Robot-Assisted Transcranial Magnetic Stimulation Guided by Cortical Topography

Robot-assisted transcranial magnetic stimulation guided by cortical topography reduced head-to-MRI registration error from 5.83 ± 1.04 mm to 1.07 ± 0.03 mm.

• Why it matters: Conventional neuronavigation uses simplified volumetric models that may misalign stimulation relative to subject-specific cortical geometry, limiting planning accuracy and stimulation reliability.
• What they did: The framework used ICP-based enhanced head-MRI co-registration with a 3D cortical mesh from structural MRI, then RA-TMS preserved planned coil pose versus manual alignment.
• The result: Compared with manual TMS, RA-TMS reduced translational error from 14.79 ± 8.03 mm to 5.22 ± 1.68 mm and rotational error from 7.01 ± 2.29° to 1.09 ± 0.33° (p < 0.001), and increased MEPs at M1 hand area (0.27 ± 0.05 mV vs. 0.03 ± 0.01 mV, p < 0.001).