Dosing Transcranial Magnetic Brain Stimulation

Transcranial Magnetic Stimulation (TMS) is a non-invasive method to stimulate the brain, and TMS is FDA cleared for treating depression, OCD and smoking cessation (with many other clinical applications under investigation). Although Transcranial Magnetic Stimulation (TMS) is a highly effective treatment for patients with difficult to treat depression, improvement in remission rates are critically needed. A fundamental problem is that TMS is dosed over the motor cortex which has an observable functional measure (e.g., finger twitch), however, the treatment is performed over the prefrontal cortex (i.e., no observable change). This nonivasive technology uses functional Near-Infrared Spectroscopy (fNIRS) integrated with TMS (TMS-fNIRS) to more accurately personalize treatment dosing of TMS over the prefrontal cortex by more accurately calibrating the dose to the prefrontal cortex. This technology adjusts for coil to cortex distance differences, gyrus orientation differences as well as cortical excitability differences between the motor cortex and dorsolateral prefrontal cortex. The invention involves placement of fNIRS source/detectors under, around, and contralateral to the TMS coil. Thus, a treater can measure the brain effect of TMS and adjust power ("dose”) for individual patients to ensure adequate treatment.