Prescribing the most effective TMS treatment protocol has a high degree of complexity that requires a highly skilled and experienced physician. etc.), which prescription we will follow for the course of the treatment sessions, subject to modification if indicated. Personalized TMS Prescriptions/Protocolsįrom all the above data, our psychiatrist creates a customized, specific treatment protocol or ‘prescription’, in terms of the TMS machine settings (e.g., Power Frequency Amplitude Number of pulses/sec. The patient will wear the same cap, fitted the same way for each therapy session.

The patient wears a very thin nylon/rubber cap, very similar to a swimming cap, which is marked up to indicate the areas of the brain that will be treated. EEG & “Brain Mapping”Īfter the tests are administered, the patient undergoes an EEG (electroencephalogram), which is a brain scan that indicates electrical activity, which we use for brain mapping and diagnostics – it enables us to be as precise as possible in the TMS prescription.įollowing the EEG, we ‘map’ the brain using the results of the EEG, along with measurements and features of the patient’s skull. These tests are conducted through smart computer programs that produce a tremendous amount of diagnostic information, which is aggregated, organized, and utilized by our psychiatrist in the prescription process. In the initial visit, our patients undergo a comprehensive cohort of tests, surveys, and scales over the course of approximately 2-hours’ time. During surgery, patients also undergo electrocorticography with either the CorTec high resolution hybrid grid, the PMT high-resolution grid, or the Ad-Tech grid followed by direct electrocortical stimulation.įollowing completion of study, patients are followed up within 24 hours from surgery and at 1 and 3 months.Initial Assessment, EEG, Brain Mapping, and TMS Prescription To perform a preliminary assessment of the utility of using ECoG data in these patients to quantify new neurological deficits in the short term (24 hours) and long-term (1 and 3 months), and achieve a safe maximal tumor resection. To record electrocorticogram (ECoG) data intraoperatively with surface electrode grids during various motor, sensory (tactile) and speech tasks, and identify functional brain areas through the spectral analysis, and compare the preliminary data with our current pre-surgical mapping methods: functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS), and the gold standard, intraoperative direct electrical stimulation (DES).

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Brain mapping procedure