Evidence map›Paper›PMID 40148152›Full record

ArticleClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology2025

Real-time optimization to enhance noninvasive cortical excitability assessment in the human dorsolateral prefrontal cortex.

Sara Parmigiani, Christopher C Cline, Manjima Sarkar, Lily Forman, Jade Truong, Jessica M Ross, Juha Gogulski, Corey J Keller

Abstract read
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In one paragraph

Article in Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
  2. Review
  3. Clinical utility and prospective of TMS-EEG: Updated review from an international expert group.Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026
    Review
  4. Article
  5. Article
  6. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Sara ParmigianiDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
Christopher C ClineDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
Manjima SarkarDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
Lily FormanDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
Jade TruongDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
Jessica M RossDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA 94394, USA.
Juha GogulskiDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA; Department of Clinical Neurophysiology, HUS Diagnostic Center, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki FI-00029 HUS, Finland.
Corey J KellerDepartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Healthcare System, and the Sierra Pacific Mental Illness, Research, Education, and Clinical Center (MIRECC), Palo Alto, CA 94394, USA. Electronic address: ckeller1@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe currently lack a robust noninvasive method to measure prefrontal excitability in humans. Concurrent TMS and EEG in the prefrontal cortex is usually confounded by artifacts. Here we asked if real-time optimization could reduce artifacts and enhance a TMS-EEG measure of left prefrontal excitability.

methodsThis closed-loop optimization procedure adjusts left dlPFC TMS coil location, angle, and intensity in real-time based on the EEG response to TMS. Our outcome measure was the left prefrontal early (20-60 ms) and local TMS-evoked potential (EL-TEP).

resultsIn 18 healthy participants, this optimization of coil angle and brain target significantly reduced artifacts by 63 % and, when combined with an increase in intensity, increased EL-TEP magnitude by 75 % compared to a non-optimized approach.

conclusionsReal-time optimization of TMS parameters during dlPFC stimulation can enhance the EL-TEP. SIGNIFICANCE: Enhancing our ability to measure prefrontal excitability is important for monitoring pathological states and treatment response.

Indexed as

Cortical ExcitabilityDorsolateral Prefrontal CortexElectroencephalographyPrefrontal CortexTranscranial Magnetic StimulationAdultFemaleHumansMaleYoung AdultDorsolateral prefrontal cortex (dlPFC)Electroencephalogram (EEG)Evoked potentialsReal-time optimizationTEPTMS-EEGTranscranial magnetic stimulation (TMS)

Identifiers

PMID40148152

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.