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Updated: Jun 26, 2026

Assessing Primary Motor Cortex Excitability and Excitability Modulation by Pairing Transcranial Magnetic Stimulation with Electromyography
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Quadriceps Corticospinal and Intracortical Excitability Assessment Using Transcranial Magnetic Stimulation: A

Liam C Tapsell1, Molly E Coventry1, Colin Sylvester1,2

  • 1Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.

Neurosci
|June 25, 2026
PubMed
Summary
This summary is machine-generated.

This study found that measures of quadriceps corticospinal excitability and intracortical excitability using transcranial magnetic stimulation (TMS) demonstrate good to excellent test-retest reliability in healthy adults. These findings support the use of TMS for neurophysiological research on the quadriceps muscles.

Keywords:
corticospinal excitabilityintracortical facilitationintracortical inhibitionlower limbmotor evoked potentialmotor thresholdrectus femoris

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Area of Science:

  • Neuroscience
  • Motor Control
  • Human Physiology

Background:

  • Transcranial magnetic stimulation (TMS) is a key tool for investigating corticospinal and intracortical excitability.
  • Previous TMS reliability studies have primarily focused on upper limb muscles.
  • Understanding the reliability of TMS measures in lower limb muscles, like the quadriceps, is crucial for advancing research in this area.

Purpose of the Study:

  • To evaluate the test-retest reliability of quadriceps corticospinal excitability and intracortical excitability.
  • To determine the reliability of specific TMS parameters including active motor threshold (AMT), motor evoked potential (MEP) amplitude, short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF).

Main Methods:

  • A test-retest observational cohort study involving 12 healthy adults.
  • Participants underwent two laboratory sessions with electrodes placed on the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM).
  • TMS was used to assess AMT, MEP amplitude, SICI, and ICF, with results averaged across 10 trials for each measure.

Main Results:

  • Good to excellent reliability (ICC ≥ 0.820) was observed for mean and median MEP amplitudes and RF AMT (ICC = 0.991).
  • SICI showed good reliability for RF and VL, moderate for VM, and non-significant for VL median measure.
  • ICF demonstrated excellent reliability for mean measures across all muscles and median RF, with good to moderate reliability for VL and VM median measures.

Conclusions:

  • The mean values of quadriceps corticospinal and intracortical excitability measures exhibit good or excellent test-retest reliability across all tested muscles (except SICI of the VM).
  • These findings provide essential reliability data for TMS applications in quadriceps neurophysiological research.
  • This study expands the understanding of TMS reliability beyond the upper limbs into the quadriceps femoris muscle group.