{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:32:35Z","timestamp":1787585555512,"version":"build-2736575974"},"reference-count":131,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sci.","Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: Transcranial magnetic stimulation (TMS) initiates a cascade from intracranial electric-field exposure through neural recruitment and plasticity to distributed network responses. Neuronavigation improves the geometric reproducibility of delivery but does not guarantee equivalent cortical exposure or target engagement. This narrative review integrates these levels within an operational framework for precision TMS. Methods: Six domain-specific PubMed searches covering 1 January 1985 to 31 July 2026 were supplemented by Google Scholar and citation tracking. A documented rerun on 17 August 2026 yielded 6430 records (5617 unique after cross-query deduplication). Evidence was synthesized narratively; no quantitative synthesis or formal risk-of-bias assessment was performed. Results: Neuronavigation improves geometric precision by stabilizing target definition and coil pose, whereas individualized electric-field models estimate intracranial exposure. Neither establishes biological precision, which also depends on neuronal orientation, brain state, circuit architecture, medication, and behavior. Motor-system measures are not validated as universal biomarkers for nonmotor cortex, and no single validated biomarker captures TMS-induced plasticity. Convergent, controlled multimodal evidence may strengthen inference about target engagement; adaptive and closed-loop approaches remain experimental. Conclusions: Geometric delivery, modeled exposure, biological engagement, and durable functional or clinical benefit require separate validation. Spatial accuracy alone does not establish clinical value.<\/jats:p>","DOI":"10.3390\/brainsci16090901","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T14:49:34Z","timestamp":1787582974000},"page":"901","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Precision in Delivery, Variability in Response: A Multiscale Mechanistic Framework for Neuronavigated Transcranial Magnetic Stimulation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9863-8173","authenticated-orcid":false,"given":"Marcin Karol","family":"Setlak","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Clinical Center, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5648-8138","authenticated-orcid":false,"given":"Bart\u0142omiej","family":"B\u0142aszczyk","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Clinical Center, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Wojtacha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Clinical Center, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Rudnik","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University Clinical Center, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/S0140-6736(85)92413-4","article-title":"Non-invasive magnetic stimulation of human motor cortex","volume":"1","author":"Barker","year":"1985","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.neuron.2007.06.026","article-title":"Transcranial magnetic stimulation: A primer","volume":"55","author":"Hallett","year":"2007","journal-title":"Neuron"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.clinph.2022.04.022","article-title":"Transcranial magnetic stimulation of the brain: What is stimulated?\u2014A consensus and critical position paper","volume":"140","author":"Siebner","year":"2022","journal-title":"Clin. Neurophysiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/j.brs.2022.08.013","article-title":"Neuronavigation maximizes accuracy and precision in TMS positioning: Evidence from 11,230 distance, angle, and electric field modeling measurements","volume":"15","author":"Caulfield","year":"2022","journal-title":"Brain Stimul."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1152\/physrev.00026.2025","article-title":"Mechanisms of transcranial magnetic brain stimulation","volume":"106","author":"Massimini","year":"2026","journal-title":"Physiol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101396","DOI":"10.1016\/j.cobeha.2024.101396","article-title":"Transcranial magnetic stimulation","volume":"58","author":"Shirota","year":"2024","journal-title":"Curr. Opin. Behav. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.pneurobio.2010.10.003","article-title":"Modulation of cortical excitability induced by repetitive transcranial magnetic stimulation: Influence of timing and geometrical parameters and underlying mechanisms","volume":"93","author":"Pell","year":"2011","journal-title":"Prog. Neurobiol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"M\u00fcller-Dahlhaus, F., and Vlachos, A. (2013). Unraveling the cellular and molecular mechanisms of repetitive magnetic stimulation. Front. Mol. Neurosci., 6.","DOI":"10.3389\/fnmol.2013.00050"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1038\/s41386-022-01453-8","article-title":"Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation","volume":"48","author":"Jannati","year":"2023","journal-title":"Neuropsychopharmacology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2232","DOI":"10.1016\/j.neuroimage.2012.03.035","article-title":"Measuring and manipulating brain connectivity with resting state functional connectivity magnetic resonance imaging (fcMRI) and transcranial magnetic stimulation (TMS)","volume":"62","author":"Fox","year":"2012","journal-title":"NeuroImage"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.biopsych.2023.11.016","article-title":"Repetitive transcranial magnetic stimulation-induced neuroplasticity and the treatment of psychiatric disorders: State of the evidence and future opportunities","volume":"95","author":"Fitzsimmons","year":"2024","journal-title":"Biol. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.biopsych.2023.09.011","article-title":"Target engagement and brain state dependence of transcranial magnetic stimulation: Implications for clinical practice","volume":"95","author":"Sack","year":"2024","journal-title":"Biol. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.neuroimage.2011.06.069","article-title":"How the brain tissue shapes the electric field induced by transcranial magnetic stimulation","volume":"58","author":"Opitz","year":"2011","journal-title":"NeuroImage"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.neuroimage.2010.07.061","article-title":"Impact of the gyral geometry on the electric field induced by transcranial magnetic stimulation","volume":"54","author":"Thielscher","year":"2011","journal-title":"NeuroImage"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s41073-019-0064-8","article-title":"SANRA-a scale for the quality assessment of narrative review articles","volume":"4","author":"Baethge","year":"2019","journal-title":"Res. Integr. Peer Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.biopsych.2023.11.022","article-title":"Electric field modeling in personalizing transcranial magnetic stimulation interventions","volume":"95","author":"Dannhauer","year":"2024","journal-title":"Biol. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.brs.2011.10.001","article-title":"Fundamentals of transcranial electric and magnetic stimulation dose: Definition, selection, and reporting practices","volume":"5","author":"Peterchev","year":"2012","journal-title":"Brain Stimul."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1113\/jphysiol.2010.190314","article-title":"Determinants of the induction of cortical plasticity by non-invasive brain stimulation in healthy subjects","volume":"588","author":"Ridding","year":"2010","journal-title":"J. Physiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1146\/annurev.bioeng.9.061206.133100","article-title":"Noninvasive human brain stimulation","volume":"9","author":"Wagner","year":"2007","journal-title":"Annu. Rev. Biomed. Eng."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.brs.2012.02.005","article-title":"Electric field depth-focality tradeoff in transcranial magnetic stimulation: Simulation comparison of 50 coil designs","volume":"6","author":"Deng","year":"2013","journal-title":"Brain Stimul."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1016\/j.clinph.2013.11.038","article-title":"Coil design considerations for deep transcranial magnetic stimulation","volume":"125","author":"Deng","year":"2014","journal-title":"Clin. Neurophysiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"046033","DOI":"10.1088\/1741-2552\/aac967","article-title":"Design of transcranial magnetic stimulation coils with optimal trade-off between depth, focality, and energy","volume":"15","author":"Gomez","year":"2018","journal-title":"J. Neural Eng."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1088\/0031-9155\/59\/1\/203","article-title":"Effects of coil orientation on the electric field induced by TMS over the hand motor area","volume":"59","author":"Laakso","year":"2014","journal-title":"Phys. Med. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s12984-015-0036-2","article-title":"The coil orientation dependency of the electric field induced by TMS for M1 and other brain areas","volume":"12","author":"Janssen","year":"2015","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1016\/j.clinph.2013.01.011","article-title":"Pulse width dependence of motor threshold and input-output curve characterized with controllable pulse parameter transcranial magnetic stimulation","volume":"124","author":"Peterchev","year":"2013","journal-title":"Clin. Neurophysiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.brs.2018.01.001","article-title":"TMS of primary motor cortex with a biphasic pulse activates two independent sets of excitable neurones","volume":"11","author":"Sommer","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.brs.2015.08.013","article-title":"Enhancement of Neuromodulation with Novel Pulse Shapes Generated by Controllable Pulse Parameter Transcranial Magnetic Stimulation","volume":"9","author":"Goetz","year":"2016","journal-title":"Brain Stimul."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Lucarelli, D., Pizzella, V., Marzetti, L., and Guidali, G. (2026). Recent progress and emerging perspectives on how technical parameters of transcranial magnetic stimulation shape cortical measures derived from concurrent electroencephalography. Neuromodulation, online ahead of print.","DOI":"10.1016\/j.neurom.2026.03.004"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4520","DOI":"10.1152\/jn.00067.2005","article-title":"Simple metric for scaling motor threshold based on scalp-cortex distance: Application to studies using transcranial magnetic stimulation","volume":"94","author":"Stokes","year":"2005","journal-title":"J. Neurophysiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1109\/TBME.2004.827925","article-title":"Three-dimensional head model simulation of transcranial magnetic stimulation","volume":"51","author":"Wagner","year":"2004","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1016\/j.clinph.2018.04.749","article-title":"Impact of non-brain anatomy and coil orientation on inter- and intra-subject variability in TMS at midline","volume":"129","author":"Lee","year":"2018","journal-title":"Clin. Neurophysiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.neuroimage.2013.04.067","article-title":"Physiological observations validate finite element models for estimating subject-specific electric field distributions induced by transcranial magnetic stimulation of the human motor cortex","volume":"81","author":"Opitz","year":"2013","journal-title":"NeuroImage"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.nicl.2017.04.014","article-title":"The impact of large structural brain changes in chronic stroke patients on the electric field caused by transcranial brain stimulation","volume":"15","author":"Minjoli","year":"2017","journal-title":"NeuroImage Clin."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"102563","DOI":"10.1016\/j.nicl.2021.102563","article-title":"Evaluating transcranial magnetic stimulation (TMS) induced electric fields in pediatric stroke","volume":"29","author":"Mantell","year":"2021","journal-title":"NeuroImage Clin."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.nicl.2014.03.004","article-title":"Validating computationally predicted TMS stimulation areas using direct electrical stimulation in patients with brain tumors near precentral regions","volume":"4","author":"Opitz","year":"2014","journal-title":"NeuroImage Clin."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1002\/hbm.21479","article-title":"Electric field calculations in brain stimulation based on finite elements: An optimized processing pipeline for the generation and usage of accurate individual head models","volume":"34","author":"Windhoff","year":"2013","journal-title":"Hum. Brain Mapp."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"066032","DOI":"10.1088\/1741-2552\/ab41ba","article-title":"Electric field simulations for transcranial brain stimulation using FEM: An efficient implementation and error analysis","volume":"16","author":"Saturnino","year":"2019","journal-title":"J. Neural Eng."},{"key":"ref_38","first-page":"222","article-title":"Field modeling for transcranial magnetic stimulation: A useful tool to understand the physiological effects of TMS? Annu","volume":"2015","author":"Thielscher","year":"2015","journal-title":"Int. Conf. IEEE Eng. Med. Biol. Soc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1016\/j.brs.2021.06.012","article-title":"Four electric field modeling methods of Dosing Prefrontal Transcranial Magnetic Stimulation (TMS): Introducing APEX MT dosimetry","volume":"14","author":"Caulfield","year":"2021","journal-title":"Brain Stimul."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"imag-2-00106","DOI":"10.1162\/imag_a_00106","article-title":"Electric-field-based dosing for TMS","volume":"2","author":"Numssen","year":"2024","journal-title":"Imaging Neurosci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"120379","DOI":"10.1016\/j.neuroimage.2023.120379","article-title":"Outcome measures for electric field modeling in tES and TMS: A systematic review and large-scale modeling study","volume":"281","author":"Nuyts","year":"2023","journal-title":"NeuroImage"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Pashut, T., Wolfus, S., Friedman, A., Lavidor, M., Bar-Gad, I., Yeshurun, Y., and Korngreen, A. (2011). Mechanisms of magnetic stimulation of central nervous system neurons. PLoS Comput. Biol., 7.","DOI":"10.1371\/journal.pcbi.1002022"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"066023","DOI":"10.1088\/1741-2552\/aadbb1","article-title":"Biophysically realistic neuron models for simulation of cortical stimulation","volume":"15","author":"Aberra","year":"2018","journal-title":"J. Neural Eng."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.12688\/f1000research.9277.1","article-title":"A multi-scale computational model of the effects of TMS on motor cortex","volume":"5","author":"Seo","year":"2016","journal-title":"F1000Research"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.brs.2019.10.002","article-title":"Simulation of transcranial magnetic stimulation in head model with morphologically-realistic cortical neurons","volume":"13","author":"Aberra","year":"2020","journal-title":"Brain Stimul."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"imag-1-00036","DOI":"10.1162\/imag_a_00036","article-title":"Directional sensitivity of cortical neurons towards TMS-induced electric fields","volume":"1","author":"Weise","year":"2023","journal-title":"Imaging Neurosci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1016\/j.brs.2025.08.025","article-title":"Single pointwise samples of electric field on a neuron model cannot predict activation threshold by brain stimulation","volume":"18","author":"Wang","year":"2025","journal-title":"Brain Stimul."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Worbs, T.H., Nielsen, J.D., Wang, B., Hansen, J.W., Grill, W.M., Peterchev, A.V., and Thielscher, A. (2026). Histologically informed multiscale modeling of the neuronal elements activated by TMS. bioRxiv, 2026.06.05.730288.","DOI":"10.64898\/2026.06.05.730288"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/0304-3940(96)12659-8","article-title":"Direct and indirect activation of human corticospinal neurons by transcranial magnetic and electrical stimulation","volume":"210","author":"Nakamura","year":"1996","journal-title":"Neurosci. Lett."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1111\/j.1469-7793.1998.625bq.x","article-title":"Effects of voluntary contraction on descending volleys evoked by transcranial stimulation in conscious humans","volume":"508","author":"Restuccia","year":"1998","journal-title":"J. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1007\/s002210100722","article-title":"The effect on corticospinal volleys of reversing the direction of current induced in the motor cortex by transcranial magnetic stimulation","volume":"138","author":"Oliviero","year":"2001","journal-title":"Exp. Brain Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1152\/jn.00640.2010","article-title":"Transcranial magnetic stimulation in different current directions activates separate cortical circuits","volume":"105","author":"Ni","year":"2011","journal-title":"J. Neurophysiol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Di Lazzaro, V., and Ziemann, U. (2013). The contribution of transcranial magnetic stimulation in the functional evaluation of microcircuits in human motor cortex. Front. Neural Circuits, 7.","DOI":"10.3389\/fncir.2013.00018"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1152\/jn.00459.2024","article-title":"Single and paired TMS pulses engage spatially distinct corticomotor representations in human pericentral cortex","volume":"133","author":"Madsen","year":"2025","journal-title":"J. Neurophysiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1113\/jphysiol.1996.sp021734","article-title":"Interaction between intracortical inhibition and facilitation in human motor cortex","volume":"496","author":"Ziemann","year":"1996","journal-title":"J. Physiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/BF00228633","article-title":"The effect of lorazepam on the motor cortical excitability in man","volume":"109","author":"Ziemann","year":"1996","journal-title":"Exp. Brain Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1212\/WNL.51.5.1320","article-title":"Dextromethorphan decreases the excitability of the human motor cortex","volume":"51","author":"Ziemann","year":"1998","journal-title":"Neurology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1007\/s00221-006-0365-2","article-title":"The role of GABA(B) receptors in intracortical inhibition in the human motor cortex","volume":"173","author":"McDonnell","year":"2006","journal-title":"Exp. Brain Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1152\/jn.00346.2023","article-title":"The paired-pulse TMS paradigm of short intracortical inhibition is mediated by a reduction of repetitive motor neuron discharges","volume":"131","author":"Batzianouli","year":"2024","journal-title":"J. Neurophysiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1016\/j.clinph.2008.05.031","article-title":"Interference of short-interval intracortical inhibition (SICI) and short-interval intracortical facilitation (SICF)","volume":"119","author":"Peurala","year":"2008","journal-title":"Clin. Neurophysiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.brs.2017.11.016","article-title":"Real-time EEG-defined excitability states determine efficacy of TMS-induced plasticity in human motor cortex","volume":"11","author":"Zrenner","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3766","DOI":"10.1093\/cercor\/bhy255","article-title":"Sensorimotor Oscillatory Phase-Power Interaction Gates Resting Human Corticospinal Output","volume":"29","author":"Hussain","year":"2019","journal-title":"Cereb. Cortex"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"ENEURO.0450-24.2024","DOI":"10.1523\/ENEURO.0450-24.2024","article-title":"State-Dependent Motor Cortex Stimulation Reveals Distinct Mechanisms for Corticospinal Excitability and Cortical Responses","volume":"11","author":"Perera","year":"2024","journal-title":"eNeuro"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Wang, Q., Gong, A., Feng, Z., Bai, Y., and Ziemann, U. (2024). Interactions of transcranial magnetic stimulation with brain oscillations: A narrative review. Front. Syst. Neurosci., 18.","DOI":"10.3389\/fnsys.2024.1489949"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1523\/JNEUROSCI.5016-03.2004","article-title":"Learning modifies subsequent induction of long-term potentiation-like and long-term depression-like plasticity in human motor cortex","volume":"24","author":"Ziemann","year":"2004","journal-title":"J. Neurosci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.biopsych.2004.07.017","article-title":"Preconditioning with transcranial direct current stimulation sensitizes the motor cortex to rapid-rate transcranial magnetic stimulation and controls the direction of after-effects","volume":"56","author":"Lang","year":"2004","journal-title":"Biol. Psychiatry"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1093\/brain\/123.3.572","article-title":"Induction of plasticity in the human motor cortex by paired associative stimulation","volume":"123","author":"Stefan","year":"2000","journal-title":"Brain"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.neuron.2004.12.033","article-title":"Theta burst stimulation of the human motor cortex","volume":"45","author":"Huang","year":"2005","journal-title":"Neuron"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1016\/j.clinph.2007.01.021","article-title":"The after-effect of human theta burst stimulation is NMDA receptor dependent","volume":"118","author":"Huang","year":"2007","journal-title":"Clin. Neurophysiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"17514","DOI":"10.1523\/JNEUROSCI.0409-12.2012","article-title":"Repetitive magnetic stimulation induces functional and structural plasticity of excitatory postsynapses in mouse organotypic hippocampal slice cultures","volume":"32","author":"Vlachos","year":"2012","journal-title":"J. Neurosci."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"3323","DOI":"10.1007\/s00429-014-0859-9","article-title":"Repetitive magnetic stimulation induces plasticity of excitatory postsynapses on proximal dendrites of cultured mouse CA1 pyramidal neurons","volume":"220","author":"Lenz","year":"2015","journal-title":"Brain Struct. Funct."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1016\/j.brs.2025.07.008","article-title":"Repetitive magnetic stimulation with iTBS600 induces persistent structural and functional plasticity in mouse organotypic slice cultures","volume":"18","author":"Lu","year":"2025","journal-title":"Brain Stimul."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Hananeia, N., Ebner, C., Galanis, C., Cuntz, H., Opitz, A., Vlachos, A., and Jedlicka, P. (2025). Multi-scale modelling of location- and frequency-dependent synaptic plasticity induced by repetitive magnetic stimulation in the dendrites of pyramidal neurons. PLoS Comput. Biol., 21.","DOI":"10.1371\/journal.pcbi.1012295"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0896-6273(00)81010-7","article-title":"Ca2+ influx regulates BDNF transcription by a CREB family transcription factor-dependent mechanism","volume":"20","author":"Tao","year":"1998","journal-title":"Neuron"},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Baek, A., Park, E.J., Kim, S.Y., Nam, B.G., Kim, J.H., Jun, S.W., Kim, S.H., and Cho, S.R. (2018). High-Frequency Repetitive Magnetic Stimulation Enhances the Expression of Brain-Derived Neurotrophic Factor Through Activation of Ca2+-Calmodulin-Dependent Protein Kinase II-cAMP-Response Element-Binding Protein Pathway. Front. Neurol., 9.","DOI":"10.3389\/fneur.2018.00285"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"11044","DOI":"10.1523\/JNEUROSCI.2125-11.2011","article-title":"Repetitive transcranial magnetic stimulation enhances BDNF-TrkB signaling in both brain and lymphocyte","volume":"31","author":"Wang","year":"2011","journal-title":"J. Neurosci."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1016\/j.brs.2025.08.019","article-title":"Repetitive magnetic stimulation induces plasticity of excitatory synapses through cooperative pre- and postsynaptic activity","volume":"18","author":"Galanis","year":"2025","journal-title":"Brain Stimul."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00221-008-1356-2","article-title":"High- and low-frequency repetitive transcranial magnetic stimulation differentially activates c-Fos and zif268 protein expression in the rat brain","volume":"188","author":"Trippe","year":"2008","journal-title":"Exp. Brain Res."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"7521","DOI":"10.1523\/JNEUROSCI.6751-10.2011","article-title":"Long-term effects of repetitive transcranial magnetic stimulation on markers for neuroplasticity: Differential outcomes in anesthetized and awake animals","volume":"31","author":"Gersner","year":"2011","journal-title":"J. Neurosci."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.12786\/bn.2022.15.e27","article-title":"Gene Expression Profile Changes in the Stimulated Rat Brain Cortex After Repetitive Transcranial Magnetic Stimulation","volume":"15","author":"Hwang","year":"2022","journal-title":"Brain Neurorehabil."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.brs.2020.12.007","article-title":"Low intensity repetitive magnetic stimulation reduces expression of genes related to inflammation and calcium signalling in cultured mouse cortical astrocytes","volume":"14","author":"Clarke","year":"2021","journal-title":"Brain Stimul."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Luo, J., Feng, Y., Li, M., Yin, M., Qin, F., and Hu, X. (2022). Repetitive Transcranial Magnetic Stimulation Improves Neurological Function and Promotes the Anti-inflammatory Polarization of Microglia in Ischemic Rats. Front. Cell. Neurosci., 16.","DOI":"10.3389\/fncel.2022.878345"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1002\/glia.23620","article-title":"Low-intensity transcranial magnetic stimulation promotes the survival and maturation of newborn oligodendrocytes in the adult mouse brain","volume":"67","author":"Cullen","year":"2019","journal-title":"Glia"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"3537","DOI":"10.1097\/00001756-199711100-00024","article-title":"Neuronal responses to magnetic stimulation reveal cortical reactivity and connectivity","volume":"8","author":"Ilmoniemi","year":"1997","journal-title":"NeuroReport"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"3178","DOI":"10.1523\/JNEUROSCI.17-09-03178.1997","article-title":"Transcranial magnetic stimulation during positron emission tomography: A new method for studying connectivity of the human cerebral cortex","volume":"17","author":"Paus","year":"1997","journal-title":"J. Neurosci."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"12458","DOI":"10.1038\/s41598-021-90663-z","article-title":"Perturbation of resting-state network nodes preferentially propagates to structurally rather than functionally connected regions","volume":"11","author":"Momi","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"2642","DOI":"10.1038\/s41467-019-10638-7","article-title":"Neural effects of transcranial magnetic stimulation at the single-cell level","volume":"10","author":"Romero","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/j.biopsych.2010.06.021","article-title":"The role of the corpus callosum in transcranial magnetic stimulation induced interhemispheric signal propagation","volume":"68","author":"Voineskos","year":"2010","journal-title":"Biol. Psychiatry"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.neuroimage.2018.10.052","article-title":"The non-transcranial TMS-evoked potential is an inherent source of ambiguity in TMS-EEG studies","volume":"185","author":"Conde","year":"2019","journal-title":"NeuroImage"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.brs.2018.09.009","article-title":"EEG-triggered TMS reveals stronger brain state-dependent modulation of motor evoked potentials at weaker stimulation intensities","volume":"12","author":"Schaworonkow","year":"2019","journal-title":"Brain Stimul."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/s42003-020-0764-0","article-title":"Concurrent human TMS-EEG-fMRI enables monitoring of oscillatory brain state-dependent gating of cortico-subcortical network activity","volume":"3","author":"Peters","year":"2020","journal-title":"Commun. Biol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"21229","DOI":"10.1073\/pnas.1113103109","article-title":"Transcranial magnetic stimulation modulates the brain\u2019s intrinsic activity in a frequency-dependent manner","volume":"108","author":"Eldaief","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.neuroimage.2017.09.022","article-title":"Towards understanding rTMS mechanism of action: Stimulation of the DLPFC causes network-specific increase in functional connectivity","volume":"162","author":"Tik","year":"2017","journal-title":"NeuroImage"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1093\/brain\/117.4.847","article-title":"Responses to rapid-rate transcranial magnetic stimulation of the human motor cortex","volume":"117","author":"Wassermann","year":"1994","journal-title":"Brain"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1212\/WNL.48.5.1398","article-title":"Depression of motor cortex excitability by low-frequency transcranial magnetic stimulation","volume":"48","author":"Chen","year":"1997","journal-title":"Neurology"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/S1388-2457(99)00323-5","article-title":"Modulation of corticospinal excitability by repetitive transcranial magnetic stimulation","volume":"111","author":"Maeda","year":"2000","journal-title":"Clin. Neurophysiol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s002210000432","article-title":"Interindividual variability of the modulatory effects of repetitive transcranial magnetic stimulation on cortical excitability","volume":"133","author":"Maeda","year":"2000","journal-title":"Exp. Brain Res."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Magnuson, J., Ozdemir, M.A., Mathieson, E., Kirkman, S., Passera, B., Rampersad, S., Dufour, A.B., Brooks, D., Pascual-Leone, A., and Fried, P.J. (2023). Neuromodulatory effects and reproducibility of the most widely used repetitive transcranial magnetic stimulation protocols. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0286465"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s10548-010-0165-7","article-title":"Neuronavigation increases the physiologic and behavioral effects of low-frequency rTMS of primary motor cortex in healthy subjects","volume":"24","author":"Bashir","year":"2011","journal-title":"Brain Topogr."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1113\/jphysiol.2005.087288","article-title":"Theta-burst repetitive transcranial magnetic stimulation suppresses specific excitatory circuits in the human motor cortex","volume":"565","author":"Pilato","year":"2005","journal-title":"J. Physiol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"3871","DOI":"10.1113\/jphysiol.2008.152736","article-title":"The physiological basis of the effects of intermittent theta burst stimulation of the human motor cortex","volume":"586","author":"Pilato","year":"2008","journal-title":"J. Physiol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/s00429-023-02634-x","article-title":"A systematic review of the neurobiological effects of theta-burst stimulation (TBS) as measured using functional magnetic resonance imaging (fMRI)","volume":"228","author":"Kirkovski","year":"2023","journal-title":"Brain Struct. Funct."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1152\/jn.00507.2021","article-title":"Reliability of theta burst stimulation as a neuromodulation tool","volume":"127","author":"Park","year":"2022","journal-title":"J. Neurophysiol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s00221-010-2293-4","article-title":"Simply longer is not better: Reversal of theta burst after-effect with prolonged stimulation","volume":"204","author":"Gamboa","year":"2010","journal-title":"Exp. Brain Res."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/cercor\/bhm087","article-title":"Effect of physiological activity on an NMDA-dependent form of cortical plasticity in human","volume":"18","author":"Huang","year":"2008","journal-title":"Cereb. Cortex"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1016\/j.brs.2020.07.018","article-title":"Large-scale analysis of interindividual variability in theta-burst stimulation data: Results from the \u2018Big TMS Data Collaboration\u2019","volume":"13","author":"Corp","year":"2020","journal-title":"Brain Stimul."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"066037","DOI":"10.1088\/1741-2552\/aca71a","article-title":"Accuracy and precision of navigated transcranial magnetic stimulation","volume":"19","author":"Nieminen","year":"2022","journal-title":"J. Neural Eng."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"IMAG.a.1086","DOI":"10.1162\/IMAG.a.1086","article-title":"Cortical markers of PAS-induced long-term potentiation and depression in the motor system: A TMS-EEG Registered Report","volume":"4","author":"Arrigoni","year":"2026","journal-title":"Imaging Neurosci."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.clinph.2023.06.016","article-title":"Can we manipulate brain connectivity? A systematic review of cortico-cortical paired associative stimulation effects","volume":"154","author":"Wang","year":"2023","journal-title":"Clin. Neurophysiol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"13773","DOI":"10.1523\/JNEUROSCI.1777-13.2013","article-title":"Paired associative stimulation enforces the communication between interconnected areas","volume":"33","author":"Veniero","year":"2013","journal-title":"J. Neurosci."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"109677","DOI":"10.1016\/j.jneumeth.2022.109677","article-title":"The role of neuronavigation in TMS-EEG studies: Current applications and future perspectives","volume":"380","author":"Lioumis","year":"2022","journal-title":"J. Neurosci. Methods"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"117696","DOI":"10.1016\/j.neuroimage.2020.117696","article-title":"Fast computational optimization of TMS coil placement for individualized electric field targeting","volume":"228","author":"Gomez","year":"2021","journal-title":"NeuroImage"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1093\/cercor\/bhs147","article-title":"The role of interneuron networks in driving human motor cortical plasticity","volume":"23","author":"Hamada","year":"2013","journal-title":"Cereb. Cortex"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"11828","DOI":"10.1038\/ncomms11828","article-title":"Circadian regulation of human cortical excitability","volume":"7","author":"Ly","year":"2016","journal-title":"Nat. Commun."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"133330","DOI":"10.1016\/j.neulet.2017.12.058","article-title":"Variability in non-invasive brain stimulation studies: Reasons and results","volume":"719","author":"Guerra","year":"2020","journal-title":"Neurosci. Lett."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.brs.2017.12.003","article-title":"The intensity of continuous theta burst stimulation, but not the waveform used to elicit motor evoked potentials, influences its outcome in the human motor cortex","volume":"11","author":"Sasaki","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.clinph.2015.02.001","article-title":"Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee","volume":"126","author":"Rossini","year":"2015","journal-title":"Clin. Neurophysiol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1113\/jphysiol.1993.sp019912","article-title":"Corticocortical inhibition in human motor cortex","volume":"471","author":"Kujirai","year":"1993","journal-title":"J. Physiol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.brs.2023.02.009","article-title":"TMS combined with EEG: Recommendations and open issues for data collection and analysis","volume":"16","author":"Veniero","year":"2023","journal-title":"Brain Stimul."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"e70048","DOI":"10.1002\/hbm.70048","article-title":"Methodological choices matter: A systematic comparison of TMS-EEG studies targeting the primary motor cortex","volume":"45","author":"Beck","year":"2024","journal-title":"Hum. Brain Mapp."},{"key":"ref_121","first-page":"805","article-title":"Reliability and validity of transcranial magnetic stimulation-electroencephalography biomarkers","volume":"8","author":"Parmigiani","year":"2023","journal-title":"Biol. Psychiatry Cogn. Neurosci. Neuroimaging"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"109631","DOI":"10.1016\/j.jneumeth.2022.109631","article-title":"Identifying novel biomarkers with TMS-EEG\u2014Methodological possibilities and challenges","volume":"377","author":"Kallioniemi","year":"2022","journal-title":"J. Neurosci. Methods"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.neuroimage.2016.02.012","article-title":"Combining non-invasive transcranial brain stimulation with neuroimaging and electrophysiology: Current approaches and future perspectives","volume":"140","author":"Bergmann","year":"2016","journal-title":"NeuroImage"},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s40798-024-00698-5","article-title":"Evaluation of Orexin-A salivary levels and its correlation with attention after non-invasive brain stimulation in female volleyball players","volume":"10","author":"Moscatelli","year":"2024","journal-title":"Sports Med. Open"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/j.brs.2018.04.011","article-title":"Atlas of optimal coil orientation and position for TMS: A computational study","volume":"11","author":"Hamasaka","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"015012","DOI":"10.1088\/1361-6560\/ad0219","article-title":"Predicting the hotspot location and motor threshold prior to transcranial magnetic stimulation using electric field modelling","volume":"69","author":"Matilainen","year":"2024","journal-title":"Phys. Med. Biol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.brs.2019.10.007","article-title":"Brain oscillation-synchronized stimulation of the left dorsolateral prefrontal cortex in depression using real-time EEG-triggered TMS","volume":"13","author":"Zrenner","year":"2020","journal-title":"Brain Stimul."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"061001","DOI":"10.1088\/1741-2552\/ad8a8e","article-title":"Real-time TMS-EEG for brain state-controlled research and precision treatment: A narrative review and guide","volume":"21","author":"Wischnewski","year":"2024","journal-title":"J. Neural Eng."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1016\/j.brs.2019.01.010","article-title":"Reproducibility in TMS-EEG studies: A call for data sharing, standard procedures and effective experimental control","volume":"12","author":"Belardinelli","year":"2019","journal-title":"Brain Stimul."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.brs.2019.09.015","article-title":"Conditions for numerically accurate TMS electric field simulation","volume":"13","author":"Gomez","year":"2020","journal-title":"Brain Stimul."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.1016\/j.clinph.2012.05.003","article-title":"A checklist for assessing the methodological quality of studies using transcranial magnetic stimulation to study the motor system: An international consensus study","volume":"123","author":"Chipchase","year":"2012","journal-title":"Clin. Neurophysiol."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/9\/901\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:08:43Z","timestamp":1787584123000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/16\/9\/901"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,23]]},"references-count":131,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["brainsci16090901"],"URL":"https:\/\/doi.org\/10.3390\/brainsci16090901","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,23]]}}}