Mixed reality assisted target localization for transcranial magnetic stimulation navigation: a feasibility study.
Zhongjie Shi, Zhengbo Yuan, Lu Gao and 8 others
PMID 42271499WHAT IT FOUND
Mixed reality navigation located TMS targets on plastic head models with median errors between 1.9 and 2.6 mm and under 10 minutes per run.
No patients took part, so this is device accuracy, not evidence that treatment improves.
Key findings
01Three researchers using the mixed reality system localised all 50 target points on five simulation head models, with median errors ranging from 1.9 to 2.6 mm depending on the researcher and whether the model was standing or lying.
02Each researcher completed localisation across the five models in under 10 minutes on average: 7.0 minutes, 6.8 minutes and 6.2 minutes. Building each 3D model took about 10 minutes.
03Errors did not differ significantly between the standing and lying positions for any researcher (p = 0.31, 0.53, 0.15), but they did differ significantly between the three researchers in both positions (p < 0.001), with one researcher consistently higher; the paper states these between-researcher differences did not exceed 1 mm.
STILL TO COME
How it was doneWhat they found
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What it does not show
No patients were tested. The accuracy figures come from five plastic head models, so they cannot account for hair, scalp movement, real skull anatomy, or a patient who moves during treatment. The sample is five models and three researchers. The authors call this a preclinical validation and say larger, multi-centre studies in patients are needed before clinical use. The test used CT scans of the phantom. The authors say future work with healthy volunteers or patients, and with MRI-based anatomical data, is needed to judge clinical feasibility and how well it generalises. The coil tracker is built for one specific TMS coil, so the reported accuracy may not carry over to other coils, although the authors say extending it is feasible. The system runs on the headset's lithium battery, and the authors note that as the battery drains, performance can gradually decline and localisation error may increase. All the statistical analyses were exploratory. The researchers received only a 30-minute training session, which may not reflect how the system behaves in routine hands over time. The study did not examine whether the choice of different target points affects accuracy, which the authors list as a limitation. Prolonged use of a head-mounted display can cause discomfort to the operator; this was not seen here, but the authors say lighter headsets should be explored.
Declared interests
The only funding statement in the text is the Xiamen Municipal Guiding Project for Medical and Health Services. No other funding source and no author competing-interest declarations appear in the text provided. The paper names two commercial products it relies on: the HoloLens 2 headset and a YIRUIDE TMS device (Wuhan, China), and it notes that the authors have begun evaluating SeerLens headsets from Xvisio Technology (Shanghai, China), but no relationship with those companies is declared.
The easy way to misread this
Do not read the millimetre-level accuracy as evidence that this system improves TMS treatment. No patients were treated and no clinical outcome was measured; the distances were between a pen mark and a pin on a plastic head that stayed still, so real-world accuracy, patient comfort and any treatment benefit remain untested.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →