Method and system for combining anatomical connectivity patterns and navigated brain stimulation
Inventors
Neuvonen, Tuomas • Hannula, Henri
Assignees
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Publication Number
US-11951324-B2
Publication Date
2024-04-09
Expiration Date
Abstract
When operating a brain stimulation device, it is critical to understand and control the network effects associated with the area being targeted for stimulation. The combined system and methods provided herein provides the operator with a real-time view of the brain network potentially affected by the stimulation. The system and method are capable of increasing the accuracy of diagnostic information. Additionally, disclosed herein are a system and method for combining navigated brain stimulation data and anatomical data with brain connectivity data for an individual.
Core Innovation
The invention enables transcranial magnetic stimulation (TMS) treatment by acquiring an anatomical image and functional data of a subject’s brain, coregistering functional data portions associated with a portion of interest to corresponding locations from the anatomical image to form a combined view, and stereotactically aligning the combined view with a transcranial magnetic stimulation (TMS) stimulation device in real-time. A location of the brain to stimulate with a TMS pulse is selected based on the combined view.
The location selection is refined using a response-driven and tractography-guided connectivity approach. The method stimulates the brain with the TMS device to generate a predetermined response, selects one or more seed locations in the brain that generate the predetermined response, and determines white matter tracts that extend from the one or more seed locations to a deep and/or distant target using a tractography algorithm.
The method then further stimulates at the one or more seed locations to stimulate the deep and/or distant target. If further stimulating at the seed locations generates a desired response at the deep and/or distant target, the method treats the brain with additional stimulation at the one or more seed locations. If the desired response is not generated at the deep and/or distant target, the method varies at least one of a stimulation parameter, the tractography algorithm, a tractography algorithm parameter, and the one or more seed locations.
Claims Coverage
The patent includes one independent claim that covers an end-to-end TMS enabling method using anatomical/functional coregistration, real-time stereotactic alignment, and response-informed tractography-based seed-to-target selection with conditional iteration or parameter/algorithm/seed variation.
Real-time stereotactic TMS alignment to a combined anatomical-functional view
Stereotactically aligning the combined view of the brain and a transcranial magnetic stimulation (TMS) stimulation device in real-time after forming the combined view by coregistering at least a portion of functional data with a corresponding location from the anatomical image.
Response-driven seed selection
Selecting a location of the brain to stimulate with a TMS pulse, wherein the location is selected by stimulating the brain with the TMS stimulation device to generate a predetermined response in the subject and selecting one or more seed locations in the brain that generate the predetermined response.
Tractography-based determination of white matter tracts from seed to deep and/or distant target
Determining white matter tracts that extend from the one or more seed locations to a deep and/or distant target utilizing a tractography algorithm.
Seed re-stimulation with desired response decision for treating additional stimulation
After determining the tracts, further stimulating the brain with the TMS stimulation device at the one or more seed locations to stimulate the deep and/or distant target; if the further stimulating generates a desired response at the deep and/or distant target, treating the brain with additional stimulation at the one or more seed locations.
Conditional variation of stimulation parameters, tractography algorithm, and/or seed locations
If the further stimulating does not generate the desired response at the deep and/or distant target, varying at least one of a stimulation parameter, the tractography algorithm, a tractography algorithm parameter, and the one or more seed locations.
Across the independent claim, the inventive coverage centers on coregistration of anatomical and functional data into a combined view, real-time stereotactic alignment with a TMS device, and a response-driven, tractography-guided selection process that uses seed-to-deep/distant target tract identification and conditional iteration via parameter, algorithm, or seed variation.
Stated Advantages
Enables TMS treatment by selecting and refining a stimulation location and deciding whether to apply additional stimulation based on generating a desired response at a deep and/or distant target.
Provides an iterative refinement mechanism by varying stimulation parameters, the tractography algorithm, tractography algorithm parameters, and/or seed locations when a desired response is not generated.
Documented Applications
Tumor resection planning and safe resections (including tumor/lesion).
Motor mapping and corticospinal tract identification using motor evoked potentials (MEP) and electromyography (EMG).
Depression.
Visual cortex mapping.
Speech mapping (including Broca and Wernicke).
Stroke therapy, including applications related to Aphasia.
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