Prestimulation phase predicts the TMS-evoked response.

Prestimulation oscillatory phase and power in particular frequency bands predict perception of at-threshold visual stimuli and of transcranial magnetic stimulation (TMS)-induced phosphenes. These effects may be due to changes in cortical excitability, such that certain ranges of power and/or phase values result in a state in which a particular brain area is more receptive to input, thereby biasing behavior. However, the effects of trial-by-trial fluctuations in phase and power of ongoing oscillations on the brain's electrical response to TMS itself have thus far not been addressed. The present study adopts a combined TMS and electroencepalography (EEG) approach to determine whether the TMS-evoked response is sensitive to momentary fluctuations in prestimulation phase and/or power in different frequency bands. Specifically, TMS was applied to superior parietal lobule while subjects performed a short-term memory task. Results showed that the prestimulation phase, particularly within the beta (15-25 Hz) band, predicted pulse-by-pulse variations in the global mean field amplitude. No such relationship was observed between prestimulation power and the global mean field amplitude. Furthermore, TMS-evoked power in the beta band fluctuated with prestimulation phase in the beta band in a manner that differed from spontaneous brain activity. These effects were observed in areas at and distal to the stimulation site. Together, these results confirm the idea that fluctuating phase of ongoing neuronal oscillations create "windows of excitability" in the brain, and they give insight into how TMS interacts with ongoing brain activity on a pulse-by-pulse basis.