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Resting Motor Threshold, MEP and TEP Variability During Daytime.

Esther M Ter Braack1, Annika A de Goede2, Michel J A M van Putten2,3

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Time of day does not significantly alter transcranial magnetic stimulation (TMS) readouts like resting motor threshold (RMT) or motor evoked potentials (MEP). TMS evoked potentials (TEP) are reproducible throughout the day, indicating stable cortical excitability.

Keywords:
Daytime variationEEGTMSTMS evoked potential

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Area of Science:

  • Neuroscience
  • Physiology
  • Biomedical Engineering

Background:

  • Circadian rhythms influence human physiological processes.
  • Understanding daily variations in cortical excitability is crucial for reliable transcranial magnetic stimulation (TMS) assessments.
  • Daytime variations in TMS metrics may necessitate adjustments in scheduling follow-up measurements.

Purpose of the Study:

  • To investigate the impact of time of day on resting motor threshold (RMT), motor evoked potential (MEP) amplitude, and TMS evoked potential (TEP) in healthy individuals.
  • To determine the reproducibility of TMS measures across multiple sessions within a single day.

Main Methods:

  • 16 healthy subjects underwent TMS-EMG-EEG recordings.
  • Stimulation was delivered to both motor cortices at 110% RMT intensity across five sessions daily (8:00 AM to 6:00 PM).
  • TEP waveforms were analyzed using cluster-based permutation analysis; RMT and MEP amplitude were compared using rmANOVA.

Main Results:

  • No significant differences were observed in RMT, MEP amplitude, or overall TEP across the five daily sessions.
  • A minor increase in left-side N100 amplitude was noted at 3:30 PM compared to 10:30 AM.
  • Intra-individual variation in TEP (P30, N100) was low and less than inter-individual variation, indicating high reproducibility.

Conclusions:

  • Cortical excitability, as measured by RMT, MEP, and TEP, demonstrates high reproducibility throughout the day in healthy subjects.
  • Time of day does not appear to be a significant confounding factor for TMS measurements in this cohort.
  • The findings support the reliability of TMS assessments irrespective of the time of day they are performed.