A comparison of relative-frequency and threshold-hunting methods to determine stimulus intensity in transcranial magnetic stimulation

► Evaluated the latest International Federation of Clinical Neurophysiology recommendation for determining motor threshold. ► Adaptive threshold-hunting (PEST) determined threshold with fewer stimuli and with comparable results to the Rossini–Rothwell relative-frequency method. ► Equivalent results...

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Veröffentlicht in:Clinical neurophysiology Jg. 124; H. 4; S. 708 - 712
Hauptverfasser: Silbert, B.I., Patterson, H.I., Pevcic, D.D., Windnagel, K.A., Thickbroom, G.W.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Netherlands Elsevier Ireland Ltd 01.04.2013
Schlagworte:
Adolescent
Adult
Cross-Over Studies
Data Interpretation, Statistical
Electromyography
Evoked Potentials, Motor - physiology
Female
Humans
IFCN
Male
Motor Cortex - physiology
Neurology
PEST
Rossini–Rothwell
Threshold
Transcranial magnetic stimulation
Transcranial Magnetic Stimulation - methods
Young Adult
IFCN
Transcranial magnetic stimulation
PEST
Rossini–Rothwell
Threshold
ISSN:1388-2457, 1872-8952, 1872-8952
Online-Zugang:Volltext
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Zusammenfassung:► Evaluated the latest International Federation of Clinical Neurophysiology recommendation for determining motor threshold. ► Adaptive threshold-hunting (PEST) determined threshold with fewer stimuli and with comparable results to the Rossini–Rothwell relative-frequency method. ► Equivalent results are obtained when targeting a supra-threshold MEP amplitude (1mV). Stimulation intensity (SI) in transcranial magnetic stimulation is commonly set in relation to motor threshold (MT), or to achieve a motor-evoked potential (MEP) of predefined amplitude (usually 1mV). Recently, IFCN recommended adaptive threshold-hunting over the previously endorsed relative-frequency method. We compared the Rossini–Rothwell (R–R) relative-frequency method to an adaptive threshold-hunting method based on parameter estimation by sequential testing (PEST) for determining MT and the SI to target a MEP amplitude of 1mV (I1mV). In 10 healthy controls we determined MT and I1mV with R–R and PEST using a blinded crossover design, and performed within-session serial PEST measurements of MT. There was no significant difference between methods for MT (52.6±2.6% vs. 53.7±3.1%; p=0.302; % maximum stimulator output; R–R vs. PEST, respectively) or I1mV (66.7±3.0% vs. 68.8±3.8%; p=0.146). There was strong correlation between R–R and PEST estimates for both MT and I1mV. R–R required significantly more stimuli than PEST. Serial measurements of MT with PEST were reproducible. PEST has the advantage of speed without sacrificing precision when compared to the R–R method, and is adaptable to other SI targets. Our results in healthy controls add to increasing evidence in favour of adaptive threshold-hunting methods for determining SI.
Bibliographie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:1388-2457
1872-8952
1872-8952
DOI:10.1016/j.clinph.2012.09.018