Alpha-synchronized stimulation of the left DLPFC in depression using real-time EEG-triggered TMS

Abstract

High-frequency repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) shows therapeutic potential in patients with major depression. However, clinical efficacy is limited by high inter-individual variability and low response rates. Recently it was shown in human motor cortex that synchronizing TMS pulses with instantaneous brain oscillations reduces variability and increases efficacy of TMS-induced plasticity, but it remained unclear whether such a paradigm is feasible, safe and has neuromodulatory effects when targeting the DLPFC of patients with major depressive disorder (MDD).