Resting Motor Threshold, MEP and TEP Variability During Daytime

Humans show a variation in physiological processes during the day. To reliably assess (changes in) cortical excitability with transcranial magnetic stimulation (TMS), it is relevant to know the natural variation in TMS readouts during the day. In case of significant daytime variations, this should be taken into account when scheduling (follow-up) measurements. This study aims to evaluate the influence of the time of day on the resting motor threshold (RMT), motor evoked potential (MEP) and TMS evoked potential (TEP) in healthy controls. TMS–EMG–EEG was recorded in 16 healthy subjects. At both motor cortices, we administered 75 pulses at an intensity of 110% RMT. Subjects were stimulated during five sessions in one day (8:00 AM, 10:30 AM, 1:00 PM, 3:30 PM and 6:00 PM) while keeping the stimulation intensity constant. We compared the TEP waveforms between the five sessions with a cluster-based permutation analysis, and the RMT and MEP amplitude with rmANOVA. In general there were no significant differences between the five sessions in the RMT, MEP amplitude or TEP. Only for the left side, N100 amplitude was larger at 3:30 PM than 10:30 AM. The standard deviation of the P30 and N100 amplitude was significantly higher between subjects within one session than within single subjects during the day. The TEP is highly reproducible during the day, with a low intra-individual variation compared to the inter-individual variation. In addition, we found no significant variation of the RMT and MEP amplitude between multiple sessions on one day.