Unveiling Major Depressive Disorder Through TMS-EEG: From Traditional to Emerging Approaches

Area of Science:

• Neuroscience
• Psychiatry
• Biomarker Research

Background:

• Major depressive disorder (MDD) is a prevalent condition with complex neurophysiological underpinnings.
• Current diagnostic and treatment strategies for MDD face challenges due to a lack of objective biomarkers.
• Transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) shows promise for investigating brain dynamics.

Purpose of the Study:

• To review recent advances in TMS-EEG applications for major depressive disorder (MDD).
• To highlight the shift from traditional TMS-evoked potential (TEP) analyses to multidimensional approaches.
• To explore the potential of advanced TMS-EEG techniques for biomarker discovery and clinical applications in MDD.

Main Methods:

• Review of original research articles published between 2020 and 2025 on TMS-EEG in MDD.
• Analysis of traditional TEP measures and emerging multidimensional approaches.
• Inclusion of computational and multivariate techniques for enhanced biomarker sensitivity.

Main Results:

• Traditional TEP measures offer insights into local cortical responses but are limited in capturing network dysfunction.
• Emerging TMS-EEG approaches characterize oscillatory activity, connectivity, and large-scale network dynamics.
• Advanced computational and multivariate techniques enhance the sensitivity and predictive value of MDD biomarkers.

Conclusions:

• TMS-EEG is a powerful tool for investigating the neurophysiological basis of MDD.
• Multidimensional TMS-EEG assessments provide a comprehensive view of cortical function and dysfunction.
• Advanced TMS-EEG approaches facilitate biomarker discovery, patient stratification, and treatment monitoring for precision psychiatry in MDD.