Brain-State-Resolved Consistency of Corticospinal Responses to TMS

Published October 23, 2026. TMS responses were more consistent when the sensorimotor mu rhythm had higher power just before a pulse. This healthy-volunteer result may help researchers design more reliable brain-state-guided stimulation, but it does not show a treatment benefit.

van Hattem T, Hougland JR, Ahola O, Goetz SM, Humaidan D, Jooß A, Ziemann U.
Brain Stimulation · Publication date: 2026-10-23
Added to site: 2026-10-24
DOI: 10.1016/j.brs.2026.103239

Published October 23, 2026. Added to Neurofeedback.com October 24, 2026.

Modalities

TMS, EEG, Brain-state-dependent stimulation

Clinical focus

Motor-evoked potentials, Sensorimotor mu rhythm, Response variability

Population

Healthy adult volunteers

Sample

29 participants received 1,200 single TMS pulses; 10 completed two sessions

Intervention / method

Single-pulse TMS over left primary motor cortex during concurrent EEG, with trials stratified by pre-stimulus mu power, phase and interhemispheric functional connectivity

Comparator

Within-participant comparison of motor-evoked-potential variability across pre-stimulus brain-state strata

Clinician summary

High pre-stimulus mu-power trial subsets showed lower motor-evoked-potential coefficient of variation. Mu phase did not significantly influence variability at group level. The mu-power pattern was reproducible across sessions and sites in an exploratory analysis, while only 10 participants contributed repeat-session data.

How to interpret the findings

This was a mechanistic study in 29 healthy volunteers rather than a clinical intervention. Only 10 participants completed a second session, the test-retest assessment was exploratory, and the checked abstract does not provide complete effect estimates, confidence intervals or evidence that brain-state selection improves therapeutic outcomes. A within-trial association is not proof that closed-loop targeting will reduce clinical response variability.

Equipment and disclosures

The abstract describes concurrent EEG and TMS over primary motor cortex but does not identify device manufacturers. No equipment is attributed to BrainMaster or another vendor.

The authors declared no known competing financial interests or personal relationships. Funding details were not available in the checked abstract. No indexed correction, retraction or expression-of-concern relation appeared in the retained PubMed or Crossref records; this is a bounded check. AI-assisted source review.

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