PMID- 29971634
OWN - NLM
STAT- MEDLINE
DCOM- 20190314
LR  - 20190314
IS  - 1573-6792 (Electronic)
IS  - 0896-0267 (Linking)
VI  - 31
IP  - 6
DP  - 2018 Nov
TI  - Efficient Mapping of the Motor Cortex with Navigated Biphasic Paired-Pulse 
      Transcranial Magnetic Stimulation.
PG  - 963-971
LID - 10.1007/s10548-018-0660-9 [doi]
AB  - Navigated transcranial magnetic stimulation (nTMS) can be applied to locate 
      cortical muscle representations. Usually, single TMS pulses are targeted to the 
      motor cortex with the help of neuronavigation and by measuring motor evoked 
      potential (MEP) amplitudes from the peripheral muscles. The efficacy of 
      single-pulse TMS to induce MEPs has been shown to increase by applying 
      facilitatory paired-pulse TMS (ppTMS). Therefore, the aim was to study whether 
      the facilitatory ppTMS could enable more efficient motor mapping. Biphasic 
      single-pulse TMS and ppTMS with inter-stimulus intervals (ISIs) of 1.4 and 2.8 ms 
      were applied to measure resting motor thresholds (rMTs) as a percentage of the 
      maximal stimulator output and to determine the cortical representation areas of 
      the right first dorsal interosseous muscle in healthy volunteers. The areas, 
      shapes, hotspots, and center of gravities (CoGs) of the representations were 
      calculated. Biphasic ppTMS with ISI of 1.4 ms resulted in lower rMTs than those 
      obtained with the other protocols (p = 0.001). With ISI of 2.8 ms, rMT was lower 
      than with single-pulse TMS (p = 0.032). The ppTMS mapping was thus performed with 
      lower intensity than when using single-pulse TMS. The areas, shapes, hotspots, 
      and CoGs of the muscle representations were in agreement. Hence, biphasic ppTMS 
      has potential in the mapping of cortical hand representations in healthy 
      individuals as an alternative for single-pulses, but with lower stimulation 
      intensity by utilizing cortical facilitatory mechanism. This could improve 
      application of nTMS in subjects with low motor tract excitability.
FAU - Pitkanen, Minna
AU  - Pitkanen M
AUID- ORCID: 0000-0003-1716-3909
AD  - Department of Clinical Neurophysiology, Kuopio University Hospital, P. O. Box 
      100, 70029 KYS, Kuopio, Finland. minna.pitk@gmail.com.
AD  - Department of Neuroscience and Biomedical Engineering, Aalto University School of 
      Science, Espoo, Finland. minna.pitk@gmail.com.
FAU - Kallioniemi, Elisa
AU  - Kallioniemi E
AD  - Department of Clinical Neurophysiology, Kuopio University Hospital, P. O. Box 
      100, 70029 KYS, Kuopio, Finland.
AD  - Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
AD  - Brain Stimulation Laboratory, Department of Psychiatry and Behavioral Sciences, 
      Stanford University School of Medicine, Stanford, USA.
FAU - Jarnefelt, Gustaf
AU  - Jarnefelt G
AD  - Nexstim Plc, Helsinki, Finland.
FAU - Karhu, Jari
AU  - Karhu J
AD  - Nexstim Plc, Helsinki, Finland.
FAU - Julkunen, Petro
AU  - Julkunen P
AD  - Department of Clinical Neurophysiology, Kuopio University Hospital, P. O. Box 
      100, 70029 KYS, Kuopio, Finland.
AD  - Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180703
PL  - United States
TA  - Brain Topogr
JT  - Brain topography
JID - 8903034
SB  - IM
MH  - Adult
MH  - Brain Mapping/*methods
MH  - Electromyography
MH  - Evoked Potentials, Motor/*physiology
MH  - Female
MH  - Hand
MH  - Healthy Volunteers
MH  - Humans
MH  - Male
MH  - Motor Cortex/*physiology
MH  - Muscle, Skeletal
MH  - Neuronavigation
MH  - Rest
MH  - Transcranial Magnetic Stimulation/*methods
MH  - Young Adult
OTO - NOTNLM
OT  - Motor cortex
OT  - Motor evoked potential
OT  - Motor mapping
OT  - Navigated transcranial magnetic stimulation
OT  - Short-interval intracortical facilitation
EDAT- 2018/07/05 06:00
MHDA- 2019/03/15 06:00
CRDT- 2018/07/05 06:00
PHST- 2017/12/08 00:00 [received]
PHST- 2018/06/29 00:00 [accepted]
PHST- 2018/07/05 06:00 [pubmed]
PHST- 2019/03/15 06:00 [medline]
PHST- 2018/07/05 06:00 [entrez]
AID - 10.1007/s10548-018-0660-9 [pii]
AID - 10.1007/s10548-018-0660-9 [doi]
PST - ppublish
SO  - Brain Topogr. 2018 Nov;31(6):963-971. doi: 10.1007/s10548-018-0660-9. Epub 2018 
      Jul 3.