Strelnikov Kuzma, Silvanto Juha
Centre for Cognitive and Brain Sciences, University of Macau, Macau SAR 999078, China.
Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau SAR 999078, China.
Vision (Basel). 2025 Jun 20;9(3):50. doi: 10.3390/vision9030050.
The effects of Transcranial Magnetic Stimulation (TMS) depend on stimulation parameters such as intensity, location, frequency, and duration. In clinical practice, these parameters are often adapted from studies carried out in healthy individuals. However, in this narrative review, we indicate that the impact of TMS is also highly state-dependent, meaning it is influenced by the excitability of the targeted brain region at the time of stimulation. This state-dependency complicates the translation of findings from healthy individuals to clinical populations, as neurological disorders often alter brain states, limiting the applicability of standard stimulation protocols. To address this challenge, stimulation parameters must be chosen within a framework that accounts for the interaction between external stimulation and the brain's internal state. Such an approach enhances the specificity of interventions, allowing for targeted modulation of neural populations by manipulating brain states prior to stimulation. State-dependent TMS has shown promise in conditions like cortical blindness and amblyopia, where tailored approaches based on the brain state associated with the condition have facilitated more precise and effective treatments. We advocate that integrating state-dependent knowledge tailored to the specifics of visual disorders alongside judicious selection of stimulation parameters holds the potential to establish a comprehensive paradigm for future investigations.
经颅磁刺激（TMS）的效果取决于刺激参数，如强度、位置、频率和持续时间。在临床实践中，这些参数通常是根据在健康个体中进行的研究进行调整的。然而，在本叙述性综述中，我们指出TMS的影响也高度依赖于状态，这意味着它受到刺激时目标脑区兴奋性的影响。这种状态依赖性使得从健康个体到临床人群的研究结果转化变得复杂，因为神经疾病常常会改变脑状态，限制了标准刺激方案的适用性。为应对这一挑战，必须在一个考虑外部刺激与脑内状态相互作用的框架内选择刺激参数。这种方法提高了干预的特异性，通过在刺激前操纵脑状态，实现对神经群体的靶向调节。状态依赖性TMS在皮质盲和弱视等病症中已显示出前景，在这些病症中，基于与病症相关的脑状态的定制方法有助于实现更精确、有效的治疗。我们主张，将针对视觉障碍具体情况的状态依赖性知识与明智选择刺激参数相结合，有可能为未来的研究建立一个全面的范式。
