{"doi":"10.1016/j.brs.2020.07.005","title":"Phase-dependent transcranial magnetic stimulation of the lesioned hemisphere is accurate after stroke","abstract":"Transcranial magnetic stimulation (TMS) can produce plastic changes within descending motor pathways and distributed brain networks [[1]Ziemann U. Paulus W. Nitsche M.A. Pascual-Leone A. Byblow W.D. Berardelli A. et al.Consensus: motor cortex plasticity protocols.Brain Stimulation. 2008; 1: 164-182Abstract Full Text Full Text PDF PubMed Scopus (421) Google Scholar,[2]Wang J.X. Rogers L.M. Gross E.Z. Ryals A.J. Dokucu M.E. Brandstatt K.L. et al.Targeted enhancement of cortico-hippocampal brain networks and associative memory.Science. 2014; 435: 1054-1057Crossref Scopus (268) Google Scholar]. It has been proposed that TMS could enhance post-stroke motor recovery by normalizing imbalanced sensorimotor network function and/or upregulating corticospinal output [[3]Hummel F.C. Cohen L.G. Non-invasive brain stimulation: a new strategy to improve neurorehabilitation after stroke?.Lancet Neurol. 2006; 5: 708-712Abstract Full Text Full Text PDF PubMed Scopus (582) Google Scholar,[4]Di Lazzaro V. Dileone M. Profice P. Pilato F. Cioni B. Meglio M. et al.Direct demonstration that repetitive transcranial magnetic stimulation can enhance corticospinal excitability in stroke. vol. 37. 2006: 2850-2853Google Scholar] but studies using TMS to boost motor recovery have shown heterogeneous results [[5]Smith M.C. Stinear C.M. Transcranial magnetic stimulation (TMS) in stroke: Ready for clinical practice?.J Clin Neurosci. 2016; 31: 10-14Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar]. However, TMS has traditionally been delivered uncoupled from endogenous brain oscillatory activity, leading to indiscriminate application of individual TMS pulses across different, physiologically distinct brain states. Thus, failure to control for endogenous brain states during TMS application may have contributed to the overall weak effect sizes and high response variability often observed in TMS studies [[6]López-Alonso V. Cheeran B. Río-Rodríguez D. Fernández-del-Olmo M. Inter-individual variability in response to non-invasive brain stimulation paradigms.Brain Stimul. 2014; 7: 372-380Abstract Full Text Full Text PDF PubMed Scopus (418) Google Scholar]. Phase-dependent TMS, which involves delivering individual TMS pulses or trains of pulses during pre-defined brain oscillatory phases, attempts to address this limitation. Early results using phase-dependent TMS in healthy individuals are promising: TMS applied during sensorimotor mu (8–12 Hz) trough phases reflecting increased sensorimotor cortical neuronal spiking [[7]Haegens S. Nácher V. Luna R. Romo R. Jensen O. α-oscillations in the monkey sensorimotor network influence discrimination performance by rhythmical inhibition of neuronal spiking.Proc Natl Acad Sci. 2011; 108: 19377-19382Crossref PubMed Scopus (395) Google Scholar] and inter-regional neuronal communication [[8]Stefanou M.I. Desideri D. Belardinelli P. Zrenner C. Ziemann U. Phase synchronicity of μ-rhythm determines efficacy of interhemispheric communication between human motor cortices.J Neurosci. 2018; 38: 10525-10534Crossref PubMed Scopus (21) Google Scholar] enhances corticospinal output to a larger extent than TMS applied irrespective of these phases [[9]Zrenner C. Desideri D. Belardinelli P. Ziemann U. Real-time EEG-defined excitability states determine efficacy of TMS-induced plasticity in human motor cortex.Brain Stimul. 2018; 11: 374-389Abstract Full Text Full Text PDF PubMed Scopus (119) Google Scholar]. These findings raise the hypothesis that phase-dependent TMS could be more effective than TMS uncoupled from sensorimotor mu phases. Yet, for phase-dependent TMS to be therapeutically useful after stroke, it must first be possible to accurately deliver TMS during pre-defined brain oscillatory phases in the lesioned brain. Why might accurate phase-dependent TMS delivery be challenging after stroke? In order to account for time-delays inherent to signal acquisition and processing, phase-dependent TMS approaches typically use ","journal":"Brain stimulation","year":2020,"id":103274,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":25,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9624,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":503240,"name":"William Hayward","orcid":"0000-0002-9344-4203","position":1,"is_corresponding":false},{"id":503241,"name":"Farah Fourcand","orcid":"0000-0002-2230-9741","position":2,"is_corresponding":false},{"id":292626,"name":"Christoph Zrenner","orcid":"0000-0002-9595-6923","position":3,"is_corresponding":false},{"id":106065,"name":"Ulf Ziemann","orcid":"0000-0001-8372-3615","position":4,"is_corresponding":false},{"id":503242,"name":"Ethan R. 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