cTBS over primary motor cortex increased contralateral corticomuscular coupling and interhemispheric functional connection.

Objective. Transcranial magnetic stimulation is a non-invasive brain stimulation technique that changes the activity of the cerebral cortex. Contralesional continuous theta burst stimulation (cTBS) has been proposed and verified beneficial to stroke motor recovery. However, the underlying mechanism is still unclear. Approach. 20 healthy right-handed subjects were recruited in this study, receiving real-cTBS over their left primary motor cortex or sham-cTBS. We designed the finger tapping task (FTT) before and after stimulation and recorded the accuracy and reaction time (RT) of the task. The electroencephalogram and surface electromyogram signals were recorded during the left finger pinching task (FPT) before and after stimulation. We calculated cortico-muscular coherence (CMC) in the contralateral hemisphere and cortico-cortical coherence (CCC) in the bilateral hemisphere. The two-way repeated measures analysis of variance was used to analyze the effect of cTBS. Main results. In the FTT, there was a significant main effect of 'time' on RT ( F (1, 38) = 24.739, p < 0.001). In the FPT, the results showed that there was a significant interaction effect on the CMC peak and area in the beta band (peak: F (1, 38) = 8.562, p = 0.006; area: F (1, 38) = 5.273, p = 0.027), on the CCC peak in the alpha band ( F (1, 38) = 4.815, p = 0.034) and area in the beta band ( F (1, 38) = 4.822, p = 0.034). The post hoc tests showed that the CMC peak ( W = 20, p = 0.002), the CMC area ( W = 13, p = 0.003) and the CCC peak ( t = -2.696, p = 0.014) increased significantly after real-cTBS. However, there was no significant decrease or increase after sham-cTBS. Significance. Our study found that cTBS can improve CMC of contralateral hemisphere and CCC of bilateral hemisphere, indicating that cTBS can strengthen cortico-muscular and cortico-cortical coupling.