Identifying site- and stimulation-specific TMS-evoked EEG potentials using a quantitative cosine similarity metric

The ability to interpret transcanial magnetic stimulation (TMS) evoked EEG potentials (TEPs) is limited by artifacts, such as auditory evoked responses produced by the TMS coil. TEPs generated from direct cortical stimulation should vary in spatial distribution with stimulation site and from responses to sham stimulation. Responses that do not show these effects are likely to be artifactual. In 20 healthy volunteers, we delivered active and sham TMS to right prefrontal, left primary motor, and left posterior parietal cortex and compared the waveform similarity of TEPs between stimulation sites and active and sham TMS with a cosine similarity-based analysis method. We looked for epochs after the stimulus when the spatial pattern of TMS-evoked activation had greater than random similarity between stimulation sites and sham vs. active TMS, indicating presence of a dominant artifact, such as the auditory brain response. We calculated and binarized the derivatives of the TEPs recorded from 30 EEG channels and calculated cosine similarity between conditions at each time point with millisecond resolution. Only TEP components occurring before approximately 80 ms differed across stimulation sites and between active and sham, indicating site and condition-specific responses. TEP components before about 80 ms can be safely interpreted as stimulation location-specific responses to TMS, but components beyond this latency should be interpreted with caution due to high similarity in their spatial distribution.