Intra- and intersession reliability of ipsilateral motor pathway excitability measurements in male and female adults

J Appl Physiol (1985). 2026 May 1;140(5):1389-1402. doi: 10.1152/japplphysiol.01122.2025. Epub 2026 Apr 14.

Abstract

Examining ipsilateral motor pathways, purportedly reflecting cortico-reticulospinal excitability, has received growing attention in rehabilitation and exercise science. However, the reliability of measures used to assess its excitability, such as ipsilateral motor-evoked potential (iMEP), remains largely unverified. Fifty-three participants (26 males and 27 females) completed two laboratory visits 1 wk apart. Dominant arm contralateral MEP (cMEP) and nondominant arm iMEP, along with maximal compound muscle action potential (M-max), from both m.biceps brachii were recorded. After determination of preacher curl one-repetition maximum (1-RM), participants performed four sets of five preacher curl repetitions at 30% of 1-RM, with 30 s rest between sets. Transcranial magnetic stimulation was delivered at 100% of maximum stimulator output during the concentric phase of the contraction (110° of flexion). Intraclass correlation coefficients (ICCs) for all variables indicated good-to-excellent intrasession (ICC ≥ 0.88) and intersession reliability (ICC ≥ 0.80). Notably, the ICCs for iMEP and cMEP amplitudes demonstrated excellent reliability for both intrasession (ICC ≥ 0.98) and intersession (ICC ≥ 0.91) measurements. iMEP presence was reliable (ICC = 0.87) and had similar variability as iMEP amplitude. However, ICC for iMEP/cMEP ratio (ICAR) was 0.83, and there was substantial intersession variability (coefficient of variation = 56.8%; relative standard error of measurement = 31.7%). Sex did not influence the reliability of the measures. iMEP and cMEP measured during preacher curl exhibited excellent intrasession and good-to-excellent intersession reliability in both sexes. Thus, this test is a useful tool to evaluate cortico-reticulospinal and corticospinal excitability in humans, although caution is advised if using ICAR.NEW & NOTEWORTHY The cortico-reticulospinal tract is now thought to be an important regulator of voluntary force, but there is a shortage of accepted measures assessing its excitability. Here, we used transcranial magnetic stimulation to elicit ipsilateral motor-evoked potentials (iMEPs) in a large group of healthy males and females. We demonstrated good-to-excellent reproducibility across all iMEP characteristics (including latency, amplitude, and presence) in both sexes. iMEPs are, thus, a useful tool to assess cortico-reticulospinal excitability.

Keywords: bicep curl; cortico-reticulospinal excitability; ipsilateral motor evoked potential; reproducibility; sex.

MeSH terms

  • Adult
  • Electromyography / methods
  • Evoked Potentials, Motor* / physiology
  • Female
  • Humans
  • Male
  • Motor Cortex* / physiology
  • Muscle Contraction / physiology
  • Muscle, Skeletal / physiology
  • Pyramidal Tracts* / physiology
  • Reproducibility of Results
  • Transcranial Magnetic Stimulation / methods
  • Young Adult