Transcranial magnetic stimulation and stroke: A computer-based human model study

This paper explores how transcranial magnetic stimulation (TMS) induced currents in the brain are perturbed by electrical and anatomical changes following a stroke in its chronic stage. Multiple MRI derived finite element head models were constructed and evaluated to address the effects that strokes...

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Bibliographic Details
Published in:NeuroImage (Orlando, Fla.) Fla.), 2006-04, Vol.30 (3), p.857-870
Main Authors: Wagner, Tim, Fregni, Felipe, Eden, Uri, Ramos-Estebanez, Ciro, Grodzinsky, Alan, Zahn, Markus, Pascual-Leone, Alvaro
Format: Article
Language:English
Subjects:
Computer Simulation
Conductivity
Electrophysiology
Finite element model
Geometry
Humans
Neural networks
Software
Stroke - physiopathology
Stroke rehabilitation
Studies
Transcranial magnetic stimulation
Transcranial Magnetic Stimulation - instrumentation
Transcranial Magnetic Stimulation - methods
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Summary:This paper explores how transcranial magnetic stimulation (TMS) induced currents in the brain are perturbed by electrical and anatomical changes following a stroke in its chronic stage. Multiple MRI derived finite element head models were constructed and evaluated to address the effects that strokes can have on the induced stimulating TMS currents by comparing stroke models of various sizes and geometries to a healthy head model under a number of stimulation conditions. The TMS induced currents were significantly altered for stimulation proximal to the lesion site in all of the models analyzed. The current density distributions were modified in magnitude, location, and orientation such that the population of neural elements that are stimulated will be correspondingly altered. The current perturbations were minimized for conditions tested where the coil was far removed from the lesion site, including models of stimulation contralateral to the lesioned hemisphere. The present limitations of TMS to the peri-lesional cortex are explored, ultimately concluding that conventional clinical standards for stimulation are unreliable and potentially dangerous predictors of the site and degree of stimulation when TMS is applied proximal to infarction site.
ISSN:1053-8119
1095-9572
DOI:10.1016/j.neuroimage.2005.04.046