Introduction
depressive disorder, obsessive–compulsive disorder
Repetitive transcranial magnetic stimulation (rTMS) is a safe and effective treatment for major depressive disorder, obsessive–compulsive disorder, smoking cessation, and migrainesUnlike other noninvasive metrics, the TMS-evoked potential (TEP) provides a causal measurement of cortical excitabilityFor analysis of the post-train TMS-evoked potentials (TEPs), we focus on the early (< 80 ms) components of the TEP under the site of stimulation (early local TEP) as our primary outcome measure as it likely reflects local cortical excitabilityIn the current study, we sought to evaluate the acute neural effects of single and sequential dlPFC TMS trains using a sham-controlled, event-related study design. We hypothesized that single TMS trains but not sham would modulate acute cortical excitability, captured in the early local TEP, and that sequential TMS trains would lead to accumulated effects in the early local TEP. However, we did not observe single train or cumulative train effects on the early local TEP quantified using standard methods. In contrast, exploratory analyses revealed that single TMS trains may induce non-local effects on the evoked response as well as early local effects when using more sophisticated methods