Comparison of figure-of-8 and circular coils for threshold tracking transcranial magnetic stimulation measurements

Søren Ørskov, Hugh Bostock, James Howells, Kirsten Pugdahl, Anders Fuglsang-Frederiksen, Christina Shen-Zhuang Nielsen, Bülent Cengiz, Gintaute Samusyte, Martin Koltzenburg, Hatice Tankisi*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objectives: The transcranial magnetic stimulation (TMS) technique of threshold-tracking short-interval intracortical inhibition (T-SICI) has been proposed as a diagnostic tool for amyotrophic lateral sclerosis (ALS). Most of these studies have used a circular coil, whereas a figure-of-8 coil is usually recommended for paired-pulse TMS measurements. The aim of this study was to compare figure-of-8 and circular coils for T-SICI in the upper limb, with special attention to reproducibility, and the pain or discomfort experienced by the subjects. Methods: Twenty healthy subjects (aged: 45.5 ± 6.7, mean ± SD, 9 females, 11 males) underwent two examinations with each coil, in morning and afternoon sessions on the same day, with T-SICI measured at interstimulus intervals (ISIs) from 1−7 ms. After each examination the subjects rated degree of pain/discomfort from 0 to 10 using a numerical rating scale (NRS). Results: Mean T-SICI was higher for the figure-of-8 than for the circular coil at ISI of 2 ms (p < 0.05) but did not differ at other ISIs. Intra-subject variability did not differ between coils, but mean inhibition from 1−3.5 ms was less variable between subjects with the figure-of-8 coil (SD 7.2% vs. 11.2% RMT, p < 0.05), and no such recordings were without inhibition (vs. 6 with the circular coil). The subjects experienced less pain/discomfort with the figure-of-8 coil (mean NRS: 1.9 ± 1.28 vs 2.8 ± 1.60, p < 0.005). Discussion: The figure-of-8 coil may have better applicability in patients, due to the lower incidence of lack of inhibition in healthy subjects, and the lower experience of pain or discomfort.
Original languageEnglish
JournalNeurophysiologie Clinique
Volume51
Issue number2
Pages (from-to)153-160
Number of pages8
ISSN0987-7053
DOIs
Publication statusPublished - Mar 2021
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 Elsevier Masson SAS

Keywords

  • Circular coil
  • Figure-of-8 coil
  • SICI
  • Short interval intracortical inhibition
  • TMS
  • Threshold tracking
  • Transcranial magnetic stimulation

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