Image artifacts in concurrent transcranial magnetic stimulation (TMS) and fMRI caused by leakage currents: Modeling and compensation

Purpose To characterize and eliminate a new type of image artifact in concurrent transcranial magnetic stimulation and functional MRI (TMS‐fMRI) caused by small leakage currents originating from the high‐voltage capacitors in the TMS stimulator system. Materials and Methods The artifacts in echo‐planar images (EPI) caused by leakage currents were characterized and quantified in numerical simulations and phantom studies with different phantom‐coil geometries. A relay‐diode combination was devised and inserted in the TMS circuit that shorts the leakage current. Its effectiveness for artifact reduction was assessed in a phantom scan resembling a realistic TMS‐fMRI experiment. Results The leakage‐current‐induced signal changes exhibited a multipolar spatial pattern and the maxima exceeded 1% at realistic coil‐cortex distances. The relay‐diode combination effectively reduced the artifact to a negligible level. Conclusion The leakage‐current artifacts potentially obscure effects of interest or lead to false‐positives. Since the artifact depends on the experimental setup and design (eg, amplitude of the leakage current, coil orientation, paradigm, EPI parameters), we recommend its assessment for each experiment. The relay‐diode combination can eliminate the artifacts if necessary. J. Magn. Reson. Imaging 2009;29:1211–1217. © 2009 Wiley‐Liss, Inc.