{"paper_id":"1d18fb85-4459-41bf-bb24-c7c0a028d8c0","body_text":"Abstract\nBackground Transcranial Magnetic Stimulation (TMS) studies identify the Resting Motor Threshold (RMT) to calibrate stimulation intensity. However, this procedure is time-consuming and subject to variability. We developed an automated procedure to improve the efficiency and standardization of RMT determination.\nNew method We developed an algorithm that measures MEP amplitudes and automatically adjusts stimulation intensity to determine the RMT. Experiment 1 compared this automated method with the manual procedure in terms of reliability and equivalence. Experiment 2 developed a “Fast” automated process, assessing it against both the manual and initial automated procedures.\nResults Across both experiments the automated approach demonstrated excellent test-retest reliability and strong agreement with the manual method (Intraclass Correlation Coefficients ≥0.95), giving estimates of RMT statistically equivalent to those of manual measurements within ±3% MSO, with the majority of comparisons within ±2% MSO. Experiment 2 optimized the procedure, allowing empirical determination of the RMT in an average of <3 minutes with only 33-34 pulses.\nComparison with existing methods ‘RMT-Finder’ provides a reliable and time-efficient alternative to manual approaches. To the best of our knowledge RMT-Finder presents the first ‘closed-loop feedback’ approach to identify the RMT without manual intervention. This procedure can improve standardization and reproducibility in TMS studies.\nConclusions Automating RMT assessment allows rapid and highly reproducible assessment of this standard TMS measurement, making it viable for inclusion in routine clinical applications that require standardized procedures.\nCompeting Interest Statement\nThe authors have declared no competing interest.","source_license":"CC-BY-4.0","license_restricted":false}