Personalized models of Beam/F3 targeting in transcranial magnetic stimulation for depression: Implications for precision clinical translation

作者：Divya Rajasekharan, Michelle R. Madore, Paul E. Holtzheimer, Kelvin O. Lim, Leanne M. Williams, Noah S. Philip · 发表于：Brain stimulation · 年份：2025 · DOI：10.1016/j.brs.2025.04.003 · 被引用次数：11 · 研究领域：Transcranial Magnetic Stimulation Studies、Electromagnetic Fields and Biological Effects、Functional Brain Connectivity Studies

Background Clinical transcranial magnetic stimulation (TMS) for depression routinely relies on the scalp-based Beam/F3 targeting method to identify stimulation targets in the dorsolateral prefrontal cortex (dLPFC). Scalp-based targeting offers a low-cost and easily implemented method for TMS coil placement, enhancing treatment availability. However, limited anatomical and functional specificity of the Beam/F3 method may affect treatment outcomes, motivating assessment of the clinical standard. Methods In a naturalistic clinical trial of TMS conduced at four Veterans Affairs hospitals, the authors evaluate the Beam/F3 method using neuroimaging incorporated before TMS, after five treatment sessions, and after all thirty sessions. Personalized anatomical and electric field (E-field) models were developed to assess target location and network engagement, as well as subsequent effects on clinical outcomes. Results Anatomical models demonstrate that the Beam/F3 method produced reliable targets in the dLPFC across individuals and repeated treatment sessions. E-field models revealed that baseline anticorrelation between the stimulation center and the sgACC was associated with antidepressant symptom response after five TMS sessions ( p = 0.032 , r 2 = 0.100 , N = 46 ) and at the end of treatment ( p = 0.042 , r 2 = 0.107 , N = 39 ). Relatedly, E-field magnitude at the sgACC-anticorrelated peak in the prefrontal cortex correlated with symptom response throughout treatment (early treatm...