TMS Coil Positioning Guide From Caputron

TMS Mapping Software

Beam Protocol - This program allows the user to quickly locate the F3 position from the 10-20 EEG system for prefrontal TMS applications.

When using TMS for the treatment of Major Depressive Disorder in adult patients who have failed to receive satisfactory improvement from prior antidepressant medication in the current episode, it is important to be able to correctly position the coil of the Dorsal Laterla PreFrontal Cortex (DLPFC). There are many different methods available that clinicians use to locate the treatement area. Early studies used a "5 cm" rule which involved moving the coil 5 cm to the motor cortex where the motor threshold evoke potential was determined. This method has limitations as it does not take into affect variability in head size and other variables that change between individuals. As the left DLPFC corresponds to the F3 location of the international 10-20 EEG system, it is possible to take measurements of the individual and use an algorithm to determine the desired placement of the TMS coil.

Using the Beam protocol, named after William Beam, a clinician can take three measurements (tragus to tragus, nasion to inion and head circumfrence) and input them into the free software that provides the position of the F3 - DLPFC position that corresponds to that individual.

The software is availble for both Windows and Mac on the Clincal Researcher website.

The publication, An efficient and accurate new method for locating the F3 position for prefrontal TMS applications is available for review.

EEG Locator - Borckardt/Hanlon System

An alternative method to mapping the international 10-20 EEG measurements involves using the Borckardt/Hanlon System. The system works similar to the beam protocal which uses three measurements (tragus to tragus, nasion to inion and head circumfrence). The free software than allowes you to choose the desired point of interest and the algorithm provides the mapping to the location.

The sofwre is a javascript based online tool available from the Clincal Researcher website.

TMS Mapping Videos

Locating the superior temporal gyrus
Dr. Rustin Berlow locates the superior temporal gyrus.
Locating the EEG positions T3 and T4
Dr. Rustin Berlow locates the eeg positions T3 & P3 for TMS location targeting.
DMPFC for stimulation
Dr. Rustin Berlow places a TMS coil over the DMFC for stimulation.
Locating DMPFC
Dr. Rustin Berlow locates the DMPFC for TMS stimulation, resulting in the stimulation of the salience network.
Locating DMPFC, SMA, & CZ
Dr. Rustin Berlow locates DMPFC, SMA, & CZ in this video.
Locating M1 (Motor Cortex)
Dr. Rustin Berlow locates M1 (motor cortex).
Locating the SMA
Dr. Rustin Berlow locates the SMA (supplementary motor cortex).
Locating the DMPFC
Dr. Rustin Berlow locates the DMPFC (dorsomedial prefrontal cortex).
Locating M1
Dr. Rustin Berlow locates M1, the primary motor cortex for TMS stimulation
Locating the Orbitofrontal Cortex
Dr. Rustin Berlow locates the Orbitofrontal cortex for TMS stimulation indicated for the treatment of obsessive compulsive disorder
Locating the SMA
Dr. Rustin locates the SMA (supplementary Motor cortex) for TMS stimulation
Locating the Auditory Cortex
Dr. Rustin Berlow locates the auditory cortex for TMS stimulation