Transient hemispheric lateralization is associated with intensity-dependent aftereffects of low-frequency rTMS

Low-frequency repetitive transcranial magnetic stimulation (rTMS) can alter brain activity during and after stimulation, but the relationship between these immediate responses and subsequent effects remains unclear. In a randomized, single-blind crossover design, twenty healthy adults receive 1 Hz rTMS over the left motor cortex at sham, 80%, 100%, and 120% of resting motor threshold (RMT). electroencephalography (EEG) is recorded before, during, and after rTMS. Stimulation at and above threshold elicits robust transient responses, characterized by enhanced TMS-evoked potentials, increased beta-band power, increased beta-band lateralization and recruited bilateral cortical activities.

Also, they induce significant aftereffect with a decrease in hemispheric lateralization after rTMS. Mediation analyses links stimulation intensity to this subsequent rebalancing through transient beta-band lateralization. In an exploratory stroke cohort, lower beta-band lateralization is associated with better motor function.

These findings suggest that low-frequency rTMS induces intensity-dependent transient responses and aftereffects. Transient beta-band lateralization is associated with subsequent interhemispheric rebalancing and may serve as a marker for optimizing personalized neurorehabilitation. This work was supported in part by the National Natural Science Foundation of China under Grant 62276262 and 62301560, by the Beijing Natural Science Foundation under Grant 7252291, and in part by the Beijing Nova Program under Grant 20250484879.

Laboratory of Brain Atlas and Brain-inspired Intelligence, Institute of Automation, Chinese Academy of Sciences, Beijing, China Shuang Qiu, Ying Gao, Chuncheng Zhang, Ximo Zhu, Shengpei Wang & Huiguang He State Key Laboratory of Brain Cognition and Brain-inspired Intelligence Technology, Beijing, China Shuang Qiu, Ying Gao, Chuncheng Zhang, Shengpei Wang & Huiguang He Research Center of Human Performance Modification Technology, Beijing Institute of Mechanical Equipment, Beijing, China Department of Rehabilitation Medicine, Beijing Tian’tan Hospital, Capital Medical University, Beijing, China Correspondence to Shengpei Wang or Huiguang He. The authors declare no competing interests. Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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