Variability of motor cortical excitability using a novel mapping procedure

The purpose of this study was to assess the reliability of a novel TMS motor cortex mapping procedure. The procedure was designed to take less time and be more clinically useful by delivering fewer MEPS over fewer skull locations. Resting motor evoked potentials (MEPs) were recorded from the first dorsal interosseus muscle of 6 individuals over a fixed 15-point grid. Mean MEP amplitudes, map center of gravity (CoG), and stimulus–response characteristics were assessed before and after a 30-min rest session. As a novel feature, subregions of the map were analyzed for regions of highest test–retest reliability for use as a global measure of cortical excitability. Mean MEP amplitudes between sessions were highly reliable (ICC = 0.90–0.92). Reproducibility of MEPs was highest along an axis approximately 45° to the nasion–inion. Stimulus–response MEP amplitudes showed moderate to high reliability (ICC 0.54–0.95). Mean CoG shift between sessions was 2.79 ± 1.2 mm. This mapping procedure is reliable and allows efficient assessment of motor cortex excitability.

► MEP amplitudes were highly reliable using a newly developed technique for examining motor maps.
► MEP amplitudes along an axis ∼45° to the nasion–inion were most reliable.
► Stimulus–response MEP amplitudes showed moderate to high reliability.
► Center of Gravity shifts between sessions were minimal.