Stereotaxic localisation of the dorsolateral prefrontal cortex for transcranial magnetic stimulation is superior to the standard reference position

Objective: To determine whether the standard method of localisation of the dorsolateral prefrontal cortex for repetitive transcranial magnetic stimulation is accurate and reliable, and to develop an empirically based method for operational localisation of the dorsolateral prefrontal cortex with reference to the motor hand area.
Method: We compared stereotaxic localisation of the dorsolateral prefrontal cortex with the commonly used operational definition of 6 cm anterior to the site of the abductor pollicis brevis muscle in healthy participants (n = 18). We also report the average translational distance from the site of the abductor pollicis brevis to the stereotaxically defined dorsolateral prefrontal cortex.
Results: The stereotaxic method was less variable than the operational method of localisation and more frequently targeted the middle frontal gyrus. The average translational distance from the site of the abductor pollicis brevis to the stereotaxically targeted dorsolateral prefrontal cortex was x = −5 mm, y = 53 mm and z = −31 mm.
Conclusions: Operational localisation of the dorsolateral prefrontal cortex for repetitive transcranial magnetic stimulation with reference to the motor hand area is more variable than stereotaxic localisation. If future studies choose to use an operational definition of the left dorsolateral prefrontal cortex, we suggest it should be 5 mm lateral, 53 mm anterior and 31 mm inferior to the site of the abductor pollicis brevis.