The correspondence between EMG and EEG measures of changes in cortical excitability following transcranial magnetic stimulation

Key points TMS is commonly used to study excitatory/inhibitory neurotransmission in cortical circuits. Changes in cortical excitability following TMS are typically measured from hand (using EMG; limited to motor cortex) or scalp (using EEG); however, it is unclear whether these two measures represent the same activity when assessing motor cortex. We found that TMS‐EMG and TMS‐EEG measures of motor cortex excitability are differentially affected by sensory confounds at different time points, masking any actual relationship between them in the time domain. In the frequency domain, local high‐frequency oscillations in EEG recordings were minimally confounded by sensory artefacts and demonstrated strong correlations with EMG measures of cortical excitability across time, regardless of TMS intensity or waveform. Therefore, despite the effects of sensory artefacts, the two measures of motor cortex excitability share a response component, suggesting that they index a similar cortical activity and perhaps the same neuronal population. Abstract Transcranial magnetic stimulation (TMS) is a powerful tool for investigating cortical circuits. Changes in cortical excitability following TMS are typically assessed by measuring changes in either conditioned motor‐evoked potentials (MEPs) following paired‐pulse TMS over motor cortex or evoked potentials measured with electroencephalography following single‐pulse TMS (TEPs). However, it is unclear whether these two measures of cortical excitability index the same cortical response. Twenty‐four healthy participants received local and interhemispheric paired‐pulse TMS over motor cortex with eight inter‐pulse intervals, sub‐ and suprathreshold conditioning intensities, and two different pulse waveforms, while MEPs were recorded from a hand muscle. TEPs were also recorded in response to single‐pulse TMS using the conditioning pulse alone. The relationships between TEPs and conditioned‐MEPs were evaluated using metrics sensitive to both their magnitude at each time point and their overall shape across time. The impacts of undesired sensory potentials resulting from TMS pulse and muscle contractions were also assessed on both measures. Both conditioned‐MEPs and TEPs were sensitive to re‐afferent somatosensory activity following motor‐evoked responses, but over different post‐stimulus time points. Moreover, the amplitude of low‐frequency oscillations in TEPs was strongly correlated with the sensory potentials, whereas early and local high‐frequency responses showed minimal relationships. Accordingly, conditioned‐MEPs did not correlate with TEPs in the time domain but showed high shape similarity with the amplitude of high‐frequency oscillations in TEPs. Therefore, despite the effects of sensory confounds, the TEP and MEP measures share a response component, suggesting that they index a similar cortical response and perhaps the same neuronal populations.