Noninvasive mapping of muscle representations in human motor cortex.

We used transcranial magnetic stimulation to map the cortical representations of 4 upper extremity muscles (abductor pollicis brevis, flexor carpi radialis, biceps, and deltoid) of 10 normal subjects. Three stimuli were delivered to scalp positions 1 cm apart, and the amplitude and latency of the motor evoked potentials (MEPs) were averaged for each position. Maps were described in terms of number of excitable scalp positions, amplitude of MEPs, scalp positions for evoking largest amplitude MEPs, and threshold for producing MEPs. We compared different muscles across subjects and the same muscles on the left and right sides in individual subjects. Distal muscles had larger representations with higher amplitude MEPs and lower thresholds. Biceps and deltoid on the left had larger representations and higher MEP amplitudes than on the right. Maps showed a somatotopic progression on the scalp of proximal to distal muscles along a posteromedial to anterolateral axis.