In recent years, the ongoing development of transcranial electrical stimulation (TES) and transcranial magnetic stimulation (TMS) has demonstrated significant potential in the treatment and rehabilitation of various brain diseases. In particular, the combined application of TES and TMS has shown considerable clinical value due to their potential synergistic effects. This paper first systematically reviews the mechanisms underlying TES and TMS, highlighting their respective advantages and limitations. Subsequently, the potential mechanisms of transcranial electromagnetic combined stimulation are explored, with a particular focus on three combined stimulation protocols: Repetitive TMS (rTMS) with transcranial direct current stimulation (tDCS), rTMS with transcranial alternating current stimulation (tACS), and theta burst TMS (TBS) with tACS, as well as their clinical applications in brain diseases. Finally, the paper analyzes the key challenges in transcranial electromagnetic combined stimulation research and outlines its future development directions. The aim of this paper is to provide a reference for the optimization and application of transcranial electromagnetic combined stimulation schemes in the treatment and rehabilitation of brain diseases.
Temporal interference transcranial alternating current stimulation (TI-tACS) does not readily enable synchronous cross-plane modulation of multiple brain regions in three-dimensional space. To address this challenge, this study proposes a three-dimensional (3D) cross-plane multi-target simultaneous stimulation strategy based on electrode spatial topology. Without increasing the number of electrode groups, the proposed strategy enabled cooperative target formation on multiple planes. Predictable multi-target shifts were achieved by adjusting the current-amplitude ratios across channels. Simulations showed that the strategy stably generated multi-target simultaneous stimulation and exhibited good independent controllability, as evaluated by off-target displacement. A multichannel TI-tACS stimulator was developed and was validated in a saline phantom experiment, where the target formation and shift trends agreed with the simulation results. This work provides an engineering reference for electrode configuration and parameter design for 3D cross-plane multi-target neuromodulation.
Transcranial alternating current stimulation (tACS) holds significant potential for improving motor function in stroke patients, but its underlying mechanisms remain unclear. In this study, 20 Hz tACS was applied to 15 stroke patients, and their motor imagery (MI) signals were collected before and after stimulation, which were for assessment by combining with the Fugl-Meyer Assessment for Upper Extremity (FMA-UE). Additionally, 11 subjects were recruited as a healthy control group. The study demonstrated that FMA-UE scores of stroke patients significantly increased after tACS intervention. The duration of EEG microstate C and F decreased significantly, while microstate D (coverage, duration, and occurrence probability) increased markedly, and microstate E decreased. The transition probabilities of C→D and D→B were positively correlated with FMA-UE scores. Based on these findings, this study concludes that 20 Hz tACS can enhance neuroplasticity and motor function in patients, and the transition probabilities (C→D/D→B) may serve as potential indicators for assessing motor function, providing experimental evidence for the clinical application of tACS and the development of rehabilitation brain-computer interfaces.
Corona virus disease 2019 (COVID-19) is an acute respiratory infectious disease with strong contagiousness, strong variability, and long incubation period. The probability of misdiagnosis and missed diagnosis can be significantly decreased with the use of automatic segmentation of COVID-19 lesions based on computed tomography images, which helps doctors in rapid diagnosis and precise treatment. This paper introduced the level set generalized Dice loss function (LGDL) in conjunction with the level set segmentation method based on COVID-19 lesion segmentation network and proposed a dual-path COVID-19 lesion segmentation network (Dual-SAUNet++) to address the pain points such as the complex symptoms of COVID-19 and the blurred boundaries that are challenging to segment. LGDL is an adaptive weight joint loss obtained by combining the generalized Dice loss of the mask path and the mean square error of the level set path. On the test set, the model achieved Dice similarity coefficient of (87.81 ± 10.86)%, intersection over union of (79.20 ± 14.58)%, sensitivity of (94.18 ± 13.56)%, specificity of (99.83 ± 0.43)% and Hausdorff distance of 18.29 ± 31.48 mm. Studies indicated that Dual-SAUNet++ has a great anti-noise capability and it can segment multi-scale lesions while simultaneously focusing on their area and border information. The method proposed in this paper assists doctors in judging the severity of COVID-19 infection by accurately segmenting the lesion, and provides a reliable basis for subsequent clinical treatment.