Clinical utility and prospective of TMS–EEG

A Physiological Marriage Made in Heaven: Treating and Measuring the Brain Through Stimulation

“…In the last 2 decades, efforts have also translated these measures from the motor cortex to areas of the brain more closely associated with pathophysiology of psychiatric disorders (e.g., the dorsolateral prefrontal cortex). Similar to the motor cortex, single and paired stimulation protocols can be used to evaluate both GABAergic and glutamatergic inhibitory neurotransmission . What is particularly appealing about these methods is that there is clear anatomic convergence between the site of stimulation with rTMS or ECT and the site of neurophysiological investigation through TMS‐ electroencephalography (EEG).…”

The Current and Future Potential of Transcranial Magnetic Stimulation With Electroencephalography in Psychiatry

“…Combining this with electrophysiological modalities such as high‐density electroencephalography (EEG) provides a powerful cause‐and‐effect approach to assess human brain networks. TMS‐EEG is now routinely used as a research tool to investigate clinical biomarkers and carries promise to improve the diagnostic and therapeutic efficacy for treating psychiatric illnesses …”

“…When averaging EEG recordings from several pulses over the same region, the characteristic series of positive and negative deflections—termed the TMS‐evoked potential (TEP)—are obtained. Specific TEP peaks or components have been associated with inhibitory and excitatory neurotransmission . Apart from the TEP, a myriad of measures can be obtained with TMS‐EEG, such as cortical oscillations evoked by the TMS pulses, which reflect thalamo‐cortical activity, in addition to local and global indexes of cortical reactivity …”

“…TMS-EEG is now routinely used as a research tool to investigate clinical biomarkers and carries promise to improve the diagnostic and therapeutic efficacy for treating psychiatric illnesses. 1 A TMS pulse applied to a specific region of the cortex induces neural depolarization and creates a cascade of activation in interconnected networks. This activity, which is maximal from 15 to 300 milliseconds following the TMS pulse, can be measured via EEG.…”

“…Specific TEP peaks or components have been associated with inhibitory and excitatory neurotransmission. 1 Apart from the TEP, a myriad of measures can be obtained with TMS-EEG, such as cortical oscillations evoked by the TMS pulses, which reflect thalamo-cortical activity, in addition to local and global indexes of cortical reactivity. 1 A key target site for TMS-EEG is the dorsolateral prefrontal cortex (DLPFC), an essential region for cognitive processes, such as executive functioning, attention, working memory, and emotion regulation, and central to the pathophysiology underlying psychiatric disorders.…”