Abstract
Major advancements in neuro-technology now allow to record and analyze activity of the human brain in real-time non-invasively by EEG. This information of instantaneous brain activity can be used to trigger non-invasive brain stimulation (transcranial magnetic stimulation, TMS) brain-state-dependently. This is of immense conceptual importance. We have shown that µ-oscillations in human sensorimotor cortex determine fluctuations in corticospinal excitability, as measured by motor evoked potential (MEP) size. The positive peak of the µ-oscillation is associated with smaller MEPs (low-excitability state), whereas the negative peak of the µ-oscillation (trough) is associated with larger MEPs (high-excitability state) [Zrenner et al. 2018, Brain Stimulation 11:374-389]. If these two states are now being stimulated repetitively, in two different sessions, by high-frequency bursts (100 Hz triplets) of TMS, then the identical stimulation protocol results in long-term potentiation-like corticospinal plasticity (long-term increase in MEP size) if the high-excitability state (the negative peak of the µ- oscillation) is consistently targeted, but in a trend towards long-term depression if the low- excitability state (the positive peak of the µ-oscillation) is targeted. Therefore, the outcome of non-invasive brain stimulation depends highly significantly on the instantaneous brain state. We expect that this novel technology of EEG-informed brain-state- dependent stimulation will enable a new era of highly efficacious therapy for brain network disorders, such as stroke, Alzheimer’s disease or major depression. First proof-of-principle data in depression will be demonstrated.
Published Version
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