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| ECT vs. MST. This figure highlights the most important similarities and differences between electroconvulsive therapy (ECT), and magnetic seizure therapy (MST). Both treatments are typically only used on patients with treatment-resistant depression and involve inducing a seizure, either with an electrical current or a magnetic field. The main difference is that ECT has a more global spread to subcortical structures and hippocampus, whereas MST affects more local cortical structures. However, both treatment types significantly reduce depression ratings, as measured by the HAMD-17 for ECT (pre = 24.26, post = 13.21, t(18) = 5.94, d z = 2.07, p = 1.3 x 10 -5 ) and the HAMD-24 for MST (pre = 28.13, post = 21.40, t(14) = 4.14, d z = 0.93, p = 9.97 x 10 -4 ).
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Major depressive disorder (MDD) is a leading cause of disability worldwide. One of the most efficacious treatments for treatment-resistant MDD is electroconvulsive therapy (ECT). Recently, magnetic seizure therapy (MST) was developed as an alternative to ECT due to its more favorable side effect profile. While these approaches have been very succes...
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Major depressive disorder (MDD) is a leading cause of disability worldwide. One of the most efficacious treatments for treatment-resistant MDD is electroconvulsive therapy (ECT). Recently, magnetic seizure therapy (MST) was developed as an alternative to ECT due to its more favorable side effect profile. While these approaches have been very succes...
Citations
... The rotations along the other two axes were chosen to ensure symmetric placement of the coil above both sides of the head. Distance and E-field optimization of the MagVenture MST-Twin coil: Clinical applications aim to place the two coil halves above the F3/F4 electrode positions, respectively [17,18]. ...
Background: Transcranial Magnetic Stimulation (TMS) therapies use both focal and unfocal coil designs. Unfocal designs often employ bendable windings and moveable parts, making realistic simulations of their electric fields in inter-individually varying head sizes and shapes challenging. This hampers comparisons of the various coil designs and prevents sys-tematic evaluations of their dose-response relationships. Objective: Introduce and validate a novel method for optimizing the position and shape of flexible coils taking individual head anatomies into account. Evaluate the impact of realistic modeling of flexible coils on the electric field simulated in the brain. Methods: Accurate models of four coils (Brainsway H1, H4, H7; MagVenture MST-Twin) were derived from computed tomography data and mechanical measurements. A generic representation of coil deformations by concatenated linear transformations was introduced and validated. This served as basis for a principled approach to optimize the coil positions and shapes, and to optionally maximize the electric field strength in a region of interest (ROI). Results: For all four coil models, the new method achieved configurations that followed the scalp anatomy while robustly preventing coil-scalp intersections on N=1100 head models. In contrast, setting only the coil center positions without shape deformation regularly led to physically impossible configurations. This also affected the electric field calculated in the cortex, with a median peak difference of ~16%. In addition, the new method outperformed grid search-based optimization for maximizing the electric field of a standard figure 8 coil in a ROI with a comparable computational complexity. Conclusion: Our approach alleviates practical hurdles that so far hampered accurate simula-tions of bendable coils. This enables systematic comparison of dose-response relationships across the various coil designs employed in therapy.
