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For fast estimation, start from an intensity that is close to the likely motor threshold (MT) and preferably suprathreshold (i.e., an intensity that produces motor responses more often than not). The intensity used to locate the motor hot spot is a good starting point.
The MT is estimated using a stochastic approximation method with a digital control sequence whose step size follows harmonic convergence with adaptive stepping (DCS-HA) and an initial step size of 4.2% MSO. For adaptive stepping, the control sequence is adjusted only when the response changes from suprathreshold to subthreshold or vice versa. With a good initial intensity, the estimator takes on average 25 pulses to determine the MT with median relative error |⁠δ⁠| of less than 1.5%.
Note: The fixed stepping method DCS-H, which was available up to version 1.7.4, is now deprecated, because adaptive stepping is more robust with respect to subject characteristics, target muscle, starting TMS amplitude, as well as TMS device and coil.
Known limitations and bugs:
All processing is done by the app locally. No data are shared online.
This HTML/JS application is written by Boshuo Wang and Lari M. Koponen, with contribution from Vedarsh U. Shah, Shivum Vaishnavi, and Yiwen Zhang.
If you have questions or feedback, please email Boshuo Wang at boshuo.wang@duke.edu.
The stochastic approximation MT methods are described in the following manuscript, which explores the performance of different control sequences, stepping adaptiveness, and initial step size:
The choice of initial stimulation intensity close to the MT and the description of the quality of the current estimation follow suggestions in:
Preliminary validation of SAMT in clinical trials is described in:
© 2022, Boshuo Wang, Lari M. Koponen, Stefan M. Goetz, Angel V. Peterchev, at Duke University, the University of Birmingham. All rights reserved.
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