title: Decreased corticospinal excitability after subthreshold 1 Hz rTMS over lateral premotor cortex.
abstract: OBJECTIVE
  To study whether trains of subthreshold 1 Hz repetitive transcranial magnetic stimulation (rTMS) over premotor, prefrontal, or parietal cortex can produce changes in excitability of motor cortex that outlast the application of the train.
  
  
  BACKGROUND
  Prolonged 1 Hz rTMS over the motor cortex can suppress the amplitude of motor-evoked potentials (MEP) for several minutes after the end of the train. Because TMS can produce effects not only at the site of stimulation but also at distant sites to which it projects, the authors asked whether prolonged stimulation of sites distant but connected to motor cortex can also lead to lasting changes in MEP.
  
  
  METHODS
  Eight subjects received 1500 magnetic stimuli given at 1 Hz over the left lateral frontal cortex, the left lateral premotor cortex, the hand area of the left motor cortex, and the left anterior parietal cortex on four separate days. Stimulus intensity was set at 90% active motor threshold. Corticospinal excitability was probed by measuring the amplitude of MEP evoked in the right first dorsal interosseous muscle by single suprathreshold stimuli over the left motor hand area before, during, and after the conditioning trains.
  
  
  RESULTS
  rTMS over the left premotor cortex suppressed the amplitude of MEP in the right first dorsal interosseous muscle. The effect was maximized (approximately 50% suppression) after 900 pulses and outlasted the full train of 1500 stimuli for at least 15 minutes. Conditioning rTMS over the other sites did not modify the size of MEP. A control experiment showed that left premotor cortex conditioning had no effect on MEP evoked in the left first dorsal interosseous muscle.
  
  
  CONCLUSIONS
  Subthreshold 1 Hz rTMS of the left premotor cortex induces a short-lasting inhibition of corticospinal excitability in the hand area of the ipsilateral motor cortex. This may provide a model for studying the functional interaction between premotor and motor cortex in healthy subjects and patients with movement disorders.
authors.affiliation: Institute of Neurology, MRC Human Movement & Balance Unit, Queen Square, London, United Kingdom.
authors.forename: W
authors.initials: W
authors.lastname: Gerschlager
authors.forename: H R
authors.initials: HR
authors.lastname: Siebner
authors.forename: J C
authors.initials: JC
authors.lastname: Rothwell
mesh_terms: D000328:Adult; D001931:Brain Mapping; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D005625:Frontal Lobe / Q000502:physiology; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008280:Magnetics; D008297:Male; D009044:Motor Cortex / Q000033:anatomy & histology / Q000502:physiology*; D010296:Parietal Lobe / Q000502:physiology; D013997:Time Factors