Divergent effects of high-frequency rTMS on cognitive performance in sleep-deprived nurses: An EEG brain network study

High-frequency rTMS over the left DLPFC exerts differential, task-specific effects on cognitive function in a sleep-deprived state. The impairment in working memory, despite a network configuration theoretically supportive of local processing, likely results from an inverted-U effect, where the rTMS pushed an already strained and compensating brain system past its optimal level of cortical excitability. The findings highlight the critical role of both baseline brain state and specific cognitive demands in determining the outcomes of neuromodulation, providing crucial insights for the targeted application of rTMS to mitigate cognitive deficits from sleep deprivation.