{
  "abstract": "BACKGROUND: Phase-specific brain stimulation provides a tool to probe the functional relevance of ongoing neural oscillations. Current closed-loop stimulation approaches often use predictive algorithms to compensate for processing and stimulation delays, but prediction error can limit phase-targeting accuracy, particularly at higher frequencies. A real-time approach that minimizes latency without relying on phase prediction may improve the precision and interpretability of phase-specific stimulation. METHODS: In this technical proof-of-concept study, we developed and validated a prototype real-time closed-loop system for electroencephalography-triggered transcranial magnetic stimulation (EEG-TMS). The system performs signal acquisition, phase estimation, and stimulation triggering within a 1 ms closed-loop update cycle and does not require phase prediction. Empirical testing was performed in human participants receiving EEG-triggered TMS across eight target phases and ten target frequencies ranging from 4 to 40 Hz. RESULTS: Across all target phases and frequencies, the system achieved single-digit phase accuracy without phase prediction. On average, stimulation was 5.6° away from the intended target phase. The typical single-pulse error was 3.7°, and trial-to-trial variability was 7.8° These results indicate stable phase-targeting performance across the tested phase and frequency range. CONCLUSION: This real-time EEG-TMS system demonstrates the technical feasibility of prediction-free phase-specific stimulation across physiologically relevant frequencies. By reducing dependence on predictive phase extrapolation, the approach provides a platform for studying phase-dependent brain physiology and for developing closed-loop neuromodulation protocols with improved temporal precision.",
  "abstract_shown": true,
  "affiliations": [
    "Institute for Neuromodulation and Neurotechnology, University Hospital and University of Tübingen, Tübingen, 72076, Germany"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Robert Guggenberger",
      "orcid": "0000-0003-0970-9705"
    },
    {
      "affs": [
        0
      ],
      "name": "Farzin Negahbani",
      "orcid": "0000-0001-6286-7177"
    },
    {
      "affs": [
        0
      ],
      "name": "Julian-Samuel Gebühr",
      "orcid": "0009-0003-5195-228X"
    },
    {
      "affs": [
        0
      ],
      "name": "Marius Keute",
      "orcid": "0000-0002-7173-0567"
    },
    {
      "name": "Alireza Gharabaghi",
      "orcid": "0000-0002-9782-5281"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0z71qyw29xfv9.bib",
  "cited_by": 5,
  "doi": "10.1016/j.neuroimage.2026.122216",
  "fulltext_url": null,
  "id": "0z71qyw29xfv9",
  "issns": [
    "1053-8119",
    "1095-9572"
  ],
  "landing_url": "https://doi.org/10.1016/j.neuroimage.2026.122216",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2808|Transcranial Magnetic Stimulation Studies"
    ]
  ],
  "openalex": "W7212181929",
  "pdf_url": "https://www.sciencedirect.com/science/article/pii/S1053811926005318/pdf",
  "pmcid": null,
  "pmid": "42716358",
  "published": "2026-09-10",
  "publisher": "Elsevier BV",
  "ris": "https://research.draconitic.com/paper/0z71qyw29xfv9.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T13:21:11Z",
      "native_id": "W7212181929",
      "source": "openalex",
      "url": "https://doi.org/10.1016/j.neuroimage.2026.122216"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2808|Transcranial Magnetic Stimulation Studies",
      "subfield": "neurology"
    }
  ],
  "title": "Real-time measurement instead of prediction enables high-precision phase-specific stimulation of the human brain",
  "title_text": "Real-time measurement instead of prediction enables high-precision phase-specific stimulation of the human brain",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T13:21:14Z",
  "url": "https://research.draconitic.com/paper/0z71qyw29xfv9",
  "venue": "NeuroImage",
  "versions": []
}