Brief Summary: Transcranial magnetic stimulation TMS is a widely used tool for exploring brain function in humans Siebner et al et al 2022 which has led to new therapeutics for various psychiatric and neurological disorders Lefaucheur et al 2020 However the open-loop use of this technique has raised questions about its operating principle due to the high degree of heterogeneity of results and the small to medium observed effect sizes Zrenner and Ziemann 2023 To increase the response rate it has been suggested to individualize stimulation by adapting the TMS parameters ie delivered dose target dose targeting timing etc to instantaneous estimates of brain brain state Such an approach known as closed-loop closed-loop stimulation is currently one of the main challenges challenges in this field closed-loop brain state-dependent stimulation To this end we are focusing on the combination of robotic TMS and electroencephalography EEG Hernandez-Pavon et al al 2023 The closed-loop stimulations using this combination developed to date have two limitations i they are not adaptive and focus focus mainly on calculating the phase of brain oscillations to trigger stimulation and ii are limited to central cortical sensorimotor areas where the EEG signal-to-noise ratio is optimal
This project aims to develop closed-loop TMS-EEG protocols that overcome these two limitations i by incorporating adaptive decision modeling AutoHS model Harquel et al 2017 to optimize several parameters in parallel coil location orientation intensity while using a wider range of EEG markers evoked potentials oscillatory activity strength connectivity etc and ii by integrating real-time EEG pre-processing to access any cortical target including frontal temporal and occipital lobes