Real-Time Artifacts Reduction during TMS-EEG Co-Registration: A Comprehensive Review on Technologies and Procedures.

Area of Science:

• Neuroscience
• Biomedical Engineering
• Signal Processing

Background:

• Transcranial magnetic stimulation (TMS) and electroencephalography (EEG) are powerful tools for non-invasively studying cortical activity.
• Simultaneous TMS-EEG recordings allow for direct investigation of neural responses to stimulation.
• However, TMS-induced artifacts significantly contaminate EEG signals, hindering accurate interpretation of TMS-evoked potentials (TEPs).

Purpose of the Study:

• To provide a comprehensive review of TMS-EEG artifacts, their origins, and characteristics.
• To present the current state-of-the-art in EEG technologies and hardware relevant to artifact reduction.
• To outline methodologies and propose solutions for minimizing artifacts in TMS-EEG research.

Main Methods:

• Systematic review of research on TMS-EEG artifacts and technologies over the past 40 years.
• Analysis of artifact sources, waveforms, and existing reduction techniques.
• Evaluation of advancements in EEG amplifiers, TMS-compatible hardware, and open-source software.

Main Results:

• Identified various physiological and external sources of TMS-induced artifacts in EEG.
• Detailed the evolution of EEG technologies and hardware designed to mitigate these artifacts.
• Highlighted the effectiveness of online artifact reduction techniques and subject preparation methods.

Conclusions:

• Despite significant technological advancements, challenges remain in recording early TEP components due to residual artifacts.
• The proposed synchronization toolbox and reviewed methodologies offer practical solutions for TMS-EEG laboratories.
• Further research is needed to address open challenges and refine artifact reduction strategies for improved TMS-EEG data acquisition.