Infraslow activity as a potential modulator of corticomotor excitability.

Fluctuations in cortical excitability are a candidate mechanism involved in the trial-to-trial variation of motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS). We explore whether infraslow EEG activity (<0.1 Hz) modulates corticomotor excitability by evaluating the presence of temporal and phase clustering of TMS-induced MEPs. In addition, we evaluate the dependence of MEP amplitude on the phase of the infraslow activity. Twenty-three subjects were stimulated at an intensity above the resting motor threshold (rMT) and ten at the rMT. We evaluated whether temporal and phase clustering of MEP size and MEP generation were present, using 1,000 surrogates with a similar amplitude or occurrence distribution. To evaluate the MEP amplitude dependence, we used the least-square method to approximate the linear circular data by fitting a sine function. We observed significant temporal clustering at a group level, in all individual subjects stimulated at rMT and in the majority of those stimulated above rMT, suggesting underlying determinism of corticomotor excitability instead of randomly generated fluctuations. The majority of subjects showed significant phase clustering for MEP size and for MEP occurrence, and significant phase clustering was found at the group level. Furthermore, in approximately one-quarter to one-half of the subjects we found a significant correlation and dependence of MEP amplitude on the phase of infraslow activity, respectively. Although other mechanisms very likely contribute as well, our findings seem to suggest that infraslow activity is involved in the variability of cortical excitability and TMS-induced responses. NEW & NOTEWORTHY Cortical excitability measures are highly variable during transcranial magnetic stimulation. Although ongoing brain oscillations are assumed to modulate excitability, no consistent associations are found for the traditional frequency bands. We focus on the role of infraslow EEG activity, defined as rhythms with frequencies < 0.1 Hz. We provide experimental evidence suggesting that infraslow activity most likely modulates corticomotor excitability and that response variation could be reduced when stimulation is targeted at a specific infraslow phase.