Brain State-dependent Brain Stimulation with Real-time Electroencephalography-Triggered Transcranial Magnetic Stimulation

Research output: Contribution to journalArticleScientificpeer-review


  • Maria Ioanna Stefanou
  • David Baur
  • Paolo Belardinelli
  • Til Ole Bergmann
  • Corinna Blum
  • Pedro Caldana Gordon
  • Jaakko O. Nieminen
  • Brigitte Zrenner
  • Ulf Ziemann
  • Christoph Zrenner

Research units

  • University of Tübingen


The effect of a stimulus to the brain depends not only on the parameters of the stimulus but also on the dynamics of brain activity at the time of the stimulation. The combination of electroencephalography (EEG) and transcranial magnetic stimulation (TMS) in a real-time brain state-dependent stimulation system allows the study of relations of dynamics of brain activity, cortical excitability, and plasticity induction. Here, we demonstrate a newly developed method to synchronize the timing of brain stimulation with the phase of ongoing EEG oscillations using a real-time data analysis system. This real-time EEG-triggered TMS of the human motor cortex, when TMS is synchronized with the surface EEG negative peak of the sensorimotor µ-alpha (8-14 Hz) rhythm, has shown differential corticospinal excitability and plasticity effects. The utilization of this method suggests that real-time information about the instantaneous brain state can be used for efficacious plasticity induction. Additionally, this approach enables personalized EEG-synchronized brain stimulation which may lead to the development of more effective therapeutic brain stimulation protocols.


Original languageEnglish
JournalJournal of visualized experiments : JoVE
Issue number150
Publication statusPublished - 20 Aug 2019
MoE publication typeA1 Journal article-refereed

ID: 37052141