Optimising current direction and intensity of transcranial magnetic stimulation

The method of any one of the preceding claims, comprising:

• performing transcranial magnetic stimulation of the motor cortex of the patient;
• monitoring the motor cortex, wherein the monitoring of the motor cortex includes monitoring neuron activation at the motor cortex using near infra-red spectroscopy to obtain an NIRS profile at the motor cortex at which motor threshold of the patient is achieved;
• performing the transcranial magnetic stimulation of the target cortical region;
• varying one or more of the stimulation parameters including at least the coil orientation;
• monitoring the target cortical region, wherein the monitoring of the target cortical region includes monitoring neuron activation at the motor cortex using near infra-red spectroscopy to obtain NIRS profiles at the target cortical region for different stimulation parameters;
• and
• comparing the NIRS profiles obtained at the target cortical region with the NIRS profile obtained at the motor cortex to determine one or more optimal stimulation parameters for transcranial magnetic stimulation of the target cortical region.

Transcranial magnetic stimulation apparatus adapted to optimise transcranial magnetic stimulation, the apparatus comprising:

• a coil;
• an electrical signal generator for delivering an electrical signal to the coil, wherein upon delivery of the electrical signal to the coil, the coil generates one or more magnetic field pulses for transcranial magnetic stimulation of a target cortical region of a patient, wherein the transcranial magnetic stimulation has stimulation parameters including orientation of the coil relative to the patient and intensity of the magnetic stimulation;
• means for varying the orientation of the coil relative to the patient;
• and
• a monitoring device configured to use near infra-red spectroscopy to monitor neuron activation at the target cortical region at different orientations of the coil relative to the patient;
• and
• an analysis unit that receives information about the neuron activation obtained during the monitoring and, based on the received information, determines one or more optimal coil orientations for transcranial magnetic stimulation of the target cortical region of the patient.

A method of optimising transcranial magnetic stimulation, the method comprising:

• applying an electrical signal to a coil to generate one or more magnetic field Pulses for transcranial magnetic stimulation of a target cortical region of a patient;
• varying the orientation of the coil relative to the patient;
• at different orientations of the coil relative to the patient, monitoring changes in blood flow and/or blood oxygenation at the target cortical region;
• and
• based on information obtained during the monitoring, determining one or more optimal coil orientations for the transcranial magnetic stimulation.

Transcranial magnetic stimulation apparatus adapted to optimise transcranial magnetic stimulation, the apparatus comprising:

• a coil;
• an electrical signal generator for delivering an electrical signal to the coil, wherein upon delivery of the electrical signal to the coil, the coil generates one or more magnetic field pulses for transcranial magnetic stimulation of a target cortical region of a patient;
• means for varying the orientation of the coil relative to the patient;
• a monitoring device configured to monitor changes in blood flow and/or blood oxygenation at the target cortical region at different orientations of the coil relative to the patient;
• and
• an analysis unit configured to receive information about the changes in blood flow and/or blood oxygenation obtained during the monitoring and, based on the received information, determine one or more optimal coil orientations for transcranial magnetic stimulation of the target cortical region of the patient.