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Updated: Jul 19, 2026
Measuring Contralateral Silent Period Induced by Single-Pulse Transcranial Magnetic Stimulation to Investigate M1 Corticospinal Inhibition
Published on: August 23, 2022
Ipsilateral silent period: a marker of callosal conduction abnormality in early relapsing-remitting multiple
Patrick Jung1, Astrid Beyerle, Marek Humpich
1Department of Neurology, Johann Wolfgang Goethe-University, Schleusenweg 2-16, D-60528 Frankfurt am Main, Germany.
Objective:
The corpus callosum (CC) is commonly affected in multiple sclerosis (MS). The ipsilateral silent period (iSP) is a putative electrophysiological marker of callosal demyelination. The purpose of this study was to re-assess, under recently established optimised protocol conditions [Jung P., Ziemann U. Differences of the ipsilateral silent period in small hand muscles. Muscle Nerve in press.], its diagnostic sensitivity in MS, about which conflicting results were reported in previous studies.
Methods:
ISP measurements (onset, duration, and depth) were obtained in the abductor pollicis brevis (APB) muscle of either hand in 49 patients with early relapsing-remitting MS (RRMS) (mean EDSS, 1.3). Standard central motor conduction times to the APB (CMCT(APB)) and tibial anterior muscles (CMCT(TA)), and magnetic resonance images (MRI) were also obtained.
Results:
ISP measurements showed a similar diagnostic sensitivity (28.6%) as CMCT(APB) (24.5%), while diagnostic sensitivities of CMCT(TA) (69.4%) and MRI of the CC (78.6%) were much higher. Prolongation of iSP duration was the most sensitive single iSP measure. ISP prolongation occurred more frequently when CMCT(APB) to the same hand was also prolonged (40.0% vs. 8.4%, p<0.0001). The correlation between iSP duration and CMCT(APB) was significant (Pearson's r=0.24, p<0.02), suggesting that iSP duration can be contaminated by demyelination of the contralateral corticospinal tract. ISP duration did not correlate with MRI abnormalities of the CC.
Conclusions:
ISP measures are neither a sensitive nor a specific marker of callosal conduction abnormality in early RRMS.
