Optimising Paediatric Brain Mapping with Single-Pulse Transcranial Magnetic Stimulation: A New Protocol and Insights

Rudraksh Banga; Aliya Mufti; Suman Jain; Sheffali Gulati; Kanwal Preet Kochhar; Md Iqbal Alam; Sanjay Wadhwa; Kapil Sikka; Rohit Saxena

doi:10.1177/09727531251340157

Optimising Paediatric Brain Mapping with Single-Pulse Transcranial Magnetic Stimulation: A New Protocol and Insights

Ann Neurosci. 2025 Jun 12:09727531251340157. doi: 10.1177/09727531251340157. Online ahead of print.

Authors

Rudraksh Banga¹, Aliya Mufti¹, Suman Jain¹, Sheffali Gulati², Kanwal Preet Kochhar¹, Md Iqbal Alam³, Sanjay Wadhwa⁴, Kapil Sikka⁵, Rohit Saxena⁶

Affiliations

¹ Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.
² Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
³ Department of Physiology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.
⁴ Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India.
⁵ Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India.
⁶ Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Background: Single-pulse paradigms of transcranial magnetic stimulation (TMS) have been used to understand cortical excitability and reorganisation.

Purpose: This study aims to develop a protocol for mapping of the primary motor cortex (M1) using single-pulse TMS in children.

Methods: A 11×11 manual grid was created around the hotspot of abductor pollicis brevis (APB). Motor-evoked potential (MEP) amplitude was recorded from 41 sites around the hotspot of APB and analysed.

Results: Maximum MEP amplitude was recorded from the hotspot that reduced as distance increased. Heat maps generated were consistent among the participants.

Conclusion: In children, 41 single-pulse TMS stimulations with interstimulus interval of two seconds provide reliable information about motor maps. This procedure will aid in understanding cortical reorganisation in children with neurodevelopmental disorders.

Keywords: Motor cortex maps; cerebral palsy; cortical reorganisation; motor-evoked potential; transcranial magnetic stimulation.