Abstract
Transcranial magnetic stimulation (TMS) is a safe, non-invasive technique for studying the human motor system. It can be used to evaluate primary motor cortex (M1) function after stroke, by stimulating the ipsilesional M1 and recording motor-evoked potentials (MEPs) from the paretic limbs. In this chapter, we first outline the measures of M1, intracortical and interhemispheric function that can be made with TMS. The presence or absence of MEPs is the simplest and most reliable measure that can be made with TMS. In general, patients in whom TMS can elicit MEPs from the paretic limbs make a better motor recovery and experience better functional outcomes than those patients without MEPs. We provide an overview of recent research showing that MEP status is a particularly useful biomarker for patients with initially severe motor impairment. The limitations and potential benefits of MEP status as a biomarker for patient selection in stroke rehabilitation trials are discussed.
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