TMS has the potential to both drive excitation and increase suppression of neural activity in the brain (Rattay,
1999). Although it is possible for TMS to hyperpolarize cells, this only happens under very specific conditions (Rattay,
1999), and it is, therefore, assumed that cell suppression following TMS results from the activation of inhibitory connections (Moliadze, Zhao, Eysel, & Funke,
2003; Murphy, Palmer, Nyffeler, Müri, & Larkum,
2016). Electrical stimulation of animal neural tissue triggers initial brief excitation (Adrian & Moruzzi,
1939; Patton & Amassian,
1954), followed by two waves of GABA-ergic inhibition (Connors, Malenkat, & Silva,
1988) in the first 100 ms after stimulation. This general effect of initial excitation (Boroojerdi, Battaglia, Muellbacher, & Cohen,
2001; Devanne, Lavoie, & Capaday,
1997; Hess, Mills, & Murray,
1987; Ziemann, Lönnecker, Steinhoff, & Paulus,
1996) and subsequent GABA-ergic inhibition (Kujirai et al.,
1993; Premoli et al.,
2014) has been replicated in the human motor cortex. TMS to primary visual cortex in cats suggests that stimulation predominantly triggers suppression of simple and complex cells in a 100-ms window (Moliadze, Giannikopoulos, Eysel, & Funke,
2005; Moliadze et al.,
2003).