Co-registration of transcranial magnetic stimulation (TMS) and electroencephalography (EEG) is a new, promising method for assessing cortical excitability and connectivity. Using this technique, a TMS evoked potential (TEP) can be induced and registered with the EEG. However, the TEP contains an early, short lasting artifact due to the magnetic pulse, and a second artifact, which depends on the location of stimulation and can last up to 40 ms. Different causes for this second artifact have been suggested in literature. In this study, we used principal component analysis (PCA) to suppress both the first and second artifact in TMS-EEG data. Single pulse TMS was applied at the motor and visual cortex in 18 healthy subjects. PCA using singular value decomposition was applied on single trials to suppress the artifactual components. A large artifact suppression was realized after the removal of the first five PCA components, thereby revealing early TEP peaks, with only a small suppression of later TEP components. The spatial distribution of the second artifact suggests that it is caused by electrode movement due to activation of the temporal musculature. In conclusion, we showed that PCA can be used to reduce TMS-induced artifacts in EEG, thereby revealing components of the TMS evoked potential.

Function-guided navigation is commonly used when assessing cortical excitability using transcranial magnetic stimulation (TMS). However, the required accuracy, stability and the effect of a change in coil positioning are not entirely known. This study investigates the accuracy of function-guided navigation for determining the hotspot. Furthermore, it evaluates the effect of a change in coil location on the single and paired pulse excitability measures: motor evoked potential (MEP) amplitude, TMS evoked potential (TEP) and long intracortical inhibition (LICI), and of a change in coil orientation on LICI. Eight healthy subjects participated in the single pulse study, and ten in the paired pulse study. A robot-guided navigation system was used to ensure accurate and stable coil positioning at the motor hotspot as determined using function-guided navigation. In addition, we targeted four locations at 2 mm and four at 5 mm distance around the initially defined hotspot, and we increased and decreased the coil orientation by 10°. In none of the subjects, the largest MEP amplitudes were evoked at the originally determined hotspot, resulting in a poor accuracy of function-guided navigation. At the group level, a change in coil location had no significant effect on the MEP amplitude, TEP, or LICI, and a change in coil orientation did not significantly affected LICI. However, at the subject level significant effects on MEP amplitude, TEP, and LICI were found for changes in coil location or orientation, although absolute differences were relatively small and did not show a consistent pattern. This study indicates that a high accuracy in coil positioning is especially required to measure cortical excitability reliably in individual subjects using single or paired pulse TMS.Electronic supplementary materialThe online version of this article (10.1007/s10548-018-0655-6) contains supplementary material, which is available to authorized users.

Humans show a variation in physiological processes during the day. To reliably assess (changes in) cortical excitability with transcranial magnetic stimulation (TMS), it is relevant to know the natural variation in TMS readouts during the day. In case of significant daytime variations, this should be taken into account when scheduling (follow-up) measurements. This study aims to evaluate the influence of the time of day on the resting motor threshold (RMT), motor evoked potential (MEP) and TMS evoked potential (TEP) in healthy controls. TMS-EMG-EEG was recorded in 16 healthy subjects. At both motor cortices, we administered 75 pulses at an intensity of 110% RMT. Subjects were stimulated during five sessions in one day (8:00 AM, 10:30 AM, 1:00 PM, 3:30 PM and 6:00 PM) while keeping the stimulation intensity constant. We compared the TEP waveforms between the five sessions with a cluster-based permutation analysis, and the RMT and MEP amplitude with rmANOVA. In general there were no significant differences between the five sessions in the RMT, MEP amplitude or TEP. Only for the left side, N100 amplitude was larger at 3:30 PM than 10:30 AM. The standard deviation of the P30 and N100 amplitude was significantly higher between subjects within one session than within single subjects during the day. The TEP is highly reproducible during the day, with a low intra-individual variation compared to the inter-individual variation. In addition, we found no significant variation of the RMT and MEP amplitude between multiple sessions on one day.

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