And to the rest of the amazing team and resources! 7/7
@coreykeller.bsky.social
@juhagogulski.bsky.social
@jessicamross8.bsky.social
@stanfordpntlab.bsky.social
@stanfordmedicine.bsky.social
Manjima Sarkar, Jade Truong, Lily Forman!!

Big shout out to my co-first author 👏
@chrisclineneuro.bsky.social

Interested in learning more? Read the full paper in Clinical Neurophysiology! doi.org/10.1016/j.cl... 5/7

Key findings: Optimization reduced artifacts by 63% and increased early local TMS-evoked potentials (EL-TEPs), a measure of prefrontal excitability, by 75%! #EEG #TMS #TMSEEG 4/7

We introduce a novel method for optimizing TMS parameters in the dlPFC. Based on EEG responses, this closed-loop procedure optimizes TMS coil angle, location, and intensity in real time. 3/7

Why is this important? The dlPFC is a depression treatment target, but we need clinic-ready ways to measure stimulation effects. TMS-EEG can help, but artifacts obscure responses. 2/7

This builds on influential work by
@foxmdphd.bsky.social
@shansiddiqi.bsky.social
@desmondoathes.bsky.social and many others. It would not have been possible without the support of UIowa, Stanford, and generous funding from the NIH/NIMH.

reposted from @esolomon.bsky.social

It’s important to be clear that we only had two neurosurgical patients to test these effects, so these findings need replication. But these data so far seem to align with a major hypothesis in the field: DLPFC TMS specifically alters population-level neural activity in the sgACC. 5/

We were surprised to find that, despite anticorrelated HFA signals, TMS seemed to increase phase-locking in lower frequencies (alpha and theta) between sgACC-DLPFC. Could this be a mechanism by which the DLPFC influences sgACC activity? 4/

HFA signal in the sgACC was inversely correlated with HFA signal in the DLPFC, meaning that as DLPFC activity increased following TMS, sgACC activity decreased. This mirrors what we’ve known from fMRI for a long time, but now shown with direct in-vivo measures of neural activity. 3/

Stimulation to the DLPFC may tamp down an overactive sgACC and relieve symptoms of depression. By stimulating the DLPFC with TMS in two neurosurgical patients with electrodes implanted within the sgACC, we found a reduction in high-frequency neural activity – a correlate of population spiking. 2/

9/9 @juhagogulski.bsky.social @coreykeller.bsky.social @stanfordpntlab.bsky.social @jessicamross8.bsky.social @sparmi.bsky.social @stanfordmedicine.bsky.social @stanfordpress.bsky.social @nihr.bsky.social Truong J., Sarkar M.

8/9 🔑 Key takeaways:
• Careful target selection boosts early TMS-evoked signals in dlPFC
• Most dlPFC areas can produce reliable TMS-evoked signals with optimized analysis

This work advances early TMS-evoked EEG signal as a potential biomarker for depression! #depression