Portraits and memory: Investigating HF-rTMS effects on episodic recall through a sham-controlled fMRI study

A single session of HF-rTMS over the left DLPFC selectively altered the neural dynamics of episodic memory retrieval for abstract portrait stimuli. Although behavioral performance did not improve-and showed reduced accuracy for previously seen items-stimulation elicited increased activation in hippocampal subregions and early visual cortex during successful retrieval. These findings demonstrate that prefrontal neuromodulation can reshape hippocampal-visual network engagement during episodic recall without concomitant behavioral enhancement, highlighting not only the needed engagement of the left DLPFC, but also the potential dissociation between neural recruitment and memory accuracy when processing complex abstract stimuli.