Fig 1.
Protocol timeline pre- and post- repetitive transcranial magnetic stimulation (rTMS) application.
Baseline motor evoked potential (MEP) amplitudes were obtained by applying 150 single pulses (sp) of TMS to the motor cortex (M1) at 120% resting motor threshold (RMT) and measuring peak-to-peak amplitudes of the elicited MEPs. 150 single pulses were again applied to M1 at 5 (T5) minutes post-rTMS and 60 single pulses delivered at 25 (T25) minutes post-rTMS to assess corticomotor reactivity. Resting state EEG (rsEEG) and behavioural outcomes from a motor task were also obtained before and after rTMS.
Fig 2.
Repetitive transcranial magnetic stimulation (rTMS) protocol effectiveness and repeatability for all motor evoked potential (MEP) trials in each block.
(A) Group-averaged MEP at baseline, T5 and T25 during Visit 1 (left) and Visit 2 (right) for intermittent theta burst stimulation (iTBS), continuous theta burst stimulation (cTBS), 1 Hz, 10 Hz, and Sham protocols. Data are mean ± standard error. (B) Individual participant data for Visit 1 (top, V1) and Visit 2 (bottom, V2) for each protocol. White dots show group means.
Fig 3.
Sham-corrected effects of intermittent theta burst stimulation (iTBS), continuous theta burst stimulation (cTBS), 1 Hz and 10 Hz.
(A) Group-averaged motor evoked potential (MEP) ratio values for visit 1 and visit 2 with sham subtracted out separately for each participant. Data are mean ± standard error. (B) Individual sham-corrected data for visit 1 (V1) and visit 2 (V2) for each repetitive transcranial magnetic stimulation (rTMS) protocol. Data are presented as MEP ratio for each rTMS protocol with sham MEP percent change subtracted from these effects separately for each participant.
Fig 4.
Repetitive transcranial magnetic stimulation (rTMS) protocol effectiveness and reproducibility for the first 25 motor evoked potential (MEP) trials in each block.
Group-averaged MEP at baseline (BL), T5 and T25 during Visit 1 (V1; left) and Visit 2 (V2; right) for intermittent theta burst stimulation (iTBS), continuous theta burst stimulation (cTBS), 1 Hz, 10 Hz, and Sham protocols. Data are mean ± standard error.
Fig 5.
Repetitive transcranial magnetic stimulation (rTMS) protocol effectiveness and repeatability for the 25 trials corresponding to the single pulse stimulation applied closest to the hotspot.
Group-averaged motor evoked potential (MEP) at baseline, T5 and T25 during visit 1 (left) and visit 2 (right) for intermittent theta burst stimulation (iTBS), continuous theta burst stimulation (cTBS), 1 Hz, 10 Hz, and Sham protocols. Data are mean ± standard error.
Fig 6.
Scatter plots between baseline motor evoked potential (MEP) amplitude and post repetitive transcranial magnetic stimulation (rTMS) MEPs as a percent of baseline averaged across visits for T5 (top) and T25 (bottom) for each protocol; dots represent individual participants.
Fig 7.
Scatter plots between T5 (blue) and T25 (red) ratio data during visit 1 (V1) and visit 2 (V2) for each protocol with a single dot representing each participant for (A) all trials and (B) sham-corrected data.
Table 1.
Intra-participant variability results showing c and p-values for the intraclass correlation coefficient (ICC) between visit 1 and visit 2 using ratio data at T5 and T25 for all trials, first 25 trials, closest 25 trials and sham-corrected data.
P-values less than 0.05 are highlighted in light gray, and p-values less than 0.005 (surviving multiple comparisons) are highlighted in dark gray.
Fig 8.
Individual response characteristics to rTMS.
(A) Classification of individual responses and responder types across rTMS protocols for each visit. Pie charts show the percentage of facilitation (Red: μ≥110%), suppression (Blue: μ≤ 90%) and no change (Gray: 110%<μ>90%) for each rTMS protocol in Visit-1 (upper pie charts) and Visit-2 (Lower pie charts). (B) Bar graphs showing group averaged MEP percentage changes across visits (Visit 1 and Visit) and blocks (T5 and T25). The colored dots (blue for Visit 1 and red for Visit 2) denotes the individual response and the black lines connected to the dots represent and track individual response changes across visits (MEP %Δ to Baseline; motor evoked potential percentage change to baseline).