The combination of transcranial magnetic stimulation (TMS) with functional neuroimaging has expanded the potential of TMS for human brain mapping. The precise and reliable positioning of the TMS coil is not a simple task, however. Modern frameless stereotaxic systems allow investigators to base navigation either on the subject's structural magnetic resonance imaging (MRI), functional MRI data, or the use of functional neuroimaging data from the literature, so-called "probabilistic approach." The latter assumes consistency across individuals in the location of task-related "activations" in standardized stereotaxic space. Conventional nonstereotaxic localization of brain areas is also a common method for defining the coil position. Our aim was to evaluate the accuracy of five different localization strategies in one single study. The left primary motor cortex (left M1-Hand) was used as target region. Three approaches were based on real-time frameless stereotaxy using information based on either anatomical or functional MRI. The remaining two strategies relied either on standard cranial landmarks (i.e., the International 10-20 EEG system) or a standardized function-guided procedure (i.e., the spatial relationship between the left and right M1-Hand). The results were compared to a TMS-based mapping of the primary motor cortex; center of gravity of motor-evoked potentials (MEP-CoG) was calculated for each subject (n = 10). Our findings suggest that highest precision can be achieved with fMRI-guided stimulation, which was accurate within the range of millimeters. Very consistent results were also obtained with the "probabilistic" approach. In view of these findings, we discuss the methods and special characteristics of each localization strategy.

译文

:经颅磁刺激(TMS)与功能性神经影像学的结合扩大了TMS在人脑测绘中的潜力。然而,TMS线圈的精确和可靠定位并不是一件容易的事。现代无框立体定位系统使研究人员可以根据受试者的结构磁共振成像(MRI),功能性MRI数据或使用文献中的功能性神经成像数据来进行导航,即所谓的“概率方法”。后者假设个人在标准化立体定位空间中与任务相关的“激活”的位置上具有一致性。大脑区域的常规非立体定位也是确定线圈位置的常用方法。我们的目的是在一项研究中评估五种不同定位策略的准确性。左初级运动皮层(左M1-Hand)用作目标区域。三种方法基于实时无框架立体定位,并使用基于解剖或功能MRI的信息。其余两种策略要么依靠标准的颅骨标志(即国际10-20 EEG系统),要么依靠标准化的功能指导程序(即左右M1-Hand之间的空间关系)。将结果与主运动皮层的基于TMS的映射进行比较;计算每个受试者(n = 10)的运动诱发电位(MEP-CoG)的重心。我们的发现表明,在fMRI指导的刺激下可以达到最高的精确度,该精确度在毫米范围内。使用“概率”方法也获得了非常一致的结果。鉴于这些发现,我们讨论了每种本地化策略的方法和特殊特征。

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