EEG/fMRI Controlled TMS Real-time Neural Feedback in Anti-Depressive Treatment

EEG/fMRI 控制的 TMS 实时神经反馈在抗抑郁治疗中的应用

• 批准号: 9056572
• 负责人: Truman R Brown
• 金额: $ 64.25万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-17 至 2018-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9056572
• 关键词: Alpha Rhythm; Anterior; Brain; Clinical; Clinical Trials; Computer software; Control Groups; Data; Device or Instrument Development; Drug resistance; Effectiveness; Electroencephalography; Feedback; Frequencies; Functional Magnetic Resonance Imaging; Future; Goals; Grant; Individual; Knowledge; Learning; Left; Literature; Location; Magnetism; Measurement; Measures; Mental Depression; Moods; Outcome; Pathway interactions; Pharmaceutical Preparations; Phase; Physiologic pulse; Prefrontal Cortex; Randomized; Research; Research Design; Signal Transduction; Structure; System; Testing; Time; Training; Transcranial magnetic stimulation; Universities; Variant; Work; antidepressant effect; cingulate cortex; cohort; depressed patient; depressive symptoms; design; improved; individual patient; instrument; novel; novel therapeutics; relating to nervous system; success; treatment planning; treatment response; week trial

 DESCRIPTION (provided by applicant): This R21/R33 grant will design and build a neural imager/stimulator which will integrate EEG, TMS and fMRI into a single instrument in the R21 phase. This will enable EEG and fMRI to be acquired simultaneously in conjunction with the application of TMS pulses. This instrument will test the hypothesis that TMS pulses applied in synchrony with the brain's internal rhythms will have greater local and distributed effects than will non-synchronized stimulation and specifically whether knowing and understanding the brain's rhythms and stimulating with this knowledge will have larger brain effects than the current state of the art, where stimulation is largely done without knowledge of internal brain state. The R21 phase will test these in normal subjects after the full real-time feedback system is developed. In the R33 phase we will test whether synchronized TMS will be a successful treatment in a high percentage of drug resistant depressed patients, and will result in better clinical outcomes than will non-synchronized stimulation, which is currently employed. The detailed Specific Aims to accomplish these goals are: R21 phase Specific Aim1: Integrate an EEG system with our existing simultaneous TMS and fMRI scanner so the final instrument is able to acquire and conduct simultaneous EEG-fMRI-TMS measurements. Specific Aim2: Develop the necessary software and interface hardware to detect and use in real-time the alpha phase and/or frequency to provide real-time closed loop control of the TMS pulse timing. Specific Aim 3: Show in a cohort of normal subjects that there is significant variation of rACC inhibition as the timing of TMS pulses applied to the DLPFC are varied with respect to the phase and frequency of an individual's alpha rhythms. R33 phase Specific Aim 1: Integrate a similar EEG system with our treatment TMS scanner with similar feedback circuitry as that in SA 3 in the R21. Specific Aim 2: Carry out a 4 week trial of anti-depressive therapy randomized between optimum timed TMS and standardized non-synchronous TMS in a cohort of depressed patients to estimate the success rate of such an optimized treatment.

 描述（由应用程序提供）：此R21/R33赠款将设计和构建一个神经成像器/刺激器，该神经成像仪/刺激器将在R21阶段将EEG，TMS和FMRI整合到单个仪器中。这将使EEG和FMRI仅与TMS脉冲的应用一起获取。该仪器将检验以下假设：与非同步刺激，具体了解和理解大脑的节奏和刺激相比，与当前的刺激相比，刺激在没有内部大脑的情况下，具有更大的大脑效应，与非同步刺激相比，与大脑内部节奏同步的TMS脉冲将具有更大的局部和分布效应。在开发完整的实时反馈系统后，R21阶段将在正常受试者中测试这些阶段。在R33阶段，我们将测试同步的TMS是否会成功地治疗耐药性抑郁症患者的比例，并将带来比目前使用的非同步刺激更好的临床结果。实现这些目标的详细特定目的是：R21阶段特定的目标1：将脑电图系统与我们现有的Simpletanies TMS和FMRI扫描仪整合在一起，因此最终的仪器能够同时获得并进行同时进行EEG-FMRI-TMS测量。特定AIM2：开发必要的软件和接口硬件，以实时检测和使用Alpha阶段和/或频率，以提供对TMS脉冲时序的实时闭环控制。具体目标3：在一系列正常受试者中，表明RACC抑制作用显着变化，因为应用于DLPFC的TMS脉冲的时间与个体的α节律的相位和频率变化。 R33阶段特定目标1：将类似的脑电图系统与我们的处理TMS扫描仪相结合，其反馈电路与R21中的SA 3相似。具体目标2：在一系列抑郁症患者中，对优化的定时TMS和标准化的非同步TMS进行反抑郁疗法进行了为期4周的抗抑郁疗法，以估计这种优化治疗的成功率。

项目成果

Daily prefrontal closed-loop repetitive transcranial magnetic stimulation (rTMS) produces progressive EEG quasi-alpha phase entrainment in depressed adults.

• DOI: 10.1016/j.brs.2022.02.008
• 发表时间: 2022-03
• 期刊: Brain stimulation
• 影响因子: 7.7
• 作者: Faller J;Doose J;Sun X;Mclntosh JR;Saber GT;Lin Y;Teves JB;Blankenship A;Huffman S;Goldman RI;George MS;Brown TR;Sajda P
• 通讯作者: Sajda P