How Is YINGCHI Transcranial Magnetic Stimulation (TMS) Positioned?

Release time :2022-05-26

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Precise positioning is an important cornerstone for threshold detection and guaranteeing treatment effects of transcranial magnetic stimulation (TMS). At present, there are several commonly used positioning methods, such as the 5cm positioning method and the TMS navigation system. Each positioning method has its own advantages and disadvantages. The 5cm positioning method is convenient and fast but relatively inaccurate while the navigation system is expensive and time-consuming. YINGCHI has designed a positioning cap based on the internationally recognized 10-20 EEG positioning system, which has the advantage of quickly and accurately finding stimulation targets, and is suitable for routine clinical treatment of large samples and brain function exploration.

Positioning Process

1. After the threshold is determined, select the protocol in the YINGCHI TMS software according to the safety screening scale and the patient's condition;

2. Determine the target area and the stimulation site of the positioning cap according to the protocol (see the figure below);

3. Move the coil to make the magnetic field output center coincide with the stimulation target, and the coil must be tangent to the scalp to ensure maximum magnetic field;

4. After adjusting the position, fix the coil and start the treatment according to the parameters of the selected protocol.

Precautions:
1. The operator must ask about patient’s feelings and tolerance to decide whether to adjust the stimulation intensity. If adjustments are required, adjust the intensity in 1% increments during the treatment.
2. Patients must keep their posture unchanged to avoid off-target stimulation in the process.

TMS stimulation targets and indications based on the international
10-20 system[1]
Brain AreasLeft HemisphereRight HemisphereBrodmann Areas[1,29]Indications for TMS[30]
Orbitofrontal Cortex, OFCFp1[2]Fp2[3]Area 10Depression[31]; OCD[32]; Disturbance of Consciousness After Stroke[33], etc.
Dorsolateral Prefrontal Cortex, DLPFCF3[4]F4[5]Area 46Depression[34]; Anxious Depression[35]; Parkinson's Disease-Depression[36]; Fibromyalgia[37]; Substance Addiction[38]; Schizophrenia-Negative Symptoms[39]; Disturbance of Consciousness[40]; Insomnia[41]; PTSD[42]; OCD[43], etc.
Inferior Frontal Gyrus, IFGF7[6]F8[7]Area 45, 46Aphasia After Stroke[44]; ADHD (Language Retardation)[45], etc.
Hand Hotspots in Primary Motor Cortex, HH-M1C3[8]C4[9]Area 4Stroke Dyskinesia[46]; Neuropathic Pain[47]; Parkinson’s Disease-Movement Disorder[48]; Disturbance of Consciousness[49]; Fibromyalgia[50]; Dystonia[51]; Multiple Sclerosis[52], etc.
Superior Middle Temporal Gyrus, SMTGT3[10]T4[11]Area 21, 22Tinnitus[53]; Auditory Hallucination[54], etc.
Angular Gyrus of Parietal Occipital Junction, AG-POJP3[12]P4[13]Area 7Hemispatial Neglect After Stroke[55]; Craving for Methamphetamine[56], etc.
Superior marginal gyrus, SMGTP3[14]TP4[15]Area 39, 40Schizophrenia-Auditory Hallucination[57]; Medication-Resistant Auditory Hallucinations[58]; Psychotic Major Depression-Auditory Hallucination[59]
Parahippocampal Gyrus of Posterior Temporal Lobe, PHG-PTLT5[16]T6[17]Area 37, 19, 37, 3Alzheimer's Disease-Mild Cognitive Impairment[60]; Tinnitus[61], etc.
Supplementary Motor Cortex, SMAFz[18]Fz[18]Area 6Parkinson’s Disease-Movement Disorder[62]; Essential Tremor[63]; Dystonia[64]; Restless Legs Syndrome[65]; Tourette Syndrome[66]; OCD[67], etc.
Occipital LobeO1[19]O2[20]Area 17Poststroke Dysphagia[68]; Chronic Stroke-Limbs Dysfunction[69]; Ataxia in Parkinson's Disease[70], etc.
Temporoparietal Junction, TPJThe midpoint of the line T3-P3[21]The midpoint of the line T4-P4[22]Area 41, 42Chronic Tinnitus[71]; Schizophrenia-Auditory Hallucination[72], etc.
Broca's AreaThe intersection of the line T3-Fz and the line F7-Cz[23]The intersection of the line T4-Fz and the line F8-Cz[24]Area 44, 45Aphasia[73]; Post-stroke Aphasia[74]; Alzheimer’s Disease-Cognitive Impairment of Language[75]; Schizophrenia-Auditory Hallucination[76], etc.
Wernicke’s AreaThe intersection of the line C3-T5 and the line T3-P3[25]The intersection of the line C4-T6 and the line P4-T4[26]Area 22Alzheimer’s Disease (Language Comprehension Disorder)[75]; Post-stroke Aphasia[77], etc.
Swallowing Functional Area of Primary Motor Cortex, SFA-M1The midpoint of the line C3-T3[27]The midpoint of the line C4-T4[28]Area 4Post-stroke Dysphagia[78]; Parkinson’s Disease Dysphagia[79], etc.

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