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For stimulation output to the subject, an optically isolated constant current stimulator was used (STMISOL, BIOPAC Systems Inc).
As individual rMT was used for stimulation output this resulted in approximately half of the trials having an MEP below 50 μV (conventionally considered as "subthreshold," see, e.g., [ 15] for further information) and the other half above 50 μV ("suprathreshold").
It is established that given the stimulation intensity limits of TMS, not all individuals will experience phosphenes even at the maximum stimulation output (see for example Kammer et al, Cowey & Walsh, Silvanto et al, Kammer et al, Boroojerdi et al, Gerwig et al, Kammer & Baumann, Sparing et al ).
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Daily sessions consisted of 10-min stimulation at 60% maximum stimulator output.
In some patients, the threshold was either very high or could not be determined; here, magnetic stimulation at the maximum stimulator output was used.
Stimulation (at 80% of stimulator output) commenced at this point, and the coil was then moved around this spot (up to a maximum of 0.5 cm from the marked point), until a location from which a consistently vivid phosphene was induced.
Resting motor threshold (RMT) was determined using a staircase method and was defined as the lowest stimulation intensity (% of maximum stimulator output) evoking a clearly discernable MEP in four of eight consecutive stimuli.
This procedure resulted in stimulation intensities of 48 61% of maximum stimulator output.
The average stimulation intensity was 63.25% of maximum stimulator output (range 58%66%%).
Stimulation started at suprathreshold intensity (about 60% of stimulator output) and was decreased in steps of 1 2% of the stimulator output [46].
The stimulus output is interrupted every 10 ms to create "bursts" of stimulation every second.
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