{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T10:45:02Z","timestamp":1775126702016,"version":"3.50.1"},"reference-count":56,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004955","name":"nARvibrain","doi-asserted-by":"publisher","award":["894756"],"award-info":[{"award-number":["894756"]}],"id":[{"id":"10.13039\/501100004955","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Navigated repetitive TMS (nrTMS) is widely used for non-invasive mapping of cortical functions. Methodological improvement might be achieved by optimizing coil positioning based on electric-field modeling and augmented reality (AR)-guided neuronavigation to enhance spatial targeting accuracy and stimulation-induced language errors. Therefore, we compared electric-field-optimized, AR-guided nrTMS with conventional nrTMS using manually planned coil positioning. Methods: Twenty-eight healthy subjects underwent two MRI-guided left hemispheric nrTMS language mapping sessions. Each session used 10 Hz stimulation at a 100% resting motor threshold applied for 1.5 s per region of interest (ROI) during a synchronized object naming task. ROIs were defined according to the Corina cortical parcellation system. Manually defined and electric-field-optimized coil placements obtained using SimNIBS (v4.1.0) were applied; the optimized session was assisted by AR goggles. The primary outcome was the quantitative and categorical differences in cortical regions mapped as language-eloquent. Resting-state fMRI was acquired to provide a reference for comparing nrTMS-derived language maps. Outcomes: Electric-field-optimized nrTMS did not result in an increase in positively mapped ROIs. A different distribution of language errors was observed between sessions. Manual mapping roughly followed the extracted resting-state language and motor networks, whereas electric-field-optimized mapping might correspond less. Optimized coil positions were not always practically feasible. AR guidance improved target location accuracy. Conclusions: While AR was a useful addition to the TMS experiment, electric-field optimization did not translate into significant behavioral differences. However, altered distribution of language errors can give insight into underlying neurophysiological processes of rTMS.<\/jats:p>","DOI":"10.3390\/jcm15072644","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T13:23:17Z","timestamp":1774963397000},"page":"2644","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of Electric-Field-Optimized Augmented Reality-Guided Neuronavigation in Transcranial Magnetic Stimulation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8125-9360","authenticated-orcid":false,"given":"Pia","family":"Ritter","sequence":"first","affiliation":[{"name":"Department of Radiology, Clinical Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8298-1663","authenticated-orcid":false,"given":"Sascha","family":"Freigang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Graz, 8010 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0449-5234","authenticated-orcid":false,"given":"Antonio","family":"Valentin","sequence":"additional","affiliation":[{"name":"Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King\u2019s College London, London SE5 8AF, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karla","family":"Zaar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Graz, 8010 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3068-6475","authenticated-orcid":false,"given":"Gernot","family":"Reishofer","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical University of Graz, 8010 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3376-7753","authenticated-orcid":false,"given":"Margit","family":"Jehna","sequence":"additional","affiliation":[{"name":"Department of Radiology, Clinical Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Michenthaler","sequence":"additional","affiliation":[{"name":"Department of Radiology, Clinical Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sila","family":"Karakaya","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Graz, 8010 Graz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9717-6197","authenticated-orcid":false,"given":"Philipp","family":"Moser","sequence":"additional","affiliation":[{"name":"Research Unit Medical Informatics, RISC Software GmbH, 4232 Hagenberg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis","family":"Frank","sequence":"additional","affiliation":[{"name":"cortEXplore GmbH, 4020 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Pr\u00fcckl","sequence":"additional","affiliation":[{"name":"cortEXplore GmbH, 4020 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Schaffelhofer","sequence":"additional","affiliation":[{"name":"cortEXplore GmbH, 4020 Linz, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9838-3641","authenticated-orcid":false,"given":"Stefan","family":"Thumfart","sequence":"additional","affiliation":[{"name":"Research Unit Medical Informatics, RISC Software GmbH, 4232 Hagenberg, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9938-2285","authenticated-orcid":false,"given":"Shane Matsune","family":"Fresnoza","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Graz, 8010 Graz, 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