Abstract Transcranial Magnetic Stimulation (TMS), particularly Theta Burst Stimulation (TBS), is a non-invasive, non-convulsive neuromodulation technique that induces clinically relevant network modulations with long-term effects. Two TBS protocols- continuous TBS (cTBS) and intermittent TBS (iTBS)- have been approved as effective therapeutic interventions for neuropsychiatric disorders, including mood disorders. With this aim, we examined EEG microstate temporal dynamics during resting-state recordings across three sessions of TMS. Twenty-four participants underwent cTBS, iTBS, and sham stimulation in a pseudo-randomized order, each separated by at least one week. Six distinct microstates (A–F), associated with activity in specific neural networks, were identified across six frequency bands (broadband, δ, θ, α, β, and γ). Our findings reveal frequency band-specific modulation of EEG microstates B, C, E, and F, previously reported as biomarkers in mood disorders. Notably, C microstates showed increased stability, whereas microstates E and F showed decreased dynamics up to fifty-five minutes after TBS. Most importantly, a negative association was observed for microstate E occurrence, between before stimulation (pre-cTBS) and three post-standing time points (post1-cTBS, post2-cTBS, and post3-cTBS), suggesting that baseline microstate E characteristics may be related to individual variability in cTBS treatment response. These results further support the potential of TBS to induce clinically relevant neuroplastic changes, establishing a strong foundation for the development of band-specific EEG microstate markers for assessing treatment response and personalized closed-loop TMS-EEG protocols.
Dragu et al. (Thu,) studied this question.
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