Real-time optimization to enhance noninvasive cortical excitability assessment in the human dorsolateral prefrontal cortex

Sara Parmigiani; Christopher Cline; Manjima Sarkar; Forman Lily; Jade Truong; Jessica M. Ross; Juha Gogulski; Corey J. Keller

doi:10.1016/j.clinph.2025.02.261

Real-time optimization to enhance noninvasive cortical excitability assessment in the human dorsolateral prefrontal cortex

Sara Parmigiani, Christopher Cline, Manjima Sarkar, Forman Lily, Jade Truong, Jessica M. Ross, Juha Gogulski, Corey J. Keller^*

^*Tämän työn vastaava kirjoittaja

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Tutkimustuotos: Lehtiartikkeli › Article › Scientific › vertaisarvioitu

3 Sitaatiot (Scopus)

Abstrakti

Objective: We currently lack a robust noninvasive method to measure prefrontal excitability in humans. Concurrent TMS and EEG in the prefrontal cortex is usually confounded by artifacts. Here we asked if real-time optimization could reduce artifacts and enhance a TMS-EEG measure of left prefrontal excitability.

Methods: This closed-loop optimization procedure adjusts left dlPFC TMS coil location, angle, and intensity in real-time based on the EEG response to TMS. Our outcome measure was the left prefrontal early (20–60 ms) and local TMS-evoked potential (EL-TEP).

Results: In 18 healthy participants, this optimization of coil angle and brain target significantly reduced artifacts by 63 % and, when combined with an increase in intensity, increased EL-TEP magnitude by 75 % compared to a non-optimized approach.

Conclusions: Real-time optimization of TMS parameters during dlPFC stimulation can enhance the EL-TEP.

Significance: Enhancing our ability to measure prefrontal excitability is important for monitoring pathological states and treatment response.

Alkuperäiskieli	Englanti
Sivut	225-234
Sivumäärä	10
Julkaisu	Clinical Neurophysiology
Vuosikerta	174
Varhainen verkossa julkaisun päivämäärä	11 maalisk. 2025
DOI - pysyväislinkit	https://doi.org/10.1016/j.clinph.2025.02.261
Tila	Julkaistu - kesäk. 2025
OKM-julkaisutyyppi	A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

Pääsy asiakirjaan

10.1016/j.clinph.2025.02.261

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@article{d6883dd2dca34f67b80bd70d5151e86e,

title = "Real-time optimization to enhance noninvasive cortical excitability assessment in the human dorsolateral prefrontal cortex",

abstract = "Objective: We currently lack a robust noninvasive method to measure prefrontal excitability in humans. Concurrent TMS and EEG in the prefrontal cortex is usually confounded by artifacts. Here we asked if real-time optimization could reduce artifacts and enhance a TMS-EEG measure of left prefrontal excitability.Methods: This closed-loop optimization procedure adjusts left dlPFC TMS coil location, angle, and intensity in real-time based on the EEG response to TMS. Our outcome measure was the left prefrontal early (20–60 ms) and local TMS-evoked potential (EL-TEP).Results: In 18 healthy participants, this optimization of coil angle and brain target significantly reduced artifacts by 63 % and, when combined with an increase in intensity, increased EL-TEP magnitude by 75 % compared to a non-optimized approach.Conclusions: Real-time optimization of TMS parameters during dlPFC stimulation can enhance the EL-TEP.Significance: Enhancing our ability to measure prefrontal excitability is important for monitoring pathological states and treatment response.",

keywords = "Dorsolateral prefrontal cortex (dlPFC), Electroencephalogram (EEG), Evoked potentials, Real-time optimization, TEP, TMS-EEG, Transcranial magnetic stimulation (TMS)",

author = "Sara Parmigiani and Christopher Cline and Manjima Sarkar and Forman Lily and Jade Truong and Ross, {Jessica M.} and Juha Gogulski and Keller, {Corey J.}",

year = "2025",

month = jun,

doi = "10.1016/j.clinph.2025.02.261",

language = "English",

volume = "174",

pages = "225--234",

journal = "Clinical Neurophysiology",

issn = "1388-2457",

publisher = "Elsevier",

}

TY - JOUR

T1 - Real-time optimization to enhance noninvasive cortical excitability assessment in the human dorsolateral prefrontal cortex

AU - Parmigiani, Sara

AU - Cline, Christopher

AU - Sarkar, Manjima

AU - Lily, Forman

AU - Truong, Jade

AU - Ross, Jessica M.

AU - Gogulski, Juha

AU - Keller, Corey J.

PY - 2025/6

Y1 - 2025/6

N2 - Objective: We currently lack a robust noninvasive method to measure prefrontal excitability in humans. Concurrent TMS and EEG in the prefrontal cortex is usually confounded by artifacts. Here we asked if real-time optimization could reduce artifacts and enhance a TMS-EEG measure of left prefrontal excitability.Methods: This closed-loop optimization procedure adjusts left dlPFC TMS coil location, angle, and intensity in real-time based on the EEG response to TMS. Our outcome measure was the left prefrontal early (20–60 ms) and local TMS-evoked potential (EL-TEP).Results: In 18 healthy participants, this optimization of coil angle and brain target significantly reduced artifacts by 63 % and, when combined with an increase in intensity, increased EL-TEP magnitude by 75 % compared to a non-optimized approach.Conclusions: Real-time optimization of TMS parameters during dlPFC stimulation can enhance the EL-TEP.Significance: Enhancing our ability to measure prefrontal excitability is important for monitoring pathological states and treatment response.

AB - Objective: We currently lack a robust noninvasive method to measure prefrontal excitability in humans. Concurrent TMS and EEG in the prefrontal cortex is usually confounded by artifacts. Here we asked if real-time optimization could reduce artifacts and enhance a TMS-EEG measure of left prefrontal excitability.Methods: This closed-loop optimization procedure adjusts left dlPFC TMS coil location, angle, and intensity in real-time based on the EEG response to TMS. Our outcome measure was the left prefrontal early (20–60 ms) and local TMS-evoked potential (EL-TEP).Results: In 18 healthy participants, this optimization of coil angle and brain target significantly reduced artifacts by 63 % and, when combined with an increase in intensity, increased EL-TEP magnitude by 75 % compared to a non-optimized approach.Conclusions: Real-time optimization of TMS parameters during dlPFC stimulation can enhance the EL-TEP.Significance: Enhancing our ability to measure prefrontal excitability is important for monitoring pathological states and treatment response.

KW - Dorsolateral prefrontal cortex (dlPFC)

KW - Electroencephalogram (EEG)

KW - Evoked potentials

KW - Real-time optimization

KW - TEP

KW - TMS-EEG

KW - Transcranial magnetic stimulation (TMS)

U2 - 10.1016/j.clinph.2025.02.261

DO - 10.1016/j.clinph.2025.02.261

M3 - Article

SN - 1388-2457

VL - 174

SP - 225

EP - 234

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

ER -

Real-time optimization to enhance noninvasive cortical excitability assessment in the human dorsolateral prefrontal cortex

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