Easy methods to make the neuronavigated targeting of DLPFC accurate and routinely accessible for rTMS.

Abstract

Dorsolateral prefrontal cortex (DLPFC) is the main stimulation target for rTMS treatment of depression. DLPFC is located in the middle frontal gyrus and corresponds to the lateral part of Brodmann Areas 9 and 46. Current methods to locate the DLPFC are either based on head landmarks that are inaccurate, or based on MRI-neuronavigation. Neuronavigated-methods are based either on standardized stereotactic coordinates translated to the individual patient or on brain landmarks requiring neuroanatomical skills for their identification. We developed a script automating the inclusion of already validated targets into patients' MRI, and also a new method to target DLPFC based on neuroanatomical landmarks. The present study aims to assess this new approach.