mm transmitter-receiver displacement and 20° of misalignment. Feasibility for human use was validated using Finite Element Method (FEM) simulation of the cardiac cycle, guided by pacer phantom-integrated Magnetic Resonance Images (MRI). Conclusion : This system design thus enabled sufficient wireless power transfer in the face of extensive stimulator miniaturization. Significance : Our successful feasibility studies demonstrated the capacity for minimally invasive deployment and low-risk fixation

A Subject-Specific Multiscale Model of Transcranial Magnetic Stimulation

Transcranial magnetic stimulation (TMS) is a neuromodulation technique used to treat a variety of neurological disorders. While many types of neuromodulation therapy are invasive, TMS is an attractive alternative because it is noninvasive and has a very strong safety record. However, clinical use of TMS has preceded a thorough scientific understanding: its mechanisms of action remain elusive, and the spatial extent of modulation is not well understood. We created a subject-specific, multiscale computational model to gain insights into the physiological response during motor cortex TMS. Specifically, we developed an approach that integrates three main components: 1) a high-resolution anatomical MR image of the whole head with diffusion weighted MRI data; 2) a subject-specific, electromagnetic, non-homogeneous, anisotropic, finite element model of the whole head with a novel time-dependent solver; 3) a population of multicompartmental pyramidal cell neuron models. We validated the model predictions by comparing them to motor evoked potentials (MEPs) immediately following single-pulse TMS of the human motor cortex. This modeling approach contains several novel components, which in turn allowed us to gain greater insights into the interactions of TMS with the brain. Using this approach we found that electric field magnitudes within gray matter and white matter vary substantially with coil orientation. Our results suggest that 1) without a time-dependent, subject-specific, non-homogeneous, anisotropic model, loci of stimulation cannot be accurately predicted; 2) loci of stimulation depend upon biophysical properties and morphologies of pyramidal cells in both gray and white matter relative to the induced electric field. These results indicate that the extent of neuromodulation is more widespread than originally thought. Through medical imaging and computational modeling, we provide insights into the effects of TMS at a multiscale level, which would be unachievable by either method alone. Finally, our approach is amenable to clinical implementation. As a result, it could provide the means by which TMS parameters can be prescribed for treatment and a foundation for improving coil design

Design and Validation of a MR-compatible Pneumatic Manipulandum

The combination of functional MR imaging and novel robotic tools may provide unique opportunities to probe the neural systems underlying motor control and learning. Here, we describe the design and validation of a MR-compatible, 1 degree-of-freedom pneumatic manipulandum along with experiments demonstrating its safety and efficacy. We first validated the robot\u27s ability to apply computer-controlled loads about the wrist, demonstrating that it possesses sufficient bandwidth to simulate torsional spring-like loads during point-to-point flexion movements. Next, we verified the MR-compatibility of the device by imaging a head phantom during robot operation. We observed no systematic differences in two measures of MRI signal quality (signal/noise and field homogeneity) when the robot was introduced into the scanner environment. Likewise, measurements of joint angle and actuator pressure were not adversely affected by scanning. Finally, we verified device efficacy by scanning 20 healthy human subjects performing rapid wrist flexions against a wide range of spring-like loads. We observed a linear relationship between joint torque at peak movement extent and perturbation magnitude, thus demonstrating the robot\u27s ability to simulate spring-like loads in situ. fMRI revealed task-related activation in regions known to contribute to the control of movement including the left primary sensorimotor cortex and right cerebellum

Brain and Human Body Modelling 2021

This open access book describes modern applications of computational human modelling to advance neurology, cancer treatment, and radio-frequency studies including regulatory, safety, and wireless communication fields. Readers working on any application that may expose human subjects to electromagnetic radiation will benefit from this book’s coverage of the latest models and techniques available to assess a given technology’s safety and efficacy in a timely and efficient manner. This is an Open Access book