Brain state-contingent stimulation to probe task-dependent functional networks.

The paper proposes waiting for a selected brain-network state before delivering TMS. It is a research framework, not evidence that the approach improves treatment or patient outcomes.

Brancaccio A, Miniussi C.
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · Publication date: 2026-09-15
Added to site: 2026-09-19
DOI: 10.1016/j.clinph.2026.2112406

Online-ahead-of-print publication date verified in PubMed.

Modalities

TMS, EEG, TMS-EEG

Clinical focus

Closed-loop stimulation, Functional connectivity, Brain state

Population

Human task-dependent network research and possible future clinical translation

Sample

Not applicable; no new participant study was reported

Intervention / method

Offline operationalization and validation of task-relevant network states followed by real-time estimation and stimulation contingent on a predefined network pattern

Comparator

Contrasts conventional open-loop or local resting-oscillation timing with proposed large-scale task-relevant network-state control

Clinician summary

The authors frame moment-to-moment neural variability as a condition to be measured and controlled. Their workflow links offline network validation to real-time state estimation, conditional stimulation and reproducibility standards.

How to interpret the findings

No clinical trial, patient outcome, validated biomarker, comparative performance result or implementation benchmark is reported in the accessible abstract. Feasibility, latency, reliability and generalizability remain to be tested empirically.

Equipment and disclosures

No specific EEG or TMS system was evaluated in the accessible abstract.

The authors declared no known competing financial interests or personal relationships. Funding was not reported in the checked indexed record.

Related evidence

Compare findings from the same clinical area, including mixed results.

• Intrinsic functional architecture predicts remote motor cortical excitability changes induced by intermittent theta-burst stimulation · Positive with limitations
• Frontal midline theta reduction during attentional reconfiguration links local cortical dynamics to network-level connectivity changes · Positive with limitations
• Neuromodulation effects of HF-rTMS and rPMS on stroke patients: an fNIRS study. · Positive with limitations
• Personalized Brain Stimulation based on Brain Oscillations: A Systematic Review of MEG- and EEG-informed Transcranial Alternating Current Stimulation (tACS). · Positive with limitations
• Temporal-Targeted Accelerated 40 Hz tACS Enhances Cognitive Function and Network Integration in Alzheimer's Disease: A Randomized Clinical Trial. · Positive with limitations
• Cerebellar Theta-Burst Stimulation Induces Distinct Functional Connectivity Patterns in Post-Stroke Aphasia: A Randomized Controlled Trial. · Mixed
• Machine learning-based source-level EEG functional network biomarkers of antidepressant treatment response in major depressive disorder. · Positive with limitations
• Infra-low-frequency neurofeedback alters EEG network efficiency: exploratory evidence from healthy volunteers. · Positive with limitations