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In stroke recovery, the activation of the primary motor cortex (M1) is critical for motor learning and has been found to be augmented by non-invasive brain stimulation (NIBS) recovery [1,2]. One form of interventional NIBS is transcranial direct current stimulation (tDCS), which involves the guided placement of electrodes on the scalp. Two methods to guide the somatotopic localization of the M1 area are 1) transcranial magnetic stimulation (TMS) and 2) the 10/20 International Electroencephalogram Coordinate System (10/20 EEG) [3]. The TMS M1 location, termed the motor hotspot, is derived by eliciting a motor evoked potential in a muscle corresponding to the area stimulated (e.g. the first dorsal interosseous muscle can be monitored when stimulating the hand knob of M1). In contrast, the 10/20 EEG identifies the location of M1 for the placement of scalp electrodes derived from four key individual anatomical landmarks with the nasion (lowest depression between the forehead and nose), in (lowest point of the skull from the back of the head) and the preauricular points of the right and left ears. EEG electrodes can record temporal brain activity in the form of event-related potentials (ERPs). The ERP represents a summation of neuronal activity and the location of the brain activity is inferred based on the type of task or stimuli (e.g. a motor task may infer activity in the M1 area). The coordinates for M1 include C3 (left hemisphere) and C4 (right hemisphere) areas regardless the possible cortical re-organization of M1 following a stroke.

Reliability of the Location of Primary Motor Cortex Using the International 10/20 Electroencephalogram System (10/20 EEG)