Comparison between adaptive and fixed stimulus paired-pulse transcranial magnetic stimulation (ppTMS) in normal subjects

Clinical Neurophysiology Practice
Å AmandussonH W Axelson

Abstract

Paired-pulse TMS (ppTMS) examines cortical excitability but may require lengthy test procedures and fine tuning of stimulus parameters due to the inherent variability of the elicited motor evoked potentials (MEPs) and their tendency to exhibit a 'ceiling/floor effects' in inhibition trials. Aiming to overcome some of these limitations, we implemented an 'adaptive' ppTMS protocol and compared the obtained excitability indices with those from 'conventional' fixed-stimulus ppTMS. Short- and long interval intracortical inhibition (SICI and LICI) as well as intracortical facilitation (ICF) were examined in 20 healthy subjects by adaptive ppTMS and fixed-stimulus ppTMS. The test stimulus intensity was either adapted to produce 500 μV MEPs (by a maximum likelihood strategy in combination with parameter estimation by sequential testing) or fixed to 120% of resting motor threshold (rMT). The conditioning stimulus was 80% rMT for SICI and ICF and 120% MT for LICI in both tests. There were significant (p < 0.05) intraindividual correlations between the two methods for all excitability measures. There was a clustering of SICI and LICI indices near maximal inhibition ('ceiling effect') in fixed-stimulus ppTMS which was not observed for adap...Continue Reading

Citations

Jul 11, 2019·Experimental Brain Research·Ronan A MooneyWinston D Byblow
Mar 31, 2020·Experimental Brain Research·John CirilloWinston D Byblow
Aug 3, 2018·The European Journal of Neuroscience·Ronan A MooneyWinston D Byblow
Aug 5, 2021·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Daniel T CorpUNKNOWN 'Big TMS Data Collaboration'

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