Using TMS-EEG to assess the effects of neuromodulation techniques: a narrative review

Alessandro Cruciani; Marco Mancuso; Valerio Sveva; Davide Maccarrone; Antonio Todisco; Francesco Motolese; Francesca Santoro; Fabio Pilato; Danny Adrian Spampinato; Lorenzo Rocchi; Vincenzo Di Lazzaro; Fioravante Capone

doi:10.3389/fnhum.2023.1247104

Using TMS-EEG to assess the effects of neuromodulation techniques: a narrative review

Front Hum Neurosci. 2023 Aug 14:17:1247104. doi: 10.3389/fnhum.2023.1247104. eCollection 2023.

Authors

Alessandro Cruciani^{1

2}, Marco Mancuso³, Valerio Sveva⁴, Davide Maccarrone³, Antonio Todisco^{1

2}, Francesco Motolese^{1

2}, Francesca Santoro^{1

2}, Fabio Pilato^{1

2}, Danny Adrian Spampinato³, Lorenzo Rocchi⁵, Vincenzo Di Lazzaro^{1

2}, Fioravante Capone^{1

2}

Affiliations

¹ Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Rome, Italy.
² Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
³ Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
⁴ Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Rome, Italy.
⁵ Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Abstract

Over the past decades, among all the non-invasive brain stimulation (NIBS) techniques, those aiming for neuromodulatory protocols have gained special attention. The traditional neurophysiological outcome to estimate the neuromodulatory effect is the motor evoked potential (MEP), the impact of NIBS techniques is commonly estimated as the change in MEP amplitude. This approach has several limitations: first, the use of MEP limits the evaluation of stimulation to the motor cortex excluding all the other brain areas. Second, MEP is an indirect measure of brain activity and is influenced by several factors. To overcome these limitations several studies have used new outcomes to measure brain changes after neuromodulation techniques with the concurrent use of transcranial magnetic stimulation (TMS) and electroencephalogram (EEG). In the present review, we examine studies that use TMS-EEG before and after a single session of neuromodulatory TMS. Then, we focused our literature research on the description of the different metrics derived from TMS-EEG to measure the effect of neuromodulation.

Keywords: TMS-EEG; electroencephalography analysis; motor evoked potentials; neuromodulation; transcranial evoked potentials.

Publication types

Review