A Neurostimulator System for Real, Sham, and Multi-Target Transcranial Magnetic Stimulation

Abstract

BackgroundTranscranial magnetic stimulation (TMS) is a clinically effective therapeutic instrument used to modulate neural activity. Despite three decades of research, two challenging issues remain, the possibility of changing the 1) stimulated spot and 2) stimulation type (real or sham) without physically moving the coil.ObjectiveIn this study, a second-generation programmable TMS (pTMS2) device with advanced stimulus shaping is introduced that uses a 5-level cascaded H-bridge inverter and phase-shifted pulse-width modulation (PWM). The principal idea of this research is to obtain real, sham, and multi-locus stimulation with the same TMS system.MethodsWe propose a two-channel modulation-based magnetic pulse generator and a novel coil arrangement, consisting of two circular coils with a physical distance of 20 mm between the coils and a control method for modifying the effective stimulus intensity, which leads to the live steerability of the location and type of stimulation.ResultsBased on the measured system performance, the stimulation profile can be steered ± 20 mm along a line from the centroid of the coil locations by modifying the modulation index.ConclusionThe proposed system supports electronic control of the stimulation spot without physical coil movement, resulting in tunable modulation of targets, which is a crucial step towards automated TMS machines.

Devices and Technology in Transcranial Magnetic Stimulation: A Systematic Review

“…Later, Peterchev et al [ 66 , 75 ] proposed to reduce the loud sound provoked by the coil during therapies by implementing a double plastic case around the coil to absorb the acoustic waves and reduce the undesired effects that these sounds could have on the therapy. Other groups have proposed adaptations of the TMS devices and coils to provide double-blind sham stimulation [ 87 ] by controlling the direction of the electrical current in the coils to deliver either sham or effective (real) therapy [ 71 ].…”