https://bic.berkeley.edu/sites/default/files/Rossi_09_TMS%20safety%20review.pdf

Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research

Noninvasive brain stimulation with transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) is valuable in research and has potential therapeutic applications in cognitive neuroscience, neurophysiology, psychiatry, and neurology. TMS allows neurostimulation and neuromodulation, while tDCS is a purely neuromodulatory application. TMS and tDCS allow diagnostic and interventional neurophysiology applications, and focal neuropharmacology delivery. However, the physics and basic mechanisms of action remain incompletely explored. Following an overview of the history and current applications of noninvasive brain stimulation, we review stimulation device design principles, the electromagnetic and physical foundations of the techniques, and the current knowledge about the electrophysiologic basis of the effects. Finally, we discuss potential biomedical and electrical engineering developments that could lead to more effective stimulation devices, better suited for the specif...

https://www.annualreviews.org/doi/pdf/10.1146/annurev.bioeng.9.061206.133100

Noninvasive human brain stimulation.

Electric field depth-focality tradeoff in transcranial magnetic stimulation: simulation comparison of 50 coil designs.

Transcranial magnetic stimulation in basic and clinical neuroscience: A comprehensive review of fundamental principles and novel insights.

A system for treating chronic inflammation may include an implantable microstimulator, a wearable charger, and optionally an external controller. The implantable microstimulator may be implemented as a leadless neurostimulator implantable in communication with a cervical region of a vagus nerve. The microstimulator can address several types of stimulation including regular dose delivery. The wearable charger may be worn around the subject's neck to rapidly (<10 minutes per week) charge an implanted microstimulator. The external controller may be configured as a prescription pad that controls the dosing and activity of the microstimulator.

Neural stimulation devices and systems for treatment of chronic inflammation

Magnetic stimulation can activate excitable tissues noninvasively. However, this method requires high energy to operate and can produce equipment heat that leads to inefficient stimulation. In this study, a comprehensive optimization of efficiency for magnetic stimulation has been conducted. A total of 16,781 coil designs were tested in order to determine the optimal coil geometry and inductance for neural excitation. Induced electric fields were calculated to find the optimal stimulation site (OSS) of a given coil. The threshold energy of a magnetic pulse for neural excitation was then calculated based on the transmembrane responses of a nerve model. Simulation results show that there exists an optimal inductance, as a consequence of an optimal pulse duration, corresponding to a minimum threshold energy. A longer pulse width is required to obtain the maximum efficiency for axons with slower membrane dynamics, a longer coil-to-fiber distance, and greater values of resistance (R) and capacitance (C) of the resistance-inductance-capacitance circuit. The optimal geometry features a minimum coil height, suggesting a flat coil design for optimal efficiency. The dimension of the optimal coil design increases with the coil-to-fiber distance. Moreover, the cloverleaf design achieves the highest efficiency for infinitely long fibers whereas the butterfly design is optimal for terminating or bending fibers.

Analysis of efficiency of magnetic stimulation

A novel three-dimensional (3-D) differential coil has been designed for improving the localization of magnetic stimulation. This new coil design consists of a butterfly coil with two additional wing units and an extra bottom unit, both perpendicular to the plane of the butterfly coil. The wing units produce opposite fields to restrict the spread of induced fields while the bottom unit enhances the induced fields at the excitation site. The peak induced field generated by this new design is located at the center of the coil, providing an easy identification of the excitation site. The field localization of the new coil Is comparable with that of much smaller coils but with an inductance compatible to current magnetic stimulators. Numerical computations based on the principles of electromagnetic induction and using a human nerve model were performed to analyze the induced fields and the stimulation thresholds of new coil designs. The localization of the coil design was assessed by a half power region (HPB), within which the magnitude of the normalized induced field is greater than 1//spl radic/2. The HPR for a 3-D differential coil built is improved (decreased) by a factor of three compared with a standard butterfly coil. Induced fields by this new coil were measured and in agreement with theoretical calculations.

A 3-D differential coil design for localized magnetic stimulation

A method for predicting neural excitation during magnetic stimulation using passive cable models has been developed. This method uses the information of the threshold capacitor voltage for magnetic stimulation coils to determine the equivalent excitation thresholds for the passive transient (PT) and passive steady-state (PSS) cable models as well as for the activating function. The threshold values for the PT, PSS models, and the activating function vary only with the pulsewidth of the stimulus for a variety of coils at different locations and orientations. Furthermore, the excitation threshold for the PSS model is also independent of axon diameter and best fitted to a simple mathematical function. By comparing the transmembrane potential of the PSS model with the corresponding threshold, the prediction of excitation during magnetic stimulation can be made. Similarly, it is also possible to predict excitation using the PT model and the activating function with the corresponding thresholds provided. By taking advantage of the weighted pulsewidth, this method can even predict the excitation for stimuli with various waveforms, greatly simplifying the determination of neural excitation for magnetic stimulation.

Kai-Hsiung Hsu

Papers

Analysis of efficiency of magnetic stimulation

A 3-D differential coil design for localized magnetic stimulation

Prediction of neural excitation during magnetic stimulation using passive cable models