Personalized, EEG-controlled intermittent theta burst stimulation.

Area of Science:

• Neuroscience
• Neuromodulation
• Brain-Computer Interfaces

Background:

• Real-time electroencephalography (EEG) guided transcranial magnetic stimulation (TMS) reveals that brain oscillation phase influences cortical excitability.
• Adapting this principle for repetitive TMS protocols like intermittent theta burst stimulation (iTBS) is challenging due to EEG signal corruption by stimulation pulses.
• Predicting pre-iTBS EEG theta phase for precise stimulation onset remains difficult.

Purpose of the Study:

• To develop and demonstrate a personalized framework for prefrontal EEG-phase-controlled iTBS.
• To overcome the technical hurdles of synchronizing iTBS trains with ongoing brain oscillations in real-time.
• To propose a "seed-and-sustain" hypothesis for sustained neural entrainment within iTBS trains.

Main Methods:

• Development of a personalized stimulation framework integrating EEG and iTBS.
• Demonstration of technical feasibility for aligning iTBS initial bursts to individual prefrontal theta phase.
• Utilizing real-time EEG to guide the precise timing of iTBS delivery.

Main Results:

• The presented framework enables feasible synchronization of intermittent theta burst stimulation to the prefrontal EEG theta rhythm.
• Personalized iTBS-EEG parameters demonstrated stability throughout typical experimental sessions.
• The technical feasibility of phase-controlled iTBS was successfully demonstrated.

Conclusions:

• Prefrontal EEG-phase-controlled intermittent theta burst stimulation is technically feasible.
• The developed personalized framework offers a novel approach to precisely timing iTBS.
• Future human trials are necessary to ascertain the clinical utility and practical advantages of this iTBS-EEG synchronization method.