Systems and methods for providing personalized targeted non-invasive stimulation to a brain network
Disclosed herein are devices, systems, and methods for ameliorating or treating or preventing Alzheimer's Disease and related dementias. Methods may include using individual patients' data to identify the optimal treatment target(s) as well as the stimulation intensity, frequency, or waveform, or any combination thereof, for transcranial electromagnetic induction delivered via a device as in the case of Transcranial Magnetic Stimulation. Systems and methods include a platform or infrastructure for treatment delivery and data processing. In some embodiments, methods are applied to restore cognitive function, ameliorate clinical symptoms, modify altered mechanisms of plasticity, modulate cortical excitability and reactivity, or induce changes in local brain metabolism.
1. A method for determining personalized stimulation parameters for non-invasive stimulation of a brain of a subject, the method comprising:
sequentially stimulating using transcranial magnetic stimulation (TMS), each of a plurality of locations within a brain region of the subject, the brain region forming a node of a functional brain network of connected nodes in the brain of the subject;
sensing, using one or more electroencephalography (EEG) electrodes arranged on a scalp of the subject, a plurality of TMS-evoked potentials in response to sequentially stimulating the plurality of locations within the brain region of the subject using TMS; and
determining, based at least in part on at least one characteristic of the plurality of TMS-evoked potentials, personalized stimulation parameters for the subject, wherein the personalized stimulation parameters include a location of stimulation within the brain region and one or more stimulation characteristics, the one or more stimulation characteristics including a personalized intensity of stimulation.
2. The method of claim 1 , wherein the one or more stimulation characteristics further include a personalized frequency of stimulation.
3. The method of claim 1 , further comprising:
sensing a resting motor threshold in response to providing non-invasive stimulation of a motor cortex region of the brain of the subject;
determining a baseline intensity of stimulation based, at least in part, on the resting motor threshold; and
adjusting the baseline intensity of stimulation based, at least in part, on the personalized intensity of stimulation.
4. The method of claim 1 , wherein the brain region is a node of a Default Mode Network (DMN).
5. The method of claim 1 , further comprising providing non-invasive stimulation to the determined location of stimulation of the brain of the subject according to the determined one or more stimulation characteristics, wherein the non-invasive stimulation comprises at least one of transcranial electrical stimulation or transcranial magnetic stimulation.
6. The method of claim 5 , wherein the non-invasive stimulation provided to the determined location of stimulation is combined with a different non-invasive stimulation, delivered sequentially or simultaneously, including transcranial electrical stimulation.
7. The method of claim 1 , wherein determining the personalized stimulation parameters comprises selecting a location of stimulation from the plurality of locations having a largest peak magnitude of the plurality of TMS-evoked potentials.
8. The method of claim 1 , wherein the at least one characteristic of the plurality of TMS-evoked potentials comprises a signal amplitude.
9. The method of claim 1 , wherein sequentially stimulating using transcranial magnetic stimulation (TMS) comprises sequentially stimulating using single-pulse TMS.
10. A system for determining personalized stimulation parameters for non-invasive stimulation of a brain of a subject, the system comprising:
a stimulation device configured to sequentially stimulate using transcranial magnetic stimulation (TMS), each of a plurality of locations within a brain region of the subject, the brain region forming a node of a network of connected nodes in the brain of the subject;
a sensor device including one or more electroencephalography (EEG) electrodes configured to sense, in response to the sequential stimulation of the plurality of locations within the brain region, a plurality of TMS-evoked potentials; and
a processor configured to determine personalized stimulation parameters for the subject based at least in part on at least one characteristic of the plurality of TMS-evoked potentials, wherein the personalized stimulation parameters include a location of stimulation within the brain region and one or more stimulation characteristics, the one or more stimulation characteristics including a personalized intensity of stimulation.
11. The system of claim 10 , wherein the one or more stimulation characteristics further include a personalized frequency of stimulation.
12. The system of claim 10 , wherein the sensor device is further configured to sense a resting motor threshold in response to providing non-invasive stimulation of a motor cortex region of the brain of the subject; and the processor is further configured to i) determine a baseline intensity of stimulation based, at least in part, on the resting motor threshold; and ii) adjust the baseline intensity of stimulation based, at least in part, on the personalized intensity of stimulation.
13. The system of claim 10 , wherein the brain region is a node of a Default Mode Network (DMN).
14. The system of claim 10 , wherein the stimulation device is further configured to provide non-invasive stimulation to the determined location of stimulation of the brain of the subject according to the determined one or more stimulation characteristics, wherein the non-invasive stimulation comprises at least one of transcranial electrical stimulation or transcranial magnetic stimulation.
15. The system of claim 14 , wherein the non-invasive stimulation provided to the determined location of stimulation is combined with a different non-invasive stimulation, delivered sequentially or simultaneously, including transcranial electrical stimulation.
16. The system of claim 10 , wherein determining the personalized stimulation parameters comprises selecting a location of stimulation from the plurality of locations having a largest peak magnitude of the plurality of TMS-evoked potentials.
17. The system of claim 10 , wherein the at least one characteristic of the plurality of TMS-evoked potentials comprises a signal amplitude.
18. The system of claim 10 , wherein the stimulation device is configured to sequentially stimulate each of the plurality of locations within a brain region of the subject using single-pulse TMS.