Utilization of Single-Pulse Transcranial-Evoked Potentials in Neurological and Psychiatric Clinical Practice: A Narrative Review

Hilla Fogel, Noa Zifman, Mark Hallett

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: The utility of single-pulse TMS (transcranial magnetic stimulation)-evoked EEG (electroencephalograph) potentials (TEPs) has been extensively studied in the past three decades. TEPs have been shown to provide insights into features of cortical excitability and connectivity, reflecting mechanisms of excitatory/inhibitory balance, in various neurological and psychiatric conditions. In the present study, we sought to review and summarize the most studied neurological and psychiatric clinical indications utilizing single-pulse TEP and describe its promise as an informative novel tool for the evaluation of brain physiology. Methods: A thorough search of PubMed, Embase, and Google Scholar for original research utilizing single-pulse TMS-EEG and the measurement of TEP was conducted. Our review focused on the indications and outcomes most clinically relevant, commonly studied, and well-supported scientifically. Results: We included a total of 55 publications and summarized them by clinical application. We categorized these publications into seven sub-sections: healthy aging, Alzheimer’s disease (AD), disorders of consciousness (DOCs), stroke rehabilitation and recovery, major depressive disorder (MDD), Parkinson’s disease (PD), as well as prediction and monitoring of treatment response. Conclusions: TEP is a useful measurement of mechanisms underlying neuronal networks. It may be utilized in several clinical applications. Its most prominent uses include monitoring of consciousness levels in DOCs, monitoring and prediction of treatment response in MDD, and diagnosis of AD. Additional applications including the monitoring of stroke rehabilitation and recovery, as well as a diagnostic aid for PD, have also shown encouraging results but require further evidence from randomized controlled trials (RCTs).

Original languageEnglish
Pages (from-to)1421-1437
Number of pages17
JournalNeurology International
Volume16
Issue number6
DOIs
StatePublished - 11 Nov 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 by the authors.

Keywords

  • Alzheimer’s disease
  • Parkinson’s disease
  • TMS-EEG
  • TMS-evoked potentials (TEPs)
  • major depressive disorder
  • neurophysiologic biomarker
  • single-pulse transcranial magnetic stimulation (TMS)
  • stroke recovery
  • treatment response

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