The Resting Motor Threshold--Restless or Resting? A Repeated Threshold Hunting Technique to Track Dynamic Changes in Resting Motor Threshold.

Background: The resting motor threshold (RMT) is used to individually adjust the intensity of transcranial magnetic stimulation (TMS) intensity and is assumed to be stable. Here we challenge this notion by showing that RMT expresses acute context-dependent fluctuations.

Method: In twelve participants, the RMT of the right first dorsal interosseus muscle was repeatedly determined using a threshold-hunting procedure while participants performed motor imagery and visual attention tasks with the right or left hand. Data were analyzed using repeated-measure ANOVA.

Results: RMT differed depending on which hand performed the task (P = 0.003). RMT of right FDI was lower during motor imagery than during visual attention of the right hand (P = 0.002), but did not differ between left-hand tasks (P = 0.988).

Conclusions: State-dependent changes of RMT occur in absence of overt motor activity and can be captured online by threshold hunting. These fluctuations need to be considered when RMT is used to individually adjust TMS intensity for plasticity-inducing protocols.