State-Dependent Brain Stimulation for Visual Neurorehabilitation: Principles and Applications.

Area of Science:

• Neuroscience
• Neuromodulation
• Clinical Neurophysiology

Background:

• Transcranial Magnetic Stimulation (TMS) parameters are often based on healthy individuals.
• Neurological disorders can alter brain states, complicating standard TMS protocols.
• Brain state influences TMS effects, impacting clinical applicability.

Purpose of the Study:

• To review the state-dependent nature of TMS.
• To highlight challenges in translating TMS findings from healthy to clinical populations.
• To advocate for integrating state-dependent knowledge into TMS protocols.

Main Methods:

• Narrative review of existing literature on TMS and brain states.
• Analysis of how brain excitability influences TMS outcomes.
• Examination of state-dependent TMS applications in specific conditions.

Main Results:

• TMS effects are significantly influenced by the targeted brain region's excitability (state-dependency).
• Standard TMS protocols may be less effective in clinical populations due to altered brain states.
• State-dependent TMS approaches enhance intervention specificity.

Conclusions:

• Choosing TMS parameters requires considering the interaction between external stimulation and internal brain states.
• State-dependent TMS shows promise for conditions like cortical blindness and amblyopia.
• Integrating state-dependent knowledge is crucial for advancing TMS in visual disorders and beyond.