[Triad TMS of Human Motor Cortex].

To study cortical excitability changes induced by external stimulation with a certain rhythm, we developed a new method using motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) over the primary motor cortex. In this method, three conditioning TMS with the intensity below the motor threshold are given prior to the supra-threshold test stimulus with the four TMSs were separated by a certain interval (triad-conditioning stimulation: TCS). In healthy volunteers, MEP facilitation was elicited at an interval of 25ms, whereas TCSs with other intervals induced no facilitation. This frequency-dependent facilitation may reflect some intrinsic rhythm of M1 (25ms, i.e. 40Hz). In cortical myoclonus, the facilitation at 25ms was gone whereas facilitation was elicited by triad-conditioning stimulus at 40ms (25Hz), which is consistent with a previously reported abnormal beta rhythm in cortical myoclonus reported previously. Facilitation at 25ms was evoked in neither Parkinson's disease nor in amyotrophic lateral sclerosis. With TCS, we were able to investigate the intrinsic rhythmic activity of M1 and its changes in neurological disorders.