Deep transcranial magnetic stimulation (dTMS) – beyond depression

Figures & data

Figure 1. dTMS system on a rolling medical cart including a cooling system, stimulator, interface module for double blind experiments, positioning arm and one helmet.

Table 1. Specifications of the different H-coils.

H-coil type	Target brain region	Indication^a	Clinical evidence	References
H1-coil	Bilateral PFC with preference to the left	MDD^a,b	–^c	[40,41,51,53–59]
		PTSD^b,d	–^e	[48]
		Bipolar disorder^b,d,f	–^g	[45,60,61]
		Schizophrenia – negative symptoms^b,d	–^e	[46,62]
		Alcohol addiction^d	–^e	[49–51]
		Migraine^d	–^e	[52]
		Chronic tinnitus	–^h	[63]
H2-coil	PFC, OFC, temporal and parietal cortex (bilateral symmetry)	Alzheimer’s disease^b,d	–^e	[64,65]
		Parkinson’s disease^b,d	–^g	[66,67]
H3-coil	mPFC and OFC (bilateral symmetry)	Autism and Asperger syndrome^b,^d	–^e	[68,69]
H4-coil	Insula and PFC (bilateral symmetry)	Nicotine addiction^b,d,f	–^e	[44]
		Obesity	–^h
H5-coil	Dorsal and ventral motor cortex and PFC (bilateral symmetry)	Parkinson’s disease^b,d	–^e	[70]
H6-coil	Unilateral dorsal and ventral PFC (either right or left)	ADHD^d	–^e	[71]
H7-coil	mPFC, including the ACC	OCD^b,d,f	–^e	[72]
		PTSD^d ^f ^b	–^h
		Migraine^d	–^g	[73]
		Tourette’s syndrome^d	–^h
		Cocaine addiction^d	–^h
H8-coil	Insula (right, left, or bilateral)	Obesity^d	–^h
		Alcohol addiction^d	–^h
H9-coil	Bilateral parietal cortex including the posterior cingulate cortex (PCC)	Alzheimer’s disease^b,d	–^h
		Mild cognitive impairment^d	–^h
H10-coil	Leg and hand primary motor cortex (bilateral symmetry)	Chronic neuropathic pain^b,d	–^e	[74]
		Multiple sclerosis^b,d	–^h
		Post-stroke rehabilitation^b,d	–^e	[75,76]
	Coil placed according to tumor location (high intensity use)	Blood–brain barrier Modulation for drug delivery in brain cancer patients^d	–^e	[77]
H11-coil	Insula (bilateral symmetry)	Anorexia nervosa^d	–^h
H12-coil	Temporal cortex (either right or left)	Epilepsy in children^d	–^h	[78]
H13-coil	Right temporal cortex (combined with H6-coil stimulation over the left PFC)	Low-functioning autism in children^d	–^h
H14-coil	Cerebellum and motor cortex	Ataxia^d	–^h

PFC: prefrontal cortex; OFC: orbitofrontal cortex; mPFC: medial PFC; ACC: anterior cingulate cortex; PCC: posterior cingulate cortex; MDD: major depressive disorder; PTSD: post-traumatic stress disorder; ADHD: attention deficit hyperactivity disorder; OCD: obsessive compulsive disorder.

^aFDA cleared.

^bCE approved indication.

^cProved in multicenter clinical trial.

^dOff label indication.

^eProved in randomized-controlled clinical trials.

^fOngoing multicenter double-blinded-placebo-controlled trial.

^gShowed effectiveness in open clinical trials.

^hOngoing double-blind placebo-controlled clinical trials.

Figure 2. Colored field maps for the H1-coil indicating the absolute magnitude electrical field in each pixel at 120% of hand motor threshold, for 10 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. The figure is in-press and is open access [79]. Full color available online.

Figure 3. Colored field maps for the H2-coil indicating the absolute magnitude electrical field in each pixel at 120% of hand motor threshold, for 16 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 4. Colored field maps for the H3-coil indicating the absolute magnitude electrical field in each pixel at 120% of foot motor threshold, for 9 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 5. Colored field maps for the H4-coil indicating the absolute magnitude electrical field in each pixel at 120% of hand motor threshold, for 14 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 6. Colored field maps for the H5-coil indicating the absolute magnitude electrical field in each pixel at 120% of hand motor threshold, for 14 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 7. Colored field maps for the H6-coil indicating the absolute magnitude electrical field in each pixel at 120% of hand motor threshold, for 11 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 8. Colored field maps for the H7-coil indicating the absolute magnitude electrical field in each pixel at 100% of foot motor threshold, for 14 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 9. Colored field maps for the H8-coil indicating the absolute magnitude electrical field in each pixel at 120% of hand motor threshold, for 14 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 10. Colored field maps for the H9-coil indicating the absolute magnitude electrical field in each pixel at 110% of foot motor threshold, for 16 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 11. Colored field maps for the H10-coil indicating the absolute magnitude electrical field in each pixel at 100% of foot motor threshold, for 14 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 12. Colored field maps for the H11-coil indicating the absolute magnitude electrical field in each pixel at 120% of hand motor threshold, for 14 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 13. Colored field maps for the H12-coil indicating the absolute magnitude electrical field in each pixel at 100% of hand motor threshold, for 14 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 14. Colored field maps for the H13-coil indicating the absolute magnitude electrical field in each pixel at 120% of hand motor threshold, for 14 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

Figure 15. Colored field maps for the H14-coil indicating the absolute magnitude electrical field in each pixel at 110% of leg motor threshold, for 16 coronal slices 1 cm apart. Red pixels indicate regions with field intensity above the threshold for neuronal activation. Full color available online.

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