ArticlePloS one2023
Neuromodulatory effects and reproducibility of the most widely used repetitive transcranial magnetic stimulation protocols.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Non-invasive neurostimulation for drug-resistant epilepsy: systematic review and meta-analysis of effectiveness, safety, and optimal stimulation parameters.Journal of neurology · 2025Pooled it
- Current perspectives on neuromodulation in ALS patients: A systematic review and meta-analysis.PloS one · 2024Pooled it
- Cervicothoracic trans-spinal magnetic stimulation: effect of coil position and orientation on spinal motor evoked potentials.Experimental brain research · 2026Article
- Precision in Delivery, Variability in Response: A Multiscale Mechanistic Framework for Neuronavigated Transcranial Magnetic Stimulation.Brain sciences · 2026Review
- Complexity of resting cortical activity predicts neurophysiological responses to theta-burst stimulation but fails to generalize: A rigorous machine-learning approach.PLoS computational biology · 2026Article
- Continuous Theta Burst Stimulation Inhibits Contralesional Parietal and Occipital Activity During Imagined Movements After Stroke.The European journal of neuroscience · 2026Article
- Low-Intensity Focused Ultrasound Neuromodulation in Psychiatric Disorders: Mechanisms, Models, and Missing Links.Biological psychiatry · 2026Review
- Controllable Pulse Parameter Transcranial Magnetic Stimulation in Fibromyalgia: A Randomized Control Study.Journal of pain research · 2026Article
- Reversal of repetitive TMS-induced LTP-like plasticity by a novel compound in rats.Frontiers in neural circuits · 2026Article
- Prolonged intermittent theta burst stimulation enhances hippocampal plasticity via GluN2A-mediated signaling.Frontiers in aging neuroscience · 2026Article
- Treating Depression With Repetitive Transcranial Magnetic Stimulation: A Clinician's Guide.The American journal of psychiatry · 2025Review
- Height-dependent variation in corticospinal excitability modulation after active but not sham intermittent theta burst stimulation.IBRO neuroscience reports · 2025Article
- Assessing Neuromodulation Effects of Theta Burst Stimulation to the Prefrontal Cortex Using Transcranial Magnetic Stimulation Electroencephalography (TMS-EEG).The European journal of neuroscience · 2025Article
- Reward signals in the motor cortex: from biology to neurotechnology.Nature communications · 2025Review
- Transcranial Magnetic Stimulation for Posttraumatic Stress Disorder and Generalized Anxiety Disorder.Current topics in behavioral neurosciences · 2025Review
- A Comprehensive Overview of the Current Status and Advancements in Various Treatment Strategies against Epilepsy.ACS pharmacology & translational science · 2024Review
- Continuous theta burst stimulation at 30 hz does not modulate cortical excitability in a sham-controlled study.Scientific reports · 2024Article
- Exploring Motor Network Connectivity in State-Dependent Transcranial Magnetic Stimulation: A Proof-of-Concept Study.Biomedicines · 2024Article
- The Use of Transcranial Magnetic Stimulation in Attention Optimization Research: A Review from Basic Theory to Findings in Attention-Deficit/Hyperactivity Disorder and Depression.Life (Basel, Switzerland) · 2024Review
- Methodological considerations of priming repetitive transcranial magnetic stimulation protocols in clinical populations.General psychiatry · 2024Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundRepetitive transcranial magnetic stimulation (rTMS) is widely used in both research and clinical settings to modulate human brain function and behavior through the engagement of the mechanisms of plasticity. Based upon experiments using single-pulse TMS as a probe, the physiologic mechanism of these effects is often assumed to be via changes in cortical excitability, with 10 Hz rTMS increasing and 1 Hz rTMS decreasing the excitability of the stimulated region. However, the reliability and reproducibility of these rTMS protocols on cortical excitability across and within individual subjects, particularly in comparison to robust sham stimulation, have not been systematically examined.
objectivesIn a cohort of 28 subjects (39 ± 16 years), we report the first comprehensive study to (1) assess the neuromodulatory effects of traditional 1 Hz and 10 Hz rTMS on corticospinal excitability against both a robust sham control, and two other widely used patterned rTMS protocols (intermittent theta burst stimulation, iTBS; and continuous theta burst stimulation, cTBS), and (2) determine the reproducibility of all rTMS protocols across identical repeat sessions.
resultsAt the group level, neither 1 Hz nor 10 Hz rTMS significantly modulated corticospinal excitability. 1 Hz and 10 Hz rTMS were also not significantly different from sham and both TBS protocols. Reproducibility was poor for all rTMS protocols except for sham. Importantly, none of the real rTMS and TBS protocols demonstrated greater neuromodulatory effects or reproducibility after controlling for potential experimental factors including baseline corticospinal excitability, TMS coil deviation and the number of individual MEP trials.
conclusionsThese results call into question the effectiveness and reproducibility of widely used rTMS techniques for modulating corticospinal excitability, and suggest the need for a fundamental rethinking regarding the potential mechanisms by which rTMS affects brain function and behavior in humans.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.