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Repeated right dorsolateral prefrontal continuous theta-burst stimulation improves subjective sleep quality and athletic performance in athletes with chronic insomnia

In a randomized, sham-controlled trial, 35 male athletes with chronic insomnia received either active cTBS or sham stimulation once daily for 7 days. Active cTBS produced a greater reduction in PSQI global score than sham, and improved countermovement jump height, 50 m sprint performance, and agility. Resting-state EEG microstate dynamics were also altered, but these changes are exploratory and not causal.

Last updated: Aug 29, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score42/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Repeated Continuous Theta-Burst Stimulation Modulates Resting-State EEG Microstate Dynamics in Athletes with Chronic Insomnia.

observational

He X, Cheng B, He H, Zhao L, Li Y · Brain sciences (2026)

Participants: N/A
Duration: 7 days
Intervention: Right dorsolateral prefrontal continuous theta-burst stimulation (cTBS) once daily for 7 days
Outcome: Pittsburgh Sleep Quality Index (PSQI) global score, countermovement jump height, 50 m sprint time, Illinois Agility Test performance, resting-state EEG microstate temporal parameters and transition probabilities
Effect Size: N/A
Population: Male athletes with chronic insomnia (mean age not specified; 35 randomized, 32 with usable EEG data)

Result:

PubMed: 42651151DOI: 10.3390/brainsci16080841

Mechanism Graph

cTBS modulates cortical excitability in right dorsolateral prefrontal cortex
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Alters resting-state EEG microstate dynamics (increased microstate C duration/contribution, reduced microstate A occurrence)
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Changes directional transitions among microstates B, C, and D
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Associated with improved subjective sleep quality and athletic performance

Limitations

  • ⚠Exploratory nature of EEG findings; microstate changes are potential correlates, not causal evidence
  • ⚠Small sample size (35 randomized, 32 analyzed) and all-male sample limits generalizability
  • ⚠No objective sleep measures (e.g., polysomnography) were used; only subjective PSQI
  • ⚠Short intervention duration (7 days) and lack of follow-up assessment

Frequently Asked Questions

What is cTBS?▼

Continuous theta-burst stimulation (cTBS) is a form of repetitive transcranial magnetic stimulation that uses bursts of pulses at theta frequency to modulate cortical excitability, typically producing inhibitory effects.

How long does the treatment last?▼

The study used once-daily sessions for 7 days, but the abstract does not specify the duration of each session or the persistence of effects after treatment.

Does cTBS improve athletic performance?▼

Yes, active cTBS improved countermovement jump height, 50 m sprint performance, and agility compared to sham, which only improved sprint performance.

What are EEG microstates?▼

EEG microstates are brief, quasi-stable patterns of brain electrical activity that reflect large-scale network dynamics. Changes in their temporal parameters and transitions can indicate altered brain function.

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References

  1. 1.He X, Cheng B, He H, Zhao L, Li Y. "Repeated Continuous Theta-Burst Stimulation Modulates Resting-State EEG Microstate Dynamics in Athletes with Chronic Insomnia.." Brain sciences, 2026. PMID: 42651151 DOI: 10.3390/brainsci16080841
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.