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（由申请人提供）：这项 R21/R33 拨款将设计和建造一个神经成像仪/刺激器，将 EEG、TMS 和 fMRI 集成到 R21 阶段的单个仪器中，这将使 EEG 和 fMRI 能够同时采集。该仪器将测试与大脑内部节律同步应用的 TMS 脉冲比非同步刺激具有更大的局部和分布式效应的假设。具体来说，了解和理解大脑的节律并利用这些知识进行刺激是否会比目前的技术水平产生更大的大脑影响，目前的技术水平很大程度上是在不了解大脑内部状态的情况下进行的，R21阶段将在正常受试者中进行测试。在 R33 阶段，我们将开发完整的实时反馈系统，测试同步 TMS 是否能够成功治疗高比例的耐药抑郁症患者，并且会比非同步刺激产生更好的临床结果。目前受雇。实现这些目标的详细具体目标是： R21 阶段具体目标 1：将 EEG 系统与我们现有的同步 TMS 和 fMRI 扫描仪集成，以便最终仪器能够采集并进行同步 EEG-fMRI-TMS 测量。软件和接口硬件实时检测和使用 α 相和/或频率，以提供 TMS 脉冲定时的实时闭环控制 具体目标 3：在一组正常受试者中显示存在显着变化。 rACC 抑制的影响是因为施加到 DLPFC 的 TMS 脉冲的时间根据个体的 α 节律 R33 阶段的相位和频率而变化。 具体目标 1：将类似的 EEG 系统与我们的治疗 TMS 扫描仪集成，并具有类似的反馈电路。 R21 中的 SA 3 具体目标 2：在一组抑郁患者中进行为期 4 周的抗抑郁治疗试验，随机选择最佳定时 TMS 和标准化非同步 TMS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.

每日前额叶闭环重复经颅磁刺激 (rTMS) 在抑郁成人中产生渐进的脑电图准 α 相夹带。

• 发表时间: 2022
• 影响因子: 7.7
• 作者: Faller, Josef;Doose, Jayce;Sun, Xiaoxiao;Mclntosh, James R;Saber, Golbarg T;Lin, Yida;Teves, Joshua B;Blankenship, Aidan;Huffman, Sarah;Goldman, Robin I;George, Mark S;Brown, Truman R;Sajda, Paul
• 通讯作者: Sajda, Paul

Biomarkers predict the efficacy of closed-loop rTMS treatment for refractory depression.

生物标志物预测闭环 rTMS 治疗难治性抑郁症的疗效。

• 发表时间: 2023-12-05
• 作者: Sun, Xiaoxiao;Doose, Jayce;Faller, Josef;McIntosh, James R;Saber, Golbarg T;Huffman, Sarah;Pantazatos, Spiro P;Yuan, Han;Goldman, Robin I;Brown, Truman R;George, Mark S;Sajda, Paul
• 通讯作者: Sajda, Paul