The Influence of fMRI-Guided Neuromodulation on Patient Outcomes and Disorder-Specific Efficacy in Deep Brain and Transcranial Magnetic Stimulation

Some powerful tools to treat refractory neurological and psychiatric disorders are neuromodulation techniques. These include Deep Brain Stimulation (DBS) and Transcranial Stimulation (TMS). Early studies demonstrated that both weak direct current and patterned magnetic stimulation reliably alter motor cortex excitability, supporting controlled plasticity and therapeutic potential. Clinical trials confirm rTMS efficacy in depression, tinnitus, neuropathic pain, and post-stroke recovery, though outcomes vary due to anatomical differences and imprecise targeting. In contrast, fMRI and MRI-guided neuronavigation improves precision which reduces inter-individual variability, and assures enhanced patient outcomes. Neuroimaging further reveals circuit-level disruptions in depression, bipolar disorder, Parkinson's disease, and stroke, supporting individualized, network-based neuromodulation strategies. To bridge this translational gap, it requires a systematic comparison of disorder-specific outcomes, which will validate if fMRI-guided targeting persistently take down superior clinical efficacy across DBS and TMS. The objective of this study is to determine whether fMRI-guided neuromodulation enhances clinical outcomes compared to traditional anatomical targeting methods. A further aim is to evaluate how the benefits of imaging-guided targeting vary across specific neurological and psychiatric disorders, including depression, tinnitus, Parkinson's disease, and post-stroke motor impairment.