{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:52:48Z","timestamp":1791157968813,"version":"4.1.0"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88887.254059\/2026\u201000"],"award-info":[{"award-number":["88887.254059\/2026\u201000"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J of Neuroscience"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Motor recovery after stroke is associated with changes in corticospinal integrity, intracortical excitability, and interhemispheric interactions. Transcranial magnetic stimulation (TMS) provides neurophysiological measures of these processes, but their relationship with motor recovery across randomized controlled trials remains uncertain. This systematic review synthesized evidence from randomized controlled trials investigating TMS\u2010derived neurophysiological measures associated with motor recovery following TMS\u2010based neuromodulation after stroke. PubMed\/MEDLINE, Scopus, and Embase were searched for studies published between January 1, 2016, and July 10, 2026. Eligible trials enrolled adults with ischemic or hemorrhagic stroke, assessed at least one TMS\u2010derived neurophysiological measure, and reported a motor or functional outcome. Study selection followed PRISMA 2020, risk of bias was assessed using Cochrane RoB 2, and certainty of evidence was evaluated using GRADE. Owing to methodological heterogeneity, findings were synthesized narratively. The search identified 1441 records; after removal of 519 duplicates, 922 records were screened, 55 full\u2010text reports were assessed, and 16 randomized controlled trials were included. Motor evoked potential (MEP) amplitude, MEP status, and resting motor threshold were the most frequently reported measures. Several trials found that changes in corticospinal excitability accompanied improvements in upper\u2010limb function, activities of daily living, gait, or balance. One trial found greater motor gains among participants with preserved baseline MEPs; however, the contemporary randomized\u2010trial evidence is insufficient to establish MEP status as a predictor of differential response to neuromodulation. In contrast, short\u2010interval intracortical inhibition, cortical silent period, and interhemispheric inhibition were assessed in very few trials, whereas intracortical facilitation was not directly evaluated in any eligible RCT. Most studies raised some risk\u2010of\u2010bias concerns, and one study had high overall risk. Certainty was moderate for clinical motor recovery, low for MEP\u2010 and motor\u2010threshold\u2010based measures, and very low for intracortical and interhemispheric measures. Overall, MEP\u2010derived measures and resting motor threshold were the most frequently reported neurophysiological domains, whereas baseline MEP status was evaluated in only one stratified trial. Standardized TMS protocols are needed to clarify their monitoring, prognostic, and treatment\u2010response value.<\/jats:p>","DOI":"10.1111\/ejn.70698","type":"journal-article","created":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:36:14Z","timestamp":1791156974000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["TMS\u2010Derived Neurophysiological Measures of Corticospinal Excitability, Intracortical Excitability, and Interhemispheric Interactions Associated With Post\u2010Stroke Motor Recovery: A Systematic Review"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9737-2228","authenticated-orcid":false,"given":"Gabrielly Santos","family":"Pereira","sequence":"first","affiliation":[{"name":"Neuropsychobiology and Motor Control Laboratory, Department of Health Sciences, Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5523-5910","authenticated-orcid":false,"given":"Marcelo Louren\u00e7o","family":"da Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Neuroscience, Neuromodulation and Study of Pain (LANNED) Federal University of Alfenas (UNIFAL\u2010MG)  Alfenas Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7870-3820","authenticated-orcid":false,"given":"Abrah\u00e3o Fontes","family":"Baptista","sequence":"additional","affiliation":[{"name":"School of Physiotherapy Federal University of Rio de Janeiro  Rio de Janeiro Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8709-318X","authenticated-orcid":false,"given":"Jo\u00e3o Eduardo","family":"de Araujo","sequence":"additional","affiliation":[{"name":"Neuropsychobiology and Motor Control Laboratory, Department of Health Sciences, Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo  Ribeir\u00e3o Preto S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"issue":"4","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1177\/1545968315595285","article-title":"Primed Physical Therapy Enhances Recovery of Upper Limb Function in Chronic Stroke Patients","volume":"30","author":"Ackerley S. 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