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Updated: Jun 15, 2025

Measuring and Manipulating Functionally Specific Neural Pathways in the Human Motor System with Transcranial Magnetic Stimulation
Published on: February 23, 2020
Repeated spaced cortical paired associative stimulation promotes additive plasticity in the human parietal-motor
Elana R Goldenkoff1, Joseph A Deluisi1, Taraz G Lee2
1School of Kinesiology, University of Michigan, Ann Arbor, USA.
Objective:
Repeated spaced sessions of repetitive transcranial magnetic stimulation (TMS) to the human primary motor cortex can lead to dose-dependent increases in motor cortical excitability. However, this has yet to be demonstrated in a defined cortical circuit. We aimed to examine the effects of repeated spaced cortical paired associative stimulation (cPAS) on excitability in the motor cortex.
Methods:
cPAS was delivered to the primary motor cortex (M1) and posterior parietal cortex (PPC) with two coils. In the multi-dose condition, three sessions of cPAS were delivered 50-min apart. The single-dose condition had one session of cPAS, followed by two sessions of a control cPAS protocol. Motor-evoked potentials were evaluated before and up to 40 min after each cPAS session as a measure of cortical excitability.
Results:
Compared to a single dose of cPAS, motor cortical excitability significantly increased after multi-dose cPAS. Increasing the number of cPAS sessions resulted in a cumulative, dose-dependent effect on excitability in the motor cortex, with each successive cPAS session leading to notable increases in potentiation.
Conclusion:
Repeated spaced cPAS sessions summate to increase motor cortical excitability induced by single cPAS.
Significance:
Repeated spaced cPAS could potentially restore abilities lost due to disorders like stroke.
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