Neuro-Cardiac-Guided TMS (NCG-TMS): Probing DLPFC-sgACC-vagus nerve connectivity using heart rate - First results

Brain Stimul. Sep-Oct 2017;10(5):1006-1008. doi: 10.1016/j.brs.2017.05.002. Epub 2017 May 12.


Background: Given that many studies suggest a role of DLPFC-sgACC connectivity in depression and prior research demonstrating that neuromodulation of either of these nodes modulates parasympathetic activity and results in a heart rate deceleration, a new method is proposed to individualize localization of the DLPFC. This can, among others, be useful for rTMS treatment of depression.

Methods: Ten healthy subjects received three trains of 10Hz rTMS randomly over 7 target regions (10-20 system).

Results: Overall, F3 and F4 expressed the largest heart rate deceleration, in line with studies suggesting these are the best 10-20 sites to target the DLPFC. On the individual level, 20-40% subjects expressed the largest heart rate deceleration at FC3 or FC4, indicating individual differences as to the 'optimal site for stimulation'.

Conclusions: These results show that the NCG-TMS method is valid to localize the entry into the DLPFC-sgACC network.

Keywords: DLPFC; Depression; Heart rate; Neuronavigation; Vagus nerve; rTMS.

Publication types

  • Letter

MeSH terms

  • Adult
  • Female
  • Gyrus Cinguli / physiology
  • Heart Rate / physiology*
  • Humans
  • Male
  • Middle Aged
  • Neural Pathways / physiology
  • Prefrontal Cortex / physiology*
  • Transcranial Magnetic Stimulation / methods*
  • Vagus Nerve / physiology*
  • Young Adult