Bridging the gap to clinical use: A systematic review on TMS–EEG test-retest reliability

IF 3.6 3区 医学 Q1 CLINICAL NEUROLOGY Clinical Neurophysiology Pub Date : 2025-01-23 DOI:10.1016/j.clinph.2025.01.002
Giacomo Bertazzoli , Elisa Dognini , Peter J. Fried , Carlo Miniussi , Petro Julkunen , Marta Bortoletto
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Abstract

Background

Transcranial magnetic stimulation (TMS) combined with electroencephalography (EEG) can provide insight on cortical excitability and brain circuits. TMS-evoked potentials (TEPs) are phase-locked waveforms reflecting neural activity, with potential applications in psychiatry and neurology. However, the reliability of TEPs remains underexplored, hindering clinical standardization. This systematic review evaluates TEP reliability, focusing on commonly used measures and assessments.

Methods

A systematic review was conducted on PubMed for studies from 2002 to October 10, 2024, using keywords combining TMS, EEG, and reliability terms. Systematic reviews and non-English articles were excluded.

Results

Eighteen studies met inclusion criteria, mostly assessing young, healthy populations. Late TEP components demonstrated high relative reliability, while early components exhibited lower reliability and variability across sessions. Analytical methods like the intraclass and concordance correlation coefficients, and Pearson’s correlations consistently favored late TEPs.

Discussion

Late TEPs exhibit higher reliability, while early components require further research. TMS artifacts complicate interpretation, in both late and early responses. Formal reliability assessments, standardized protocols, and diverse populations are essential for advancing TEP reliability for clinical application.

Conclusions

A more comprehensive reliability assessments is needed before the implementation of clinical applications.
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弥合临床应用的差距:对TMS-EEG测试重测可靠性的系统评价
经颅磁刺激(TMS)结合脑电图(EEG)可以深入了解皮层兴奋性和脑回路。tms诱发电位(TEPs)是一种反映神经活动的锁相波形,在精神病学和神经病学中具有潜在的应用前景。然而,TEPs的可靠性仍未得到充分探讨,阻碍了临床标准化。本系统综述评估TEP的可靠性,重点是常用的措施和评估。方法采用经颅磁刺激法(TMS)、脑电图法(EEG)和信度术语相结合的关键词,对2002年至2024年10月10日在PubMed上发表的研究进行系统评价。系统评价和非英文文章被排除在外。结果18项研究符合纳入标准,主要评估年轻健康人群。晚期TEP组件表现出较高的相对可靠性,而早期组件表现出较低的可靠性和跨会话的可变性。类内相关系数和一致性相关系数以及皮尔逊相关系数等分析方法始终倾向于晚期tep。后期的tep表现出更高的可靠性,而早期的组件需要进一步的研究。TMS工件使解释变得复杂,在后期和早期反应中都是如此。正式的可靠性评估、标准化的协议和多样化的人群对于提高TEP的临床应用可靠性至关重要。结论在临床应用前需要进行更全面的可靠性评估。
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来源期刊
Clinical Neurophysiology
Clinical Neurophysiology 医学-临床神经学
CiteScore
8.70
自引率
6.40%
发文量
932
审稿时长
59 days
期刊介绍: As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.
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