The rt-TEP tool: real-time visualization of TMS-Evoked Potentials to maximize cortical activation and minimize artifacts

Casarotto, Silvia; Fecchio, Matteo; Rosanova, Mario; Varone, Giuseppe; D’Ambrosio, Sasha; Sarasso, Simone; Pigorini, Andrea; Russo, Simone; Comanducci, Angela; Ilmoniemi, Risto J.; Massimini, Marcello

doi:10.1016/j.jneumeth.2022.109486

Cited by 78 publications

(75 citation statements)

References 53 publications

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“…The EEG feature we selected for the optimization was the amplitude of the P20–N40 complex, as it showed apparent orientation dependency in Experiment 1 across the Group A subjects (algorithm test data). The amplitudes of the early components (within the first 50 ms after the pulse) have been used also in other studies to adjust TMS parameters [ 28 , 29 ], as the early TEP deflections are thought to reflect cortical excitability [ 29 , [48] , [49] , [50] ]. Furthermore, peak-to-peak amplitudes are less susceptible to baseline drifting than the amplitudes of single peaks.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of the noise masking was tested by recording sets of 20 TEPs, which were evaluated with the help of a TMS–EEG data visualization tool presented and shared in Ref. [ 29 ] ( https://github.com/iTCf/rt-TEP ). This tool allowed cutting out the high-amplitude TMS pulse artifact within the first few milliseconds after the pulse and showing average-referenced signals to ease the visual inspection of the data.…”

Section: Methodsmentioning

confidence: 99%

“…The stimulation intensity was adjusted until in 20 trials, the average peak-to-peak amplitude of the deflections 15–50 ms after the pulse was 5–10 μV (similar approach as in Refs. [ 28 , 29 ]). We assessed the signal quality with the data visualization tool [ 29 ] with the induced peak E-field in the posterior–anterior and medial–lateral directions.…”

Section: Methodsmentioning

confidence: 99%

“…[ 28 , 29 ]). We assessed the signal quality with the data visualization tool [ 29 ] with the induced peak E-field in the posterior–anterior and medial–lateral directions. If large stimulation artifacts were present in the electrodes close to the stimulation site, the location was changed a few millimetres to reduce the artifacts.…”

Section: Methodsmentioning

confidence: 99%

“…Procedures for selecting initial stimulation parameters in TMS–EEG measurements by visually inspecting averaged EEG responses and manually adjusting the TMS settings have been applied, e.g., in Refs. [ [27] , [28] , [29] ] to acquire high-quality, artifact-free TEPs. There are, however, also other situations, such as selecting stimulus parameters for TMS treatments, that could benefit from EEG-based targeting.…”

Section: Introductionmentioning

confidence: 99%

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Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback

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Physiological symmetry of transcranial magnetic stimulation‐evoked EEG spectral features

D’Ambrosio

Jiménez‐Jiménez

Silvennoinen

et al. 2022

Human Brain Mapping

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Transcranial magnetic stimulation (TMS)-evoked EEG potentials (TEPs) have been used to study the excitability of different cortical areas (CAs) in humans. Characterising the interhemispheric symmetry of TMS-EEG may provide further understanding of structure-function association in physiological and pathological conditions. We hypothesise that, in keeping with the underlying cytoarchitectonics, TEPs in contralateral homologous CAs share similar, symmetric spectral features, whilst ipsilateral TEPs from different CAs diverge in their waveshape and frequency content. We performed single-pulse (<1 Hz) navigated monophasic TMS, combined with high-density EEG with active electrodes, in 10 healthy participants. We targeted two bilateral CAs: premotor and motor. We compared frequency power bands, computed Pearson correlation coefficient (R) and Correlated Component Analysis (CorrCA) to detect divergences, as well as common components across TEPs. The main frequency of TEPs was faster in premotor than in motor CAs (p < .05) across all participants. Frequencies were not different between contralateral homologous CAs, whilst, despite closer proximity, there was a significant difference between ipsilateral premotor and motor CAs (p > .5), with frequency decreasing from anterior to posterior CAs. Correlation was high between contralateral homologous CAs and low between ipsilateral CAs. When applying CorrCA, specific components were shared by contralateral homologous TEPs. We show physiological symmetry of TEP spectral features between contralateral homologous CAs, whilst ipsilateral premotor and motor TEPs differ despite lower geometrical distance. Our findings support the role of TEPs as biomarker of local cortical properties and provide a first reference dataset for TMS-EEG studies in asymmetric brain disorders.

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Transcranial magnetic stimulation‐evoked electroencephalography responses as biomarkers for epilepsy: A review of study design and outcomes

Gefferie

Jiménez‐Jiménez

Visser

et al. 2023

Human Brain Mapping

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Transcranial magnetic stimulation (TMS) with electroencephalography (EEG), that is TMS‐EEG, may assist in managing epilepsy. We systematically reviewed the quality of reporting and findings in TMS‐EEG studies on people with epilepsy and healthy controls, and on healthy individuals taking anti‐seizure medication. We searched the Cochrane Library, Embase, PubMed and Web of Science databases for original TMS‐EEG studies comparing people with epilepsy and healthy controls, and healthy subjects before and after taking anti‐seizure medication. Studies should involve quantitative analyses of TMS‐evoked EEG responses. We evaluated the reporting of study population characteristics and TMS‐EEG protocols (TMS sessions and equipment, TMS trials and EEG protocol), assessed the variation between protocols, and recorded the main TMS‐EEG findings. We identified 20 articles reporting 14 unique study populations and TMS methodologies. The median reporting rate for the group of people with epilepsy parameters was 3.5/7 studies and for the TMS parameters was 13/14 studies. TMS protocols varied between studies. Fifteen out of 28 anti‐seizure medication trials in total were evaluated with time‐domain analyses of single‐pulse TMS‐EEG data. Anti‐seizure medication significantly increased N45, and decreased N100 and P180 component amplitudes but in marginal numbers (N45: 8/15, N100: 7/15, P180: 6/15). Eight articles compared people with epilepsy and controls using different analyses, thus limiting comparability. The reporting quality and methodological uniformity between studies evaluating TMS‐EEG as an epilepsy biomarker is poor. The inconsistent findings question the validity of TMS‐EEG as an epilepsy biomarker. To demonstrate TMS‐EEG clinical applicability, methodology and reporting standards are required.

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The rt-TEP tool: real-time visualization of TMS-Evoked Potentials to maximize cortical activation and minimize artifacts

Cited by 78 publications

References 53 publications

Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback

Closed-loop optimization of transcranial magnetic stimulation with electroencephalography feedback

Physiological symmetry of transcranial magnetic stimulation‐evoked EEG spectral features

Transcranial magnetic stimulation‐evoked electroencephalography responses as biomarkers for epilepsy: A review of study design and outcomes

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