Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback

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openAccess

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Volume Title

A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

Date

2022-03-01

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Mcode

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Language

en

Pages

9
523-531

Series

Brain Stimulation, Volume 15, issue 2

Abstract

Background: Transcranial magnetic stimulation (TMS) is widely used in brain research and treatment of various brain dysfunctions. However, the optimal way to target stimulation and administer TMS therapies, for example, where and in which electric field direction the stimuli should be given, is yet to be determined. Objective: To develop an automated closed-loop system for adjusting TMS parameters (in this work, the stimulus orientation) online based on TMS-evoked brain activity measured with electroencephalography (EEG). Methods: We developed an automated closed-loop TMS–EEG set-up. In this set-up, the stimulus parameters are electronically adjusted with multi-locus TMS. As a proof of concept, we developed an algorithm that automatically optimizes the stimulation orientation based on single-trial EEG responses. We applied the algorithm to determine the electric field orientation that maximizes the amplitude of the TMS–EEG responses. The validation of the algorithm was performed with six healthy volunteers, repeating the search twenty times for each subject. Results: The validation demonstrated that the closed-loop control worked as desired despite the large variation in the single-trial EEG responses. We were often able to get close to the orientation that maximizes the EEG amplitude with only a few tens of pulses. Conclusion: Optimizing stimulation with EEG feedback in a closed-loop manner is feasible and enables effective coupling to brain activity.

Description

| openaire: EC/H2020/810377/EU//ConnectToBrain Funding Information: This project has received funding from the Finnish Cultural Foundation , Academy of Finland (decisions No. 294625 , 306845 , and 327326 ), Instrumentarium Science Foundation , Emil Aaltonen Foundation , Finnish Science Foundation for Technology and Economics , Jane and Aatos Erkko Foundation , and European Research Council (ERC Synergy) under the European Union's Horizon 2020 research and innovation programme (ConnectToBrain; grant agreement No. 810377 ). Publisher Copyright: © 2022 The Author(s)

Keywords

Bayesian optimization, Closed-loop, Electroencephalography, Multi-channel TMS, Multi-locus TMS, Transcranial magnetic stimulation

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Citation

Tervo, A E, Nieminen, J O, Lioumis, P, Metsomaa, J, Souza, V H, Sinisalo, H, Stenroos, M, Sarvas, J & Ilmoniemi, R J 2022, ' Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback ', Brain Stimulation, vol. 15, no. 2, pp. 523-531 . https://doi.org/10.1016/j.brs.2022.01.016