Real-time Cognitive Output Modulation through EEG-triggered TMS

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The aim of the present project is to investigate the possibility of modulating cognitive output in real-time by using non-invasive brain stimulation (transcranial magnetic stimulation - TMS) coupled with real-time analysis of electroencephalography (EEG). This enables delivering TMS pulses during specific phases of a physiologically relevant brain oscillation, here the prefrontal theta oscillation (4-7 Hz). Synchronicity of the theta oscillation in prefrontal cortex and other brain regions is associated with improved cognitive performance. Moreover, different phases of this oscillation are linked to differential neuronal firing and induction of neuroplasticity, suggesting importance in information transfer and memory formation. Despite the challenges involved in translating these data from animal experiments into human studies, we have recently reported successful modulation of prefrontal theta oscillations by using real-time analyzed EEG-triggered phase-dependent repetitive TMS (rTMS). Our goal now is to test the possibility of influencing cognitive output in real-time using the same method, by applying theta phase-locked TMS during the execution of a working memory task, aiming to modify memory retrieval performance. Moreover, we intend to investigate the possibility of further increasing the precision and effectiveness of the rTMS induced plasticity on the working memory network by delivering theta phase-locked rTMS during the execution of a working memory task.This novel approach of brain-state-dependent non-invasive network stimulation bears a high potential for the development of more effective neuromodulatory interventions for specific cognitive and neuropsychiatric disorders. The results might also be translated to other modalities of invasive and non-invasive brain stimulation.