Purpose: The present study aimed to investigate the effectiveness of personalized low-intensity transcranial magnetic stimulation (Li-TMS) based on quantitative electroencephalography (QEEG) on cognitive flexibility and competitive anxiety in elite track and field athletes.

Methods: Methods: The study was conducted using a quasi-experimental pretest–midtest–posttest design with a sham control group. Twenty elite middle- and long-distance track and field athletes (22.49±1.27 years) were randomly assigned to either an experimental group or a sham group. The experimental group received eight sessions of personalized Li-TMS based on QEEG. Cognitive flexibility was assessed using the Intra/Extra Dimensional Set Shift (IED) task from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Competitive anxiety was assessed using the Revised Competitive State Anxiety Inventory-2 (CSAI-2R), including the cognitive anxiety and somatic anxiety subscales. Data were analyzed using mixed-design repeated-measures ANOVA followed by Bonferroni post hoc tests.

Results: Significant time × group interaction effects were found for total trials (F(2,36)=16.05, P<0.001), total errors (F(2,36)=120.82, P<0.002), cognitive anxiety (F(2,36)=78.08, P<0.001), and somatic anxiety (F(2,36)=157.85, P<0.001). Bonferroni post hoc analyses demonstrated significant improvements in cognitive flexibility and significant reductions in both cognitive and somatic anxiety following the intervention in the experimental group.

Conclusion: Li-TMS was associated with improved cognitive performance and reduced cognitive and somatic competitive anxiety compared with sham stimulation. These findings support the potential application of QEEG-guided Li-TMS in sports neuroscience. However, further comparative studies including a standard stimulation protocol are needed to determine whether QEEG-guided personalization provides additional benefits.