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How Is Motor Threshold (MT) Determined?  

Before TMS treatment can begin, each patient's Motor Threshold (MT) must be determined. Stimware supports both visual and EMG-based Motor Threshold determination methods. The resulting MT value is saved to the patient's profile and is used to calculate the appropriate stimulation intensity for treatment sessions.

 How Motor Threshold Is Determined

Step 1: Locate the Motor-Hotspot

First, identify the Motor-Hotspot, which is the location on the motor cortex where stimulation produces a response in the target muscle.

Step 2: Start MT Determination

  1. Open the patient profile.
  2. Select Switch to MT Determination.
  3. Position the coil over the Motor-Hotspot.
  4. Select Start.

Step 3: Record Muscle Responses

Stimware delivers a series of single pulses and asks whether a muscle response occurred.

After each pulse:

  • Select Yes if a muscle twitch is observed.
  • Select No if no response is observed.

Stimware automatically adjusts the stimulation intensity throughout the process.

Step 4: Save the Result

Once the determination is complete, Stimware calculates the Motor Threshold value.

You can then:

  • Save the MT value to the patient profile
  • Generate an MT report
  • Use the value for future treatment sessions

Visual vs EMG Determination

Visual Determination

The operator observes the target muscle for visible movement after each pulse.

EMG Determination

A compatible EMG device measures muscle responses electronically, providing a more objective assessment and supporting Auto MT functionality.

Why Is MT Determined?

Determining MT helps:

  • Personalize treatment intensity
  • Improve treatment consistency
  • Support safe treatment delivery
  • Ensure the protocol is tailored to each patient