Toward Reliable Non-Invasive Brain Stimulation: Unraveling Sources of Variability

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurosurgery and Neuroanatomy".

Deadline for manuscript submissions: 28 February 2027 | Viewed by 411

Editor


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Guest Editor
Department of Psychology and Milan Center for Neuroscience-NeuroMI, University of Milano-Bicocca, Milan, Italy
Interests: brain plasticity; transcranial magnetic stimulation; sensorimotor integration; TMS-EEG; non-invasive brain stimulation
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Special Issue Information

Dear Colleagues,

Non-invasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial electric stimulation (tES), are widely used to probe and modulate cortical functions. Yet, their effects remain highly variable across studies and individuals. This variability arises from multiple sources, including differences in stimulation parameters (e.g., intensity, waveform, frequency, coil/electrode positioning) and state-dependent factors such as ongoing brain activity and individual anatomy. Methodological heterogeneity, combined with inconsistent reporting practices, further complicates the reproducibility and comparability of findings. Increasing evidence suggests that both biological and technical factors interact to shape NIBS outcomes, underscoring the need for standardized protocols, individualized targeting strategies, and multimodal monitoring approaches. Nowadays, addressing these sources of variability is critical to improving the reliability, interpretability, and clinical translation of NIBS protocols and interventions.

The present Special Issue aims to showcase cutting-edge studies investigating variability in NIBS outcomes. As a common feature, the works in this Special Issue should focus on exploring the inter- or intra-subject variability of NIBS protocols (such as TMS, transcranial direct current stimulation, transcranial alternating current stimulation, and focused ultrasound stimulation) to better ground the anatomo-functional underpinnings of these techniques and optimize their administration.

Contributions may adopt a neurophysiological, behavioral, or neurocomputational perspective, focusing on both the healthy and the damaged central nervous system. Research with null results is encouraged, provided they fit the topic and the investigation is methodologically sound. Studies integrating NIBS with neuroimaging (e.g., functional magnetic resonance imaging [fMRI], electroencephalography [EEG], magnetoencephalography [MEG]), behavioral paradigms, or machine learning approaches are welcome. Narrative reviews or meta-analyses that investigate the state of the art of this topic are welcome, too.

Dr. Giacomo Guidali
Guest Editor

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Keywords

  • non-invasive brain stimulation
  • transcranial electric stimulation (tES)
  • transcranial magnetic stimulation (TMS)
  • variability
  • reproducibility
  • neuroimaging
  • machine learning
  • precision neuromodulation
  • individual differences
  • protocol standardization

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Published Papers (1 paper)

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Review

27 pages, 4863 KB  
Review
Precision in Delivery, Variability in Response: A Multiscale Mechanistic Framework for Neuronavigated Transcranial Magnetic Stimulation
by Marcin Karol Setlak, Bartłomiej Błaszczyk, Maciej Wojtacha and Adam Rudnik
Brain Sci. 2026, 16(9), 901; https://doi.org/10.3390/brainsci16090901 (registering DOI) - 23 Aug 2026
Abstract
Background/Objectives: Transcranial magnetic stimulation (TMS) initiates a cascade from intracranial electric-field exposure through neural recruitment and plasticity to distributed network responses. Neuronavigation improves the geometric reproducibility of delivery but does not guarantee equivalent cortical exposure or target engagement. This narrative review integrates these [...] Read more.
Background/Objectives: Transcranial magnetic stimulation (TMS) initiates a cascade from intracranial electric-field exposure through neural recruitment and plasticity to distributed network responses. Neuronavigation improves the geometric reproducibility of delivery but does not guarantee equivalent cortical exposure or target engagement. This narrative review integrates these levels within an operational framework for precision TMS. Methods: Six domain-specific PubMed searches covering 1 January 1985 to 31 July 2026 were supplemented by Google Scholar and citation tracking. A documented rerun on 17 August 2026 yielded 6430 records (5617 unique after cross-query deduplication). Evidence was synthesized narratively; no quantitative synthesis or formal risk-of-bias assessment was performed. Results: Neuronavigation improves geometric precision by stabilizing target definition and coil pose, whereas individualized electric-field models estimate intracranial exposure. Neither establishes biological precision, which also depends on neuronal orientation, brain state, circuit architecture, medication, and behavior. Motor-system measures are not validated as universal biomarkers for nonmotor cortex, and no single validated biomarker captures TMS-induced plasticity. Convergent, controlled multimodal evidence may strengthen inference about target engagement; adaptive and closed-loop approaches remain experimental. Conclusions: Geometric delivery, modeled exposure, biological engagement, and durable functional or clinical benefit require separate validation. Spatial accuracy alone does not establish clinical value. Full article
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