TMS Combined with EEG: Recommendations and Open Issues for Data Collection and Analysis. [Review]

SOURCE: Brain Stimulation. 16(2):567-593, 2023 Mar-Apr.

AUTHORS: Hernandez-Pavon JC; Veniero D; Bergmann TO; Belardinelli P; Bortoletto M; Casarotto S; Casula EP; Farzan F; Fecchio M; Julkunen P; Kallioniemi E; Lioumis P; Metsomaa J; Miniussi C; Mutanen TP; Rocchi L; Rogasch NC; Shafi MM; Siebner HR; Thut G; Zrenner C; Ziemann U; Ilmoniemi RJ

ABSTRACT: Transcranial magnetic stimulation (TMS) evokes neuronal activity in the targeted cortex and connected brain regions. The evoked brain response can be measured with electroencephalography (EEG). TMS combined with simultaneous EEG (TMS-EEG) is widely used for studying cortical reactivity and connectivity at high spatiotemporal resolution. Methodologically, the combination of TMS with EEG is challenging, and there are many open questions in the field. Different TMS-EEG equipment and approaches for data collection and analysis are used. The lack of standardization may affect reproducibility and limit the comparability of results produced in different research laboratories. In addition, there is controversy about the extent to which auditory and somatosensory inputs contribute to transcranially evoked EEG. This review provides a guide for researchers who wish to use TMS-EEG to study the reactivity of the human cortex. A worldwide panel of experts working on TMS-EEG covered all aspects that should be considered in TMS-EEG experiments, providing methodological recommendations (when possible) for effective TMS-EEG recordings and analysis. The panel identified and discussed the challenges of the technique, particularly regarding recording procedures, artifact correction, analysis, and interpretation of the transcranial evoked potentials (TEPs). Therefore, this work offers an extensive overview of TMS-EEG methodology and thus may promote standardization of experimental and computational procedures across groups.