Personalized Brain Imaging
Quick Facts
How could personalized brain imaging improve TMS for depression?
Transcranial magnetic stimulation, or TMS, uses magnetic pulses delivered through the scalp to influence activity in mood-regulating brain circuits. Standard TMS for major depression commonly targets the left dorsolateral prefrontal cortex, a region involved in cognitive control and emotion regulation, but people's brain anatomy and network connections vary substantially.
The new report highlights a trial testing whether personalized brain imaging can refine that targeting. Instead of relying only on scalp landmarks or average brain maps, clinicians can use MRI-based information to identify a stimulation site more closely connected to the patient's own depression-related circuitry. If confirmed in larger studies, that could make TMS less of a one-size-fits-all intervention and more of a precision neuromodulation treatment.
What is treatment-resistant depression and why are new options needed?
Major depressive disorder is a leading cause of disability worldwide, and the World Health Organization estimates that about 280 million people live with depression. Many patients improve with psychotherapy, antidepressant medicines, lifestyle support, or combined care, but a substantial group continues to have disabling symptoms despite appropriate treatment.
For these patients, treatment choices may include medication augmentation, electroconvulsive therapy, ketamine-based treatment in selected settings, and neuromodulation such as TMS. TMS is noninvasive and does not require general anesthesia, but response can vary. A personalized imaging strategy is clinically important because even modest gains in targeting accuracy could matter for patients who have already spent months or years cycling through therapies.
What should patients know before asking about MRI-guided TMS?
People considering TMS should first have a full psychiatric assessment to confirm the diagnosis, review prior treatments, and screen for conditions that may affect safety, such as certain implanted devices or seizure risk. Common side effects of TMS include scalp discomfort and headache, while serious complications are uncommon when treatment is delivered under appropriate clinical protocols.
Personalized brain imaging may add time, cost, and technical complexity, and availability will likely vary by center. The key question for future research is not whether imaging can identify a biologically plausible target, but whether it consistently improves remission, durability of response, function, and quality of life compared with well-delivered standard TMS.
Frequently Asked Questions
No. Standard TMS often uses established scalp-based or anatomical targeting methods, while personalized imaging attempts to tailor the stimulation target using the patient's own brain structure or network connectivity.
No treatment can be described as a cure for all patients. Early evidence suggests personalized targeting may improve outcomes for some people, but depression care still requires follow-up, relapse prevention, and individualized treatment planning.
Yes. TMS is a noninvasive outpatient procedure that uses magnetic stimulation and does not require general anesthesia, while electroconvulsive therapy uses controlled electrical stimulation under anesthesia and is usually reserved for severe or urgent cases.
References
- Medical Xpress. Personalized brain imaging may improve outcomes for treatment-resistant depression. June 2026.
- World Health Organization. Depression fact sheet.
- O'Reardon JP et al. Efficacy and safety of transcranial magnetic stimulation in the acute treatment of major depression: a multisite randomized controlled trial. Biological Psychiatry. 2007.
- Blumberger DM et al. Effectiveness of theta burst versus high-frequency repetitive transcranial magnetic stimulation in patients with depression (THREE-D): a randomised non-inferiority trial. The Lancet. 2018.