biostudies-literatureFeng ZJBundesministerium für Bildung und Forschung (Federal Ministry of Education and Research)European Research CouncilDeutsche Forschungsgemeinschaft (German Research Foundation)Max-Planck-Gesellschaft (Max Planck Society)79https://www.ebi.ac.uk/biostudies/studies/S-EPMC12923538biostudies-literatureUnknown16(1)The dorsolateral prefrontal cortex (DLPFC) is a principal target for transcranial magnetic stimulation (TMS) in treating major depressive disorder, with therapeutic effects thought to be mediated by its connectivity with the subgenual anterior cingulate cortex. As both regions are involved in autonomic regulation, short-term heart rate changes following DLPFC stimulation may serve as physiological markers to identify stimulation targets. We employed neuro-cardiac guided TMS in a cohort of healthy participants to examine the effects of stimulation intensity and DLPFC target specificity on heart-brain coupling (HBC). We used generalized additive models to assess nonlinear effects of stimulation intensity and target location on HBC, while accounting for pain ratings and other side effects. InTranslational psychiatryTarget-Specificity and repeatability in neuro-cardiac-guided TMS for heart-brain coupling.PMC1292353801GQ2201HA 6314/3-1, HA 6314/4-2, HA 6314/9-1Lise Meitner Excellence fundingERC-2021-COG 101043747Jing YFeng ZJGerardos GNumssen OKnosche TRMartin SWeise KMartin CHartwigsen GfalseTarget-Specificity and repeatability in neuro-cardiac-guided TMS for heart-brain coupling.The dorsolateral prefrontal cortex (DLPFC) is a principal target for transcranial magnetic stimulation (TMS) in treating major depressive disorder, with therapeutic effects thought to be mediated by its connectivity with the subgenual anterior cingulate cortex. As both regions are involved in autonomic regulation, short-term heart rate changes following DLPFC stimulation may serve as physiological markers to identify stimulation targets. We employed neuro-cardiac guided TMS in a cohort of healthy participants to examine the effects of stimulation intensity and DLPFC target specificity on heart-brain coupling (HBC). We used generalized additive models to assess nonlinear effects of stimulation intensity and target location on HBC, while accounting for pain ratings and other side effects. In2026-01-01T00:00:00Z2026 Feb2026-07-16T14:52:18.71Z2026-07-09T11:03:01.888ZS-EPMC129235384165449610.1038/s41398-026-03879-w