Localization of the Upper Extremity Area on the Primary Motor Cortex with Transcranial Magnetic Stimulation Figure-of-Eight Coil: A Clinical Study

Abstract

Although stroke has always been a major cause of long-term disability, mostly occurring in the upper extremities, the current conventional rehabilitative options remain both insufficient and ineffective in restoring full motor functions. As a promising alternative solution, transcranial magnetic stimulation (TMS) can non-invasively alter the excitability of and modulate the connections within the lesioned area with electromagnetic fields through a stimulating coil. Nevertheless, identifying the upper extremity area on the primary motor cortex (M1) in different patients remains a challenge due to the heterogeneous nature of the anatomy both in terms of size and location. Therefore, this study offers a method for localizing the region of interest (ROI) through an integrated method of TMS, electromyography (EMG), and optical tracking, supported by data from a clinical study, to provide an accurate and personalized ground truth for future stimulations of the same location in each patient.