Probing interhemispheric dorsal premotor-primary motor cortex interactions with threshold hunting transcranial magnetic stimulation

Objective: To characterise the effect of altering transcranial magnetic stimulation parameters on the magnitude of interhemispheric inhibition (IHI) from dorsal premotor (PMd) to primary motor cortex (M1). Method: We used a fully automated adaptive threshold hunting paradigm to quantify PMd-M1 IHI across a range of conditioning stimulus (CS) intensities (90%, 110%, 130% of resting motor threshold, rMT) and interstimulus intervals (ISIs) (8, 10, 40 ms). M1-M1 IHI was examined with CS intensities of 110%, 120%, and 130% rMT and ISIs of 10 and 40 ms. Two test coil orientations (inducing posterior-anterior or anterior-posterior current) were used. Results: PMd-M1 IHI was obtained consistently with posterior-anterior (but not anterior-posterior) test stimuli and increased with CS intensity. M1-M1 IHI was expressed across all conditions and increased with CS intensity when posterior-anterior but not anterior-posterior induced current was used. Conclusions: The expression of PMd-M1 IHI is contingent on test coil orientation (requiring posterioranterior induced current) and increases as a function of CS intensity. The expression of M1-M1 IHI is not dependent on test coil orientation. Significance: We defined a range of parameters that elicit reliable PMd-M1 IHI. This (threshold hunting) methodology may provide a means to quantify premotor-motor pathology and reveal novel quantitative biomarkers. (C) 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).