Closed-Loop TMS–EEG: Challenges and Future Directions

Transcranial Magnetic Stimulation (TMS) is a powerful tool in clinical and cognitive neuroscience, yet its impact is constrained by static, “one-size-fits-all” protocols. Closed-loop TMS–EEG offers a shift toward precision neuromodulation by adapting stimulation to ongoing brain states in real time. Because TMS effects are highly sensitive to stimulation parameters, conventional approaches often yield variable and difficult-to-interpret results. Integrating EEG enables continuous monitoring of cortical dynamics, allowing stimulation to be adjusted on the fly to optimize timing, intensity, and dose. However, major challenges remain, most critically, the artifact barrier that obscures early neural responses. This seminar highlights challenges and recent progress toward real-time, feedback-controlled TMS, emphasizing the role of artifact rejection advances needed to make adaptive neuromodulation reliable and scalable.

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