TMS targets for multiple sclerosis related depression derived using a precomputed functional connectome

Abstract Background: Depression in multiple sclerosis (MS) is poorly responsive to conventional pharmacotherapy, highlighting the need for clinical TMS trials. However, it unclear if MS depression suitable circuit-targeted therapeutics. We developed a technique identifying single treatment targets based on distributed brain circuit maps derived from symptom-causing lesions. then tested this using published that define circuits connected lesions associated with greater depression, which have been shown predict outcomes. Methods: analyzed recently-published “MS map” normative connectivity of increase risk (Siddiqi et al., Nature Mental Health 2023). constructed precomputed functional connectome mean whole-brain 292,019 voxels across 1,000 participants. compared each voxel’s map spatial correlations. Voxels whose most strongly correlate are identified as potential targets. As comparator, we conducted same analysis previously stroke and penetrating head trauma (N=461), has reveal better Human Behaviour 2021). Results: The peak lesion-derived target was at MNI coordinates (-38,44,34). This within 1cm other lesion types, (-44,38,30), previous subgenual cingulate anti-correlations (-42,44,30). Conclusions: high-resolution atlas voxel-wise can therapeutic neuromodulation by comparing their template map. Our proposed near current suggesting may be amenable TMS. Research Category Technology Methods Translational Research: 10. Transcranial Magnetic Stimulation (TMS) Keywords: multiple, TMS,