Corticospinal facilitation during 5Hz repetitive transcranial magnetic stimulation depends on current direction and pulse waveform

Objective: To clarify the influence of current direction and pulse waveform on repetitive transcranial magnetic stimulation (rTMS) effects, in the perspective of optimising the therapeutic application of rTMS. Background: Data on the therapeutic usefulness of rTMS in neuropsychiatric disorders is inconsistent. This could be related to a lack of attention paid to stimulus characteristics such as waveform and current direction (1). Methods: In ten healthy volunteers, we applied rTMS over the dominant primary motor cortex, using 80 stimuli at 5Hz frequency at an intensity yielding baseline motor evoked potential (M…