Malekahmad Mona, Frazer Ashlyn, Zoghi Maryam, Jaberzadeh Shapour
Department of Physiotherapy, Monash University, Melbourne, Australia.
Discipline of Physiotherapy, Federation University, Melbourne, Australia.
Neurosci Lett. 2025 Jul 27;862:138283. doi: 10.1016/j.neulet.2025.138283. Epub 2025 Jun 2.
Corticospinal excitability (CSE) is the responsiveness of the corticospinal and brain-to-muscle pathway, assessed using motor-evoked potentials (MEPs) via transcranial magnetic stimulation (TMS). It provides crucial insight into motor control, neuroplasticity, and neurological conditions. The use of TMS-induced MEPs in clinical and research contexts is contingent upon their intra- and intersession reliability. This study specifically aimed to assess the reliability of two distinct methods for quantifying MEP size: peak-to-peak amplitude (PPA) and the area under the curve (AUC). Establishing the agreement between these quantification methods is critical for ensuring consistent measurements by the same assessor, especially in pre- and post-test designs conducted within and between sessions. Twelve healthy participants volunteered for this study. Thirty MEPs were recorded from each participant using a single-pulse TMS set at 120% of the resting motor threshold (RMT) over two sessions. The first session consisted of two tests (T1 and T2) with a 20-minute rest interval between sets. The second session included one set of tests (T3). Test-retest reliability of MEP amplitude and AUC were assessed using one-way ANOVA and Intraclass Correlation Coefficient (ICC). A one-way ANOVA revealed no significant effect of time on MEP amplitude or AUC value, indicating agreement between sessions. The ICC demonstrated significant intra- and inter-session reliability for PPA. However, correlations between T1-T3 were weak for AUC values. In conclusion, this study suggests that PPA a more reliable measurement than AUC for assessing changes in CSE. Future investigations should explore the reliability of the AUC method in clinical settings or research protocols.
皮质脊髓兴奋性（CSE）是指皮质脊髓和脑-肌肉通路的反应性，通过经颅磁刺激（TMS）使用运动诱发电位（MEP）进行评估。它为运动控制、神经可塑性和神经系统疾病提供了至关重要的见解。在临床和研究环境中使用TMS诱发的MEP取决于它们在不同时间点内和不同时间点间的可靠性。本研究特别旨在评估两种不同的量化MEP大小方法的可靠性：峰峰值幅度（PPA）和曲线下面积（AUC）。确定这些量化方法之间的一致性对于确保同一评估者进行一致的测量至关重要，特别是在不同时间点内和不同时间点间进行的测试前和测试后设计中。12名健康参与者自愿参加本研究。在两个时间段内，使用设置为静息运动阈值（RMT）120%的单脉冲TMS从每个参与者记录30个MEP。第一个时间段包括两次测试（T1和T2），每组之间有20分钟的休息间隔。第二个时间段包括一组测试（T3）。使用单因素方差分析和组内相关系数（ICC）评估MEP幅度和AUC的重测可靠性。单因素方差分析显示时间对MEP幅度或AUC值没有显著影响，表明不同时间段之间具有一致性。ICC显示PPA在不同时间段内和不同时间段间具有显著的可靠性。然而，AUC值在T1-T3之间的相关性较弱。总之，本研究表明，在评估CSE变化时，PPA比AUC是一种更可靠的测量方法。未来的研究应探讨AUC方法在临床环境或研究方案中的可靠性。
