Transverse-field activation mechanism in magnetic stimulation of peripheral nerves.

The activating function of peripheral nerves in magnetic stimulation is thought to be the gradient of the induced electric field component parallel to the nerve. This implies that there are several orientations of the coil that should not excite nerves. We show that these orientations, however, often yield high-amplitude and even supramaximal muscle response, indicating that the model of the activating function has to be modified. We propose that the electric field component perpendicular to the nerve is responsible for these unexpected muscle responses. Our conclusion is based on practical experiments with different coils and on computer simulations of the induced electric field and its gradient.