TY - JOUR
T1 - Optimal number of pulses as outcome measures of neuronavigated transcranial magnetic stimulation
AU - Chang, Won Hyuk
AU - Fried, Peter J.
AU - Saxena, Sadhvi
AU - Jannati, Ali
AU - Gomes-Osman, Joyce
AU - Kim, Yun Hee
AU - Pascual-Leone, Alvaro
N1 - Funding Information:
This study was supported in part by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) ( NRF-2014R1A2A1A01005128 ), the Sidney R. Baer Jr. Foundation, the National Institutes of Health ( R01HD069776 , R21 NS082870 , R01NS073601 , R21 MH099196 , R21 NS085491 , R21 HD07616 ), and Harvard Catalyst | The Harvard Clinical and Translational Science Center (NCRR and the NCATS NIH, UL1 RR025758 ). The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, the National Institutes of Health, or the Sidney R. Baer Jr. Foundation.
Publisher Copyright:
© 2016 International Federation of Clinical Neurophysiology
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Objective Identify the optimal number of pulses necessary to achieve reliable measures of motor evoked potentials (MEPs) in transcranial magnetic stimulation (TMS) studies. Methods Retrospective data was obtained from 54 healthy volunteers (30 men, mean age 61.7 ± 13.1 years) who as part of prior studies had completed three blocks of 30 consecutive TMS stimuli using neuronavigation. Data from four protocols were assessed: single-pulse TMS for measures of amplitude and latency of MEPs; paired-pulse TMS for short-interval intracortical inhibition (sICI) and intracortical facilitation (ICF); and single-pulse TMS to assess the effects of intermittent theta burst stimulation (iTBS). Two statistical methods were used: an internal consistency analysis and probability of inclusion in the 95% confidence interval (CI) around the mean MEPs amplitude. Results For single-pulse TMS, the minimum number of pulses needed to achieve reliable amplitude and latency MEPs measures was 21 and 23, respectively. For paired-pulse TMS, the minimum number of pulses needed to achieve reliable sICI and ICF measures was 20 and 25, respectively. Finally, the minimum number of pulses needed to achieve reliable amplitude and latency MEPs measures after iTBS was 22 and 23, respectively. Conclusions This study provides guidelines regarding the minimum number of pulses needed to achieve reliable MEPs measurements in various study protocols using neuronavigated TMS. Significance Results from this study have the potential to increase the reliability and quality of future neuronavigated TMS studies.
AB - Objective Identify the optimal number of pulses necessary to achieve reliable measures of motor evoked potentials (MEPs) in transcranial magnetic stimulation (TMS) studies. Methods Retrospective data was obtained from 54 healthy volunteers (30 men, mean age 61.7 ± 13.1 years) who as part of prior studies had completed three blocks of 30 consecutive TMS stimuli using neuronavigation. Data from four protocols were assessed: single-pulse TMS for measures of amplitude and latency of MEPs; paired-pulse TMS for short-interval intracortical inhibition (sICI) and intracortical facilitation (ICF); and single-pulse TMS to assess the effects of intermittent theta burst stimulation (iTBS). Two statistical methods were used: an internal consistency analysis and probability of inclusion in the 95% confidence interval (CI) around the mean MEPs amplitude. Results For single-pulse TMS, the minimum number of pulses needed to achieve reliable amplitude and latency MEPs measures was 21 and 23, respectively. For paired-pulse TMS, the minimum number of pulses needed to achieve reliable sICI and ICF measures was 20 and 25, respectively. Finally, the minimum number of pulses needed to achieve reliable amplitude and latency MEPs measures after iTBS was 22 and 23, respectively. Conclusions This study provides guidelines regarding the minimum number of pulses needed to achieve reliable MEPs measurements in various study protocols using neuronavigated TMS. Significance Results from this study have the potential to increase the reliability and quality of future neuronavigated TMS studies.
KW - Intracortical facilitation
KW - Intracortical inhibition
KW - Motor evoked potentials
KW - Reliability
KW - Transcranial magnetic stimulation
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U2 - 10.1016/j.clinph.2016.04.001
DO - 10.1016/j.clinph.2016.04.001
M3 - Article
C2 - 27156431
AN - SCOPUS:84964815952
VL - 127
SP - 2892
EP - 2897
JO - Electroencephalography and Clinical Neurophysiology - Electromyography and Motor Control
JF - Electroencephalography and Clinical Neurophysiology - Electromyography and Motor Control
SN - 1388-2457
IS - 8
ER -