Modulation of motor cortex excitability by paired peripheral and transcranial magnetic stimulation

Peripheral electrical stimulation (PES) over muscles or nerves is commonly used as an intervention to facilitate plastic changes in the motor cortex and spinal cord, enhancing recovery of motor functions (Chipchase et al 2011). Stefan et al (2000) first reported that paired- associativestimulation(PAS), which consists of repetitive low-frequency PES of the median nerve followed by TMS of the contralateral M1 cortex, induced a transient increase in MEP amplitude at rest and in the duration of the cortical silent period (CSP) during contraction.

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