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Updated: Apr 1, 2026

Assessing Primary Motor Cortex Excitability and Excitability Modulation by Pairing Transcranial Magnetic Stimulation with Electromyography
Published on: October 7, 2025
Somatosensory-evoked potential modulation by quadripulse transcranial magnetic stimulation in patients with benign
Setsu Nakatani-Enomoto1, Ritstuko Hanajima2, Masashi Hamada3
1Department of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan; Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Objective:
In patients with benign myoclonus epilepsy (ME), giant sensory-evoked potential (SEP) reflects the hyperexcitability of the sensory cortex. The aim of this study was to compare the effect of quadripulse transcranial magnetic stimulation (QPS) on the median nerve SEP between ME patients and healthy subjects.
Methods:
Ten healthy volunteers and six ME patients with giant SEP participated in this study. QPSs at interpulse intervals (IPIs) of 5, 30, 50, 100, 500 and 1250 ms were applied over the left primary motor cortex (M1) for 30 min. The peak-to-peak amplitudes of N20 to P25 (N20-P25) and P25 to N33 (P25-N33) components were measured at the left somatosensory cortex.
Results:
In healthy participants, the P25-N33 was bidirectionally modulated by QPS over M1, following the Bienenstock-Cooper-Munro (BCM) theory. The N20-P25 was not affected by any QPSs. In ME patients, the giant P25-N33 was potentiated after any QPSs. Furthermore, the N20-P25 was also potentiated after QPS at IPIs of 5, 30, 50 100 or 500 ms.
Conclusions:
In ME patients, the cascade for long-term depression-like effects may be impaired.
Significance:
The giant SEP was furthermore enhanced by QPS.
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