Characterizing an electronic-robotic targeting platform for precise and fast brain stimulation with multi-locus transcranial magnetic stimulation

Background. Multi-locus TMS (mTMS) enables precise electronic control of brain stimulation targeting, eliminating the need for physical coil movement. However, with a small number of coils, the stimulation area is constrained, and manual handling of the coil array is cumbersome. Combining electronic mTMS targeting with robotics enables automated, user-independent, and precise brain stimulation protocols. Objective. To characterize an open-source electronic-robotic mTMS platform for rapid and accurate brain stimulation targeting. Methods. We developed an automated robotic mTMS positioning platform. We used a 5-coil mTMS device coupled to a collaborative robot. The stimulation targeting accuracy of the system was quantified with a TMS characterizer that measures the TMS-induced electric field (E-field) on a model of a spherical cortex. The induced E-field distortion generated by robot coupling was evaluated for each coil. We compared the repositioning accuracy of robotic-electronic system to the conventional manual positioning. Results. Our collaborative-robot-based system offers submillimeter precision and autonomy in positioning mTMS coil sets. The electronic-robotic mTMS platform was approximately 1.8 mm and 1.0° more accurate than the conventional manual positioning. Integrating robotics and mTMS automates brain stimulation procedures, resulting in minimal reliance on user expertise and subjective analysis. Conclusion. Our open-source platform combining rapid mTMS targeting with robotic precision enhances the safety and reproducibility of TMS, enabling more efficient and reliable outcomes than previous techniques.