%0 Case Reports
%T Short-term effect of coil handle orientations on fMRI-guided rTMS on insomnia: A case report.
%A Feng ZJ
%A Song QY
%A Han Y
%A Wei ZY
%A Fu C
%A Zang YF
%J Clin Neurophysiol Pract
%V 8
%N 0
%D 2023
%M 37854662
暂无%R 10.1016/j.cnp.2023.08.004
%X <B>UNASSIGNED: </B>The coil handle orientation plays a pivotal role in the therapeutic efficacy of repetitive transcranial magnetic stimulation (rTMS). However, there is currently no consensus on the optimal individualized coil handle orientation, especially for non-motor areas.<BR><B>UNASSIGNED: </B>The present case reported a short-term effect of functional connectivity (FC)-guided rTMS with coil handle posterior-anterior 45° (PA45°) and posterior-anterior 135° (PA135°) on a patient with insomnia. Notably, in this case, the PA45° orientation was nearly perpendicular to the adjacent sulcus, while the PA135° orientation was almost parallel to it. Local brain activity and functional connectivity were assessed using resting-state functional magnetic resonance imaging (RS-fMRI). Additionally, motor evoked potentials (MEPs) were captured both pre and post-rTMS sessions.<BR><B>UNASSIGNED: </B>The coil handle orientation PA45° outperformed the PA135° in both RS-fMRI and MEP outcomes. Moreover, a 9-day rTMS treatment led to discernible improvements in symptoms of depression and anxiety, complemented by a modest enhancement in sleep quality.