{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:47:09Z","timestamp":1792140429219,"version":"4.4.0"},"reference-count":29,"publisher":"Wiley","issue":"20","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Transcranial magnetic stimulation (TMS) studies in upper limb muscles have shown that stimulus direction can influence corticospinal and intracortical excitability; however, limited evidence exists for lower limb muscles. This study investigated the effect of TMS stimulus direction on corticospinal and intracortical excitability of the tibialis anterior (TA) muscle using paired\u2010pulse TMS. Nineteen healthy adults (10 males, 9 females; mean age 41.8\u2009\u00b1\u200923\u2009years) participated. Single\u2010 and paired\u2010pulse TMS was delivered using a figure\u2010of\u2010eight coil oriented to induce anterior\u2010to\u2010posterior (AP) or posterior\u2010to\u2010anterior (PA) current flow in the left motor cortex while recording motor evoked potentials (MEPs) from the right TA. Resting motor threshold (RMT), short\u2010interval intracortical inhibition (SICI), long\u2010interval intracortical inhibition (LICI), and intracortical facilitation (ICF) were assessed under both stimulus directions in a single session. No significant differences were identified between AP and PA stimulation for RMT, SICI, or LICI (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&gt;\u20090.05). However, AP stimulation produced significantly greater ICF responses compared with PA stimulation (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.027). AP and PA stimulus directions produced comparable RMT, SICI, and LICI measures in the TA muscle, although AP stimulation elicited greater ICF. These findings suggest facilitatory intracortical circuits may be more sensitive to stimulus direction than inhibitory pathways.\n                  <\/jats:p>","DOI":"10.14814\/phy2.71144","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:28:44Z","timestamp":1792139324000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effects of\n                    <scp>TMS<\/scp>\n                    stimulus direction on corticospinal and cortico\u2010cortical excitability of the lower limb in healthy adults"],"prefix":"10.14814","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2644-3980","authenticated-orcid":false,"given":"M. C.","family":"Hall","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Non\u2010Invasive Brain Stimulation &amp; Neuroplasticity Laboratory Monash University  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Zoghi","sequence":"additional","affiliation":[{"name":"Discipline of Physiotherapy, Institute of Health and Wellbeing Federation University  Berwick Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Perraton","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Non\u2010Invasive Brain Stimulation &amp; Neuroplasticity Laboratory Monash University  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Jaberzadeh","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Non\u2010Invasive Brain Stimulation &amp; Neuroplasticity Laboratory Monash University  Frankston Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.bjpt.2017.12.001","article-title":"A new paradigm shift in musculoskeletal rehabilitation: Why we should exercise the brain?","volume":"22","author":"Armijo\u2010Olivo S.","year":"2018","journal-title":"Brazilian Journal of Physical Therapy"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.brs.2024.06.009","article-title":"On the use of the motor threshold as a dependent variable in TMS research","volume":"17","author":"Bestmann S.","year":"2024","journal-title":"Brain Stimulation"},{"issue":"4","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1080\/00222890309603153","article-title":"Force control is greater in the upper compared with the lower extremity","volume":"35","author":"Christou E. 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G.(2021).Large\u2010scale analysis of interindividual variability in single and paired\u2010pulse TMS data: Results from the \u2018big TMS data collaboration\u2019. bioRxiv: The Preprint Server for Biology.","DOI":"10.1101\/2021.01.24.428014"},{"issue":"4","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1007\/s002210050648","article-title":"Direct demonstration of interhemispheric inhibition of the human motor cortex produced by transcranial magnetic stimulation","volume":"124","author":"Di Lazzaro V.","year":"1999","journal-title":"Experimental Brain Research"},{"issue":"4","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.brs.2012.09.006","article-title":"Transcranial direct current stimulation effects on the excitability of corticospinal axons of the human cerebral cortex","volume":"6","author":"Di Lazzaro V.","year":"2013","journal-title":"Brain Stimulation"},{"issue":"5","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.brs.2021.08.022","article-title":"Two forms of short\u2010interval intracortical inhibition in human motor cortex","volume":"14","author":"Fong P.\u2010Y.","year":"2021","journal-title":"Brain Stimulation"},{"issue":"1","key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0004-9514(14)60659-0","article-title":"Using surface electromyography in physiotherapy research","volume":"29","author":"Gilmore K. 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