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PERSPECTIVE article

Front. Neurosci.
Sec. Brain Imaging Methods
Volume 19 - 2025 | doi: 10.3389/fnins.2025.1517228

Optimization of TMS target engagement: current state and future perspectives

Provisionally accepted
Pantelis Lioumis Pantelis Lioumis 1,2,3*Timo Roine Timo Roine 1,4Ida Granö Ida Granö 1Dogu Baran Aydogan Dogu Baran Aydogan 1,5Elena Ukharova Elena Ukharova 1Victor Hugo Souza Victor Hugo Souza 1Dubravko Kičić Dubravko Kičić 1Risto Juhani Ilmoniemi Risto Juhani Ilmoniemi 1Nikos Makris Nikos Makris 6,7,8
  • 1 Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, Ostrobothnia, Finland
  • 2 BioMag Laboratory, Helsinki University Hospital, Helsinki, Uusimaa, Finland
  • 3 Cognitive Brain Research Unit, Faculty of Medicine, University of Helsinki, Helsinki, Uusimaa, Finland
  • 4 Advanced Magnetic Imaging Centre, Aalto University, FI00076 AALTO, Espoo, Finland, Espoo, Finland
  • 5 A.I. Virtanen Institute for Molecular Sciences, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Northern Savonia, Finland
  • 6 Center for Morphometric Analysis, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
  • 7 Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, United States, Boston, United States
  • 8 Psychiatric Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States

The final, formatted version of the article will be published soon.

    Neuromodulation is based on the principle that brain stimulation produces plastic changes in cerebral circuitry. Given the intersubject structural and functional variability, neuromodulation has a personalized effect in the brain. Moreover, because of cerebral dominance and interhemispheric functional and structural differences in the same individual, the characterization of specific brain circuitries involved is currently not feasible. This notion is extremely important for neuromodulation treatments applied in neuropsychiatry. Specifically, the efficacy of the neuromodulation treatments is critically dependent on the anatomical precision of the brain target and the circuitry which has been affected by the TMS intervention. Furthermore, for a complete understanding of how the brain behaves under stimulation, the characterization of its neurophysiological response is necessary as well. This goal can be achieved with TMS-EEG guided by current multimodal neuroimaging techniques in real time, namely MRI-based anatomical segmentation and diffusion MRI-based tractographic analysis.

    Keywords: TMS-EEG, Target engagement, dMRI (diffusion magnetic resonance imaging), structural connectivity, neurophysiological signatures of brain circuits

    Received: 28 Oct 2024; Accepted: 10 Jan 2025.

    Copyright: © 2025 Lioumis, Roine, Granö, Aydogan, Ukharova, Souza, Kičić, Ilmoniemi and Makris. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Pantelis Lioumis, Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Espoo, 02150, Ostrobothnia, Finland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.