Towards assessing corticospinal excitability bilaterally: Validation of a double-coil TMS method

J Neurosci Methods. 2018 Jan 1;293:162-168. doi: 10.1016/j.jneumeth.2017.09.016. Epub 2017 Sep 27.


Background: For several decades, Transcranial magnetic stimulation (TMS) has been used to monitor corticospinal excitability (CSE) changes in various contexts. Habitually, single-coil TMS is applied over one primary motor cortex (M1), eliciting motor-evoked potentials (MEPs) in a contralateral limb muscle, usually a hand effector. However, in many situations, it would be useful to obtain MEPs in both hands simultaneously, to track CSE bilaterally. Such an approach requires stimulating both M1 concurrently while avoiding interference between the two descending stimuli.

New method: We examined MEPs obtained at rest using a double-coil TMS approach where the two M1 are stimulated with a 1ms inter-pulse interval (double-coil1ms). MEPs were acquired using double-coil1ms (MEPdouble) or single-coil (MEPsingle) TMS, at five different intensities of stimulation (100, 115, 130, 145 or 160% of the resting motor threshold, rMT). Given the 1ms inter-pulse interval in double-coil1ms trials, MEPdouble were either evoked by a 1st (MEPdouble-1) or a 2nd (MEPdouble-2) TMS pulse.

Results: All MEPTYPE (MEPTYPE=MEPsingle, MEPdouble-1 and MEPdouble-2) were equivalent, regardless of the hand within which they were elicited, the intensity of stimulation or the pulse order.

Comparison with existing method: This method allows one to observe state-related CSE changes for the two hands simultaneously on a trial-by-trial basis.

Conclusion: These results infer the absence of any neural interactions between the two cortico-spinal volleys with double-coil1ms TMS. Hence, this technique can be reliably used to assess CSE bilaterally, opening new research perspectives for scientists interested in physiological markers of activity in the motor output system.

Keywords: Bimanual; Electromyography; Motor-evoked potentials; Paired-pulse; Primary motor cortex; Transcallosal interactions; Transcranial magnetic stimulation.

Publication types

  • Validation Study

MeSH terms

  • Electromyography
  • Evoked Potentials, Motor / physiology
  • Female
  • Functional Laterality
  • Hand / physiology
  • Humans
  • Male
  • Motor Cortex / physiology*
  • Muscle, Skeletal / physiology
  • Pyramidal Tracts / physiology*
  • Regression Analysis
  • Rest
  • Transcranial Magnetic Stimulation / instrumentation
  • Transcranial Magnetic Stimulation / methods*
  • Young Adult