Magnetic NeuroRing: a portable adaptive brain-computer interface for real-time transcranial magnetic stimulation in post-stroke motor rehabilitation

Abstract Stroke often causes persistent upper limb and hand motor dysfunction due to disrupted neural reorganization. To address this, we developed the Magnetic NeuroRing: a portable brain-computer interface integrating real-time electroencephalogram (EEG) with closed-loop continuous theta burst stimulation (cTBS) for adaptive transcranial magnetic stimulation (TMS). A multi-channel EEG array over motor cortical regions (FC3, FC4, CP3, CP4, FT7, FT8, TP7, TP8) detects event-related desynchronization (ERD), indicating motor intent. When ERD/ERS falls below a threshold (ERD/ERS < 0 over five consecutive activations), the system delivers inhibitory cTBS to hyperactive regions, aiming to rebalance stroke-impaired interhemispheric dynamics. The lightweight, patient-specific headgear uses magnetic levitation for precise targeting and EEG-TMS synchronization. In healthy subjects, adaptive cTBS significantly modulated resting-state and task-related neural metrics, aligning with prior large-device findings and demonstrating feasibility for inducing neuroplastic changes. By bridging real-time diagnostics with targeted neuromodulation, the Magnetic NeuroRing enables dynamic, data-driven rehabilitation across clinical and home settings.