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PreprintCited by 3Traumatic Brain Injury ResearchTranscranial Magnetic Stimulation StudiesTraumatic Brain Injury and Neurovascular Disturbances

Mild traumatic brain injury alters function in the dorsolateral prefrontal cortex: a TMS-EEG study

Open access
Moore, Emily, Webb, Emily, Sasaki, Ryoki, Rogasch, Nigel C, Foo, Ngee, Semmler, John G, Opie, George M·2025·Clinical Neurophysiology
DOI 10.1101/2025.05.22.655676

Preprint — published as 10.1016/j.clinph.2026.2111858 · Paper page

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Abstract

Numerous studies highlight alterations in motor cortical neurophysiology after mild traumatic brain injury (mTBI). In contrast, understanding of effects in cognitive brain areas, which potentially underpin more impactful effects of injury, remains limited. The current study addressed this limitation by using electroencephalography to index responses to transcranial magnetic stimulation (TMS-EEG) applied over the dorsolateral prefrontal cortex (DLPFC). In 18 mTBI patients and 22 healthy controls, TMS-EEG was used to index cortical inhibition and long-term depression (LTD)-like plasticity within DLPFC. These were assessed using paired-pulse TMS (short-[SICI] and long-[LICI] interval intracortical inhibition) and continuous theta burst stimulation (cTBS), respectively. Functional effects of injury were assessed via the N-back and Trail Making Test. Responses were quantified in both temporal (i.e., TMS-evoked potentials; TEPs) and spectral (i.e., TMS-related oscillations; TROs) domains. For TEPs, measures of inhibition and plasticity both tended to be reduced by mTBI. In contrast, TRO data suggested a contradictory increased response of patients to both paired-pulse stimulation and cTBS that was specific to high-frequency bands. In addition, while TMT performance was reduced in the mTBI group, this was unrelated to neurophysiological effects of injury. These findings highlight novel effects of mTBI on DLPFC neurophysiology and emphasise the importance of considering both evoked and induced activity when examining neurophysiological effects of mTBI.

AI snapshot

Written from the paper’s full text.

TL;DR

In 37 analyzed participants, TMS-EEG over the dorsolateral prefrontal cortex showed that mild traumatic brain injury (mTBI) tended to reduce TMS-evoked potential modulation by SICI, LICI, and cTBS, while spectral TMS-related oscillations showed increased high-frequency responses in patients. TMT-A accuracy was lower in mTBI, but neurophysiological effects were largely unrelated to executive function.

Key findings

  • In the time domain, healthy controls showed SICI-related P30 reduction (pd = 96.6%, 0% in ROPE) and LICI-related N45 reduction (pd = 97.4%, 0% in ROPE); cTBS at Post 30 increased N45 and reduced P60 (both pd = 98.8%, 0% in ROPE). The mTBI group failed to show significant early TEP changes to SICI, LICI, or cTBS; normalised N45 change at Post 30 was reduced versus controls (pd = 95.3%, 0.9% in ROPE, not practically significant).
  • In the spectral domain, LICI reduced theta, upper beta, and gamma power in both groups (all pd > 97.4%, 0% in ROPE), with controls also showing alpha and lower beta reductions. SICI in controls globally decreased theta, alpha, and lower beta power and increased gamma; mTBI showed SICI-related reductions in theta, alpha, and upper beta, with between-group greater upper-beta inhibition in mTBI. cTBS reduced theta/alpha at Post 30 in controls; mTBI showed Post 0 reductions in upper beta/gamma and Post 30 reductions in theta/alpha/upper beta, with normalised lower beta at Post 30 greater in mTBI (pd = 94.8%, 2% in ROPE, not practically significant).
  • TMT-A accuracy was lower in mTBI than controls (pd = 98.3%, 0% in ROPE); N-back performance did not differ. TMT-B accuracy correlated with normalised P60 amplitude at Post 30 in mTBI (FDR-corrected P = 0.04) but not controls, while 1-back reaction time correlated with P60 at Post 30 in controls (FDR-corrected P = 0.03) but not mTBI. PCS was higher in mTBI (P = 0.01).

Methods

  • Forty participants were recruited: 18 with mTBI within the previous 24 months and 22 healthy controls; final cohort was 37 after technical issues, with ICI samples of 20 controls/17 mTBI and cTBS samples of 21 controls/16 mTBI.
  • TMS-EEG was applied over left DLPFC to assess SICI, LICI, and cTBS responses, quantified as TMS-evoked potentials (TEPs) and TMS-related oscillations (TROs); executive function was assessed with N-back and Trail Making Test.
  • Analyses used Bayesian generalised linear mixed models for ROI and executive data, cluster-based permutation for global TEP/TRO and correlation analyses, Spearman correlations with FDR correction, and multiple imputation for 3.8% missing data.

Limitations

  • The paper states that mechanisms underlying TMS-EEG indices of SICI and LICI remain unclear; normalised inhibition indices failed to provide sufficient evidence for group differences; test TEP amplitude varied over a broad range and standardisation was omitted because data collection began before required tools were available; cTBS intensity was capped at 52% MSO for 7 mTBI patients and 13 controls; independent validation is needed.
  • Evident from the text: the sample was small, some participants attended only one session, and the manuscript is a bioRxiv preprint that was not certified by peer review.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1101/2025.05.22.655676

Cites

101 of 101 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

11 of 38 cited sources checked · 9 supported · 0 flagged · accuracy not yet measured

  • Premisecitation
    § Introduction

    TMS-EEG generates a TEP whose amplitude and spatio-temporal characteristics reflect activity of cortical circuits within the stimulated cortex and interconnected areas.

    “This generates a TMS-evoked EEG potential (TEP), the amplitude and spatio-temporal characteristics of which reflect activity of cortical circuits within the stimulated cortex and interconnected areas (HernandezPavon et al. 2023).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Hernandez-Pavon et al. 2023 source
  • Study design and conductcitation
    § Tests of Executive function

    TEP quantification focused exclusively on early peaks (P30, N45, P60) to avoid sensory contributions to late components.

    “However, given the high likelihood of sensory contributions to the late components (Biabani et al. 2019, Conde et al. 2019, Biabani et al. 2021, Gordon et al. 2021, Rocchi et al. 2021, Biabani et al. 2024), TEP quantification focussed exclusively on the early peaks.”
    Quote in the paperSubstantial claim3 of 3 sources checked
    • cites Biabani et al. 2019 source
    • cites Conde et al. 2019 source
    • cites Biabani et al. 2021 source
  • Findingown data
    § Abstract

    TMT performance was reduced in the mTBI group.

    “In addition, while TMT performance was reduced in the mTBI group, this was unrelated to neurophysiological effects of injury.”
    Quote in the paperNot a substantial claim
  • Findingnone given
    § Abstract

    The reduction in TMT performance in the mTBI group was unrelated to neurophysiological effects of injury.

    “In addition, while TMT performance was reduced in the mTBI group, this was unrelated to neurophysiological effects of injury.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Abstract

    TRO data suggested a contradictory increased response of patients to both paired-pulse stimulation and cTBS that was specific to high-frequency bands.

    “In contrast, TRO data suggested a contradictory increased response of patients to both pairedpulse stimulation and cTBS that was specific to high-frequency bands.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 15
  • May combine two claims. 20
  • The quote only partly states this claim. 3

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation
    § Statistical Analysis

    Chain convergence was assessed using Rhat values < 1.1 and posterior predictive checks.

    “Chain convergence was assessed using Rhat values < 1.1 and posterior predictive checks (Gelman and Rubin 1992, Gabry et al. 2019).”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites Gelman and Rubin 1992 source

      Section 3.7 (pp. 8–9) introduces potential scale reduction (Rhat) for monitoring chain convergence and says values near 1 indicate approximate convergence. It does not specify a cutoff of < 1.1. Posterior predictive checks appear to be attributed to the other citation in the sentence, not to Gelman and Rubin. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites Gabry et al. 2019 source

      Section 4 (p. 6) identifies R-hat as a numerical summary used in MCMC diagnostics, but does not give a cutoff of < 1.1. Section 5 (p. 8) describes posterior predictive checks as evaluating model fit, not chain convergence. (LLM, conf=0.87)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation
    § Introduction

    These changes have been observed across broad post-injury timeframes ranging from days to decades and are associated with deficits in motor learning and performance.

    “These changes have been observed across broad post-injury timeframes ranging from days (Pearce et al. 2015) to decades (De Beaumont et al. 2009, Pearce et al. 2014), and have been associated with deficits in motor learning and performance (De Beaumont et al. 2012).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Pearce et al. 2015 source
    • cites De Beaumont et al. 2009 source
    • cites Pearce et al. 2014 source

  • May combine two claims.

    Premisecitation
    § Introduction

    The N-back and Trail Making Test are sensitive to mTBI.

    “these tests involve DLPFC (Owen et al. 2005, Zakzanis et al. 2005) and are sensitive to mTBI (Arciniega et al. 2021, Li et al. 2023).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Arciniega et al. 2021 source
    • cites Li et al. 2023

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Abstract

    Numerous studies highlight alterations in motor cortical neurophysiology after mild traumatic brain injury (mTBI).

    “Numerous studies highlight alterations in motor cortical neurophysiology after mild traumatic brain injury (mTBI).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites De Beaumont et al. 2009 source
    • cites Tremblay et al. 2011 source
    • cites Pearce et al. 2014 source

  • Classified as probably not a substantial claim.

    Study design and conductcitation
    § Statistical Analysis

    Cluster-based permutation analyses were used for global TEP data.

    “Identified clusters were then compared to a permutation distribution generated using the Monte-Carlo method (10,000 permutations) and deemed significant if their cluster-statistic (sum of all t-values in the cluster) exceeded P < 0.05 (Maris and Oostenveld 2007).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Maris and Oostenveld 2007 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation
    § Statistical Analysis

    All models implemented the maximal random effects structure allowed by the data.

    “All models implemented the maximal random effect's structure allowed by the data (i.e., by-participant random intercepts and slopes) in the first instance (Barr 2013).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Barr 2013 source

  • May combine two claims.

    Findingown data
    § Abstract

    For TEPs, measures of inhibition and plasticity both tended to be reduced by mTBI.

    “For TEPs, measures of inhibition and plasticity both tended to be reduced by mTBI.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § ROI analysis:

    Comparisons of normalised changes in N45 revealed that the response of mTBI patients at Post 30 was consistently (pd = 95.3%) reduced relative to healthy controls, but this failed to reach practical significance (0.9% in ROPE).

    “Comparisons of normalised changes in N45 also revealed that the response of mTBI patients at Post 30 was consistently ( pd = 95.3%) reduced relative to healthy controls, but this failed to reach a practical level of significance (0.9% in ROPE).”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data
    § Global analysis:

    Within-group comparisons for cTBS failed to identify significant clusters for any comparison.

    “Within group comparisons failed to identify significant clusters for any comparison (Fig 7C, 7D).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § ROI analysis:

    Both groups demonstrated consistent reductions in N45 at Post 0 (pd: HC = 97.4%, mTBI = 95.4%), but these failed to reach practical significance (% in ROPE: HC = 1%, mTBI = 3%).

    “Both groups also demonstrated consistent ( pd : HC = 97.4%, mTBI = 95.4%) reductions in N45 at Post 0, but these failed to reach a practical level of significance (% in ROPE: HC = 1%, mTBI = 3%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Global analysis:

    For SICI, the control group showed decreased power in theta, alpha and lower beta bands, and increased power in the gamma band.

    “For SICI, the control group showed decreased power in theta (positive cluster: P = 0.004; positive cluster: P = 0.009), alpha (positive cluster: P = 0.0007; positive cluster: P = 0.02) and lower beta (positive cluster: P = 0.01) bands, in addition to increased power in the gamma band (negative cluster: P = 0.004)(Fig 4C).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § ROI analysis:

    Normalised changes in lower beta power at Post 30 were consistently (pd = 94.8%) greater in mTBI patients compared to controls, but this failed to reach practical significance (2% in ROPE).

    “Furthermore, normalised changes in lower beta power at Post 30 were consistently ( pd = 94.8%) greater in mTBI patients when compared to controls, but this failed to reach a practical level of significance (2% in ROPE).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § ROI analysis:

    In healthy controls, LICI produced consistent (pd = 96.3%) increases in P30 amplitude relative to test, but these failed to reach practical significance (0.2% in ROPE).

    “In addition, LICI produced consistent ( pd = 96.3%) increases in amplitude, relative to test, but these failed to reach a practical level of significance (0.2% in ROPE).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § ROI analysis:

    Comparisons of normalised data showed a relatively consistent (pd = 91%) decrease in LICI of N45 when comparing mTBI patients to controls, but this failed to reach practical significance (5% in ROPE).

    “Furthermore, comparisons of normalised data showed a relatively consistent ( pd = 91%) decrease in LICI of N45 when comparing mTBI patients to controls, but this failed to reach a practical level of significance (5% in ROPE).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data
    § References

    Participants with mild traumatic brain injury reported higher post-concussion symptom (PCS) scores than healthy controls.

    “| PCS | 7.3 ± 9.1 | 20.9 ± 21.9* |”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Correlations 419

    Accuracy during the TMT-B subtest was related to normalised changes in P60 amplitude at Post 30 in the mTBI group (positive cluster: FDR-corrected P = 0.04) but not controls.

    “This identified that accuracy during the TMT-B subtest was related to normalised changes in P60 amplitude at Post 30 in the mTBI group (positive cluster: FDR-corrected P = 0.04) but not controls (Fig 11, right-upper panel).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § ROI analysis:

    All other time-domain comparisons were inconsistent and failed to provide sufficient evidence to reject or accept the null hypothesis (all pd < 90.2%, % in ROPE: 3.3-7.7).

    “All other comparisons in the time domain were inconsistent and failed to provide sufficient evidence to reject or accept the null hypothesis (all pd < 90.2%, % in ROPE: 3.3 - 7.7).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Results

    No differences in the TEP produced by single-pulse TMS were found between groups, and this was consistent across all comparisons in both temporal and spectral domains.

    “In addition, no differences in the TEP produced by single-pulse TMS were found between groups, and this was consistent across all comparisons in both temporal and spectral domains.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § Correlations 419

    Reaction time in the 1-back test was related to normalised changes in P60 amplitude at Post 30 in controls (positive cluster: FDR-corrected P = 0.03) but not the mTBI group.

    “In contrast, reaction time in the 1-back test was related to normalised changes in P60 amplitude at Post 30 in controls (positive cluster: FDR-corrected P = 0.03) but not the mTBI group (Fig 11, right-lower panel).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § ROI analysis:

    In healthy controls, LICI was associated with a reduction in N45 amplitude (less negative) that was consistent (pd = 97.4%) and significant (0% in ROPE).

    “For N45 in healthy controls, LICI was associated with a reduction in amplitude (i.e., less negative) which was consistent ( pd = 97.4%) and significant (0% in ROPE).”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data
    § ROI analysis:

    All other time-domain comparisons were inconsistent and failed to provide sufficient evidence to reject or accept the null hypothesis (all pd < 92.8%, % in ROPE: 6.7-35.0).

    “All other comparisons in the time domain were inconsistent and failed to provide sufficient evidence to pd”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Executive function

    For N-back, all within-group comparisons of d-prime and reaction time were inconsistent and failed to provide sufficient evidence to reject or accept the null hypothesis (all pd < 71.4%, % in ROPE: 11.4-12.6).

    “For N -back, all within-group comparisons of d -prime and reaction time were inconsistent and failed to provide sufficient evidence to reject or accept the null hypothesis (all pd < 71.4%, % in ROPE: 11.4 - 12.6).”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data
    § ROI analysis:

    For TROs, healthy controls showed a greater normalised change in lower beta power at Post 0 compared to Post 30, which was consistent (pd = 98.3%) and significant (0% in ROPE).

    “For TROs, healthy controls showed a greater normalised change in lower beta power at Post”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § Introduction

    The N-back and Trail Making Test involve DLPFC.

    “these tests involve DLPFC (Owen et al. 2005, Zakzanis et al. 2005) and are sensitive to mTBI (Arciniega et al. 2021, Li et al. 2023).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Owen et al. 2005 source
    • cites Zakzanis et al. 2005 source

  • Classified as probably not a substantial claim.

    Study design and conductreasoning
    § Statistical Analysis

    A false-discovery rate correction was applied within each stimulus condition to control against false positives.

    “Given the large number of comparisons made, we implemented additional control against false positives by applying a false-discovery rate correction (Benjamini and Hochberg 1995, Martinez-Cagigal 2025) within each stimulus condition (e.g., LICI, SICI, Post 0, Post 30), separately for temporal and spectral data.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Benjamini and Hochberg 1995 source
    • cites Martinez-Cagigal 2025

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Introduction

    Up to 80% of mTBI patients report ongoing symptoms 12 months after injury.

    “Up to 80% report ongoing symptoms 12 months after injury (McMahon et al. 2014)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites McMahon et al. 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given
    § Experimental Arrangement & Recordings

    The order of experimental sessions was randomised between participants.

    “Each experimental session was separated by at least 1 week, and the order of sessions was randomised between participants.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation
    § Tests of Executive function

    A subtraction procedure was implemented to remove the TEP generated by the conditioning stimulus in paired-pulse data.

    “Consistent with previously described methods (Opie et al. 2018, Opie et al. 2019, Sasaki et al. 2023), we therefore implemented a subtraction procedure to remove the TEP generated by the conditioning stimulus.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Opie et al. 2018

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Opie et al. 2019 source
    • cites Sasaki et al. 2023

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Introduction

    mTBI can cause significant and prolonged side-effects in a large proportion of patients.

    “While once considered short-term injuries, we now know mTBI can cause significant and prolonged sideeffects in a large proportion of patients.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites McMahon et al. 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation
    § Introduction

    The nature of these effects varied over the post-injury period.

    “Furthermore, the nature of these effects varied over the post-injury period (Coyle et al. 2023b, Coyle et al. 2023a).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Coyle et al. 2023b

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Coyle et al. 2023a

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationown data
    § Discussion

    For analyses in the time domain (TEPs), application of both paired-pulse TMS and cTBS modulated early TEP amplitude, but this was only apparent in the healthy control group.

    “For analyses in the time domain (i.e., TEPs), application of both paired-pulse TMS and cTBS modulated early TEP amplitude, but this was only apparent in the healthy control group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning
    § Results

    The final cohort consisted of 37 participants.

    “Consequently, the final cohort consisted of 37 participants, with baseline characteristics for this group shown in Table 1.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning
    § Tests of Executive function

    Stimulus intensity for cTBS was capped at 52% MSO, resulting in capped intensities for 7 mTBI patients and 13 healthy controls.

    “To avoid loss of stimuli, intensity was capped at 52% MSO for all participants, resulting in capped intensities for 7 mTBI patients and 13 healthy controls.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning
    § Tests of Executive function

    The linear subtraction approach may be limited by potentially non-linear interactions, so results for non-corrected data are additionally reported.

    “Given the limitations of this linear approach to potentially non-linear interactions, results for non-corrected data are additionally reported in supplementary materials.”
    Quote in the paperNot a substantial claim
34 of 34

  • The authors state this as an assumption.

    cTBS induces LTD-like changes.

    “continuous theta burst stimulation (cTBS; thought to induce LTD-like changes)”

  • The paper relies on this without support.

    mTBI is rarely associated with structural damage on conventional diagnostic imaging.

    “Although mTBI is rarely associated with structural damage on conventional diagnostic imaging, changes in brain function have been well documented.”

  • The paper relies on this without support.

    The early TEP peaks (P30, N45, P60) are not contaminated by sensory contributions.

    “However, given the high likelihood of sensory contributions to the late components (Biabani et al. 2019, Conde et al. 2019, Biabani et al. 2021, Gordon et al. 2021, Rocchi et al. 2021, Biabani et al. 2024), TEP quantification focussed exclusively on the early peaks.”

  • The paper relies on this without support.

    Injury-related changes to specific TMS-based indices of inhibitory function have only been recorded from primary motor cortex.

    “While these observations are important, a significant limitation of the field has been that injury-related changes to specific TMS-based indices of inhibitory function (i.e., via L/SICI or the cortical silent period) have only been recorded from primary motor cortex.”

  • The paper relies on this without support.

    Non-motor areas of cortex are likely to be important in the cognitive effects of mTBI.

    “In contrast, non-motor areas of cortex are likely to be important in the cognitive effects of mTBI; quantifying how inhibitory function in these areas is influenced by injury therefore has the potential to better inform our understanding of how cognitive side-effects develop following mTBI.”

  • The paper relies on this without support.

    Early TEP peaks are likely to reflect net activity of neural circuits activated by TMS (both excitatory and inhibitory).

    “Nonetheless, there is consensus that the early TEP peaks are likely to reflect net activity of neural circuits activated by TMS (both excitatory and inhibitory), and the effects in the control group are therefore consistent with inhibitory effects of cTBS on neural activity.”

  • The paper relies on this without support.

    TMS-EEG indices of SICI and LICI applied to DLPFC can be interpreted as measures of intracortical inhibitory function.

    “The current study aimed to characterise effects of mTBI on intracortical inhibitory function and LTD-like neuroplasticity in DLPFC. This was achieved by using TMS-EEG applied over DLPFC to index SICI and LICI (assessing intracortical inhibition), as well as the response to cTBS (assessing LTD-like plasticity), in participants that had suffered an mTBI in the previous 2 years.”
7 of 7

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Global SICI effect on P30 is described in opposite directions

    Major

    The global-analysis results say SICI increased P30 in controls, while the discussion says that the global analysis showed inhibition of P30 by SICI.

  • Final cohort is smaller than the session counts allow

    Minor

    The ICI session includes 17 mTBI patients, and the cTBS session includes 21 healthy controls. Because these are distinct groups, at least 38 different participants must have contributed data, not 37.

  • Healthy-control session counts conflict with two single-session controls

    Minor

    If exactly two healthy controls attended only one session, the healthy-control counts across sessions could differ by zero or two, but not by one. Table 1 gives 20 for ICI and 21 for cTBS.

3 of 3

Cites

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Research works printed but not linked: 1

  1. 10.2307/2346101 · DOI

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Authors
Moore, E., Webb, E., Sasaki, R., Rogasch, N. C., Foo, N., Semmler, J. G., & Opie, G. M.
Affiliations
  • The University of Adelaide (AU)
  • South Australian Health and Medical Research Institute (AU)
  • Royal Adelaide Hospital (AU)
Corresponding author
Opie, George M
ORCID
Venue
Clinical Neurophysiology
Publisher
openRxiv
Published
2025-05-27
Volume
186
Pages
2111858-2111858
ISSN
1388-2457 (ISSN-L)
DOI
10.1101/2025.05.22.655676
OpenAlex
W7140030498
Semantic Scholar
95c11f782b90f9ab44c9724c333d88c33e5d6af1
Cited by
3
References
89
Citations by year
2026: 3
FWCI
12.75
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Neurophysiology (publishedVersion, cc-by)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
Funders
  • Australian Research Council (DE230100022)
  • National Healthy and Medical Research Council (APP1139723)
  • Neurosurgical Research Foundation of South Australia
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
Keywords
mild traumatic brain injury, dorsolateral prefrontal cortex, cortical inhibition, long-term depression, neuroplasticity, paired-pulse TMS, continuous theta burst stimulation, TMS-evoked potentials, executive function, Trail Making Test, n-back task
MeSH terms
Dorsolateral Prefrontal Cortex, Adult, Brain Concussion, Electroencephalography, Evoked Potentials, Female, Humans, Male, Middle Aged, Neuronal Plasticity, Prefrontal Cortex, Transcranial Magnetic Stimulation, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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