Temporal variation of brain hemodynamics with accelerated iTBS for depression: A single-case concurrent TMS/fNIRS study

The Stanford Neuromodulation Therapy (SNT) protocol, which incorporates functional connectivity MRI-guided targeting, and high-dose, accelerated intermittent theta-burst stimulation (iTBS) [1], has demonstrated remarkable clinical efficacy and safety [2]. Nevertheless, the session-specific temporal dynamics in neural response remain unclear, which is critical for understanding the rapid and robust effects of accelerated protocols. Given the practical challenges of integrating neuroimaging techniques like functional MRI and EEG into such an intensive iTBS protocol, we utilized functional near-infrared spectroscopy (fNIRS, see Supplementary 1.1) to monitor real-time hemodynamic responses over the bilateral prefrontal cortex across treatment sessions and days.