Influence of reward on corticospinal excitability during movement preparation

Modulation of inhibitory corticospinal circuits induced by a nocebo procedure in motor performance

As recently demonstrated, a placebo procedure in motor performance increases force production and changes the excitability of the corticospinal system, by enhancing the amplitude of the motor evoked potentials (MEP) and reducing the duration of the cortical silent period (CSP). However, it is not clear whether these neurophysiological changes are related to the behavioural outcome (increased force) or to a general effect of expectation. To clarify this, we investigated the nocebo effect, in which the induced expectation decreases force production. Two groups of healthy volunteers (experimental and control) performed a motor task by pressing a piston with the right index finger. To induce a nocebo effect in the experimental group, low frequency transcutaneous electrical nerve stimulation (TENS) was applied over the index finger with instructions of its detrimental effects on force. To condition the subjects, the visual feedback on their force level was surreptitiously reduced after TENS. Results showed that the experimental group reduced the force, felt weaker and expected a worse performance than the control group, who was not suggested about TENS. By applying transcranial magnetic stimulation over the primary motor cortex, we found that while MEP amplitude remained stable throughout the procedure in both groups, the CSP duration was shorter in the experimental group after the nocebo procedure. The CSP reduction resembled previous findings on the placebo effect, suggesting that expectation of change in performance diminishes the inhibitory activation of the primary motor cortex, independently of the behavioural outcome.

Inhibition during response preparation is sensitive to response complexity

Motor system excitability is transiently suppressed during the preparation of movement. This preparatory inhibition is hypothesized to facilitate response selection and initiation. Given that demands on selection and initiation processes increase with movement complexity, we hypothesized that complexity would influence preparatory inhibition. To test this hypothesis, we probed corticospinal excitability during a delayed-response task in which participants were cued to prepare right- or left-hand movements of varying complexity. Single-pulse transcranial magnetic stimulation was applied over right primary motor cortex to elicit motor evoked potentials (MEPs) from the first dorsal interosseous (FDI) of the left hand. MEP suppression was greater during the preparation of responses involving coordination of the FDI and adductor digiti minimi relative to easier responses involving only the FDI, independent of which hand was cued to respond. In contrast, this increased inhibition was absent when the complex responses required sequential movements of the two muscles. Moreover, complexity did not influence the level of inhibition when the response hand was fixed for the trial block, regardless of whether the complex responses were performed simultaneously or sequentially. These results suggest that preparatory inhibition contributes to response selection, possibly by suppressing extraneous movements when responses involve the simultaneous coordination of multiple effectors.

Sexual motivation is reflected by stimulus-dependent motor cortex excitability

Sexual behavior involves motivational processes. Findings from both animal models and neuroimaging in humans suggest that the recruitment of neural motor networks is an integral part of the sexual response. However, no study so far has directly linked sexual motivation to physiologically measurable changes in cerebral motor systems in humans. Using transcranial magnetic stimulation in hetero- and homosexual men, we here show that sexual motivation modulates cortical excitability. More specifically, our results demonstrate that visual sexual stimuli corresponding with one's sexual orientation, compared with non-corresponding visual sexual stimuli, increase the excitability of the motor cortex. The reflection of sexual motivation in motor cortex excitability provides evidence for motor preparation processes in sexual behavior in humans. Moreover, such interrelationship links theoretical models and previous neuroimaging findings of sexual behavior.

Neuromuscular electrical stimulation of the median nerve facilitates low motor cortex excitability in patients with spinocerebellar ataxia

The neuromodulation of motor excitability has been shown to improve functional movement in people with central nervous system damage. This study aimed to investigate the mechanism of peripheral neuromuscular electrical stimulation (NMES) in motor excitability and its effects in people with spinocerebellar ataxia (SCA). This single-blind case-control study was conducted on young control (n=9), age-matched control (n=9), and SCA participants (n=9; 7 SCAIII and 2 sporadic). All participants received an accumulated 30 min of NMES (25 Hz, 800 ms on/800 ms off) of the median nerve. The central motor excitability, measured by motor evoked potential (MEP) and silent period, and the peripheral motor excitability, measured by the H-reflex and M-wave, were recorded in flexor carpi radialis (FCR) muscle before, during, and after the NMES was applied. The results showed that NMES significantly enhanced the MEP in all 3 groups. The silent period, H-reflex and maximum M-wave were not changed by NMES. We conclude that NMES enhances low motor excitability in patients with SCA and that the mechanism of the neuromodulation was supra-segmental. These findings are potentially relevant to the utilization of NMES for preparation of motor excitability. The protocol was registered at Clinicaltrials.gov (NCT02103075).

Dissociating the influence of response selection and task anticipation on corticospinal suppression during response preparation

Motor behavior requires selecting between potential actions. The role of inhibition in response selection has frequently been examined in tasks in which participants are engaged in some advance preparation prior to the presentation of an imperative signal. Under such conditions, inhibition could be related to processes associated with response selection, or to more general inhibitory processes that are engaged in high states of anticipation. In Experiment 1, we manipulated the degree of anticipatory preparation. Participants performed a choice reaction time task that required choosing between a movement of the left or right index finger, and used transcranial magnetic stimulation (TMS) to elicit motor evoked potentials (MEPs) in the left hand agonist. In high anticipation blocks, a non-informative cue (e.g., fixation marker) preceded the imperative; in low anticipation blocks, there was no cue and participants were required to divide their attention between two tasks to further reduce anticipation. MEPs were substantially reduced before the imperative signal in high anticipation blocks. In contrast, in low anticipation blocks, MEPs remained unchanged before the imperative signal but showed a marked suppression right after the onset of the imperative. This effect occurred regardless of whether the imperative had signalled a left or right hand response. After this initial inhibition, left MEPs increased when the left hand was selected and remained suppressed when the right hand was selected. We obtained similar results in Experiment 2 except that the persistent left MEP suppression when the left hand was not selected was attenuated when the alternative response involved a non-homologous effector (right foot). These results indicate that, even in the absence of an anticipatory period, inhibitory mechanisms are engaged during response selection, possibly to prevent the occurrence of premature and inappropriate responses during a competitive selection process.

Rapid prediction of biomechanical costs during action decisions

When given a choice between actions that yield the same reward, we tend to prefer the one that requires the least effort. Recent studies have shown that humans are remarkably accurate at evaluating the effort of potential reaching actions and can predict the subtle energetic demand caused by the nonisotropic biomechanical properties of the arm. In the present study, we investigated the time course over which such information is computed and comes to influence decisions. Two independent approaches were used. First, subjects performed a reach decision task in which the time interval for deciding between two candidate reaching actions was varied from 200 to 800 ms. Second, we measured motor-evoked potential (MEPs) to single-pulse transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) to probe the evolving decision at different times after stimulus presentation. Both studies yielded a consistent conclusion: that a prediction of the effort associated with candidate movements is computed very quickly and influences decisions within 200 ms after presentation of the candidate actions. Furthermore, whereas the MEPs measured 150 ms after stimulus presentation were well correlated with the choices that subjects ultimately made, later in the trial the MEP amplitudes were primarily related to the muscular requirements of the chosen movement. This suggests that corticospinal excitability (CSE) initially reflects a competition between candidate actions and later changes to reflect the processes of preparing to implement the winning action choice.

Placebo-induced changes in excitatory and inhibitory corticospinal circuits during motor performance

Despite behavioral evidence showing placebo modulations of motor performance, the neurophysiological underpinnings of these effects are still unknown. By applying transcranial magnetic stimulation (TMS) over the primary motor cortex, we investigated whether a placebo modulation of force could change the excitability of the corticospinal system. Healthy human volunteers performed a motor task by pressing a piston as strongly as possible with the right index finger. Two experimental groups were instructed that treatment with peripheral low-frequency transcutaneous electrical nerve stimulation (TENS) applied on the first dorsal interosseus would induce force enhancement. One experimental group was conditioned about the effects of TENS with a surreptitious amplification of the visual feedback signaling the force level. The other group, instead, was only verbally influenced, without conditioning. At the end of the instructive placebo procedure, the two experimental groups reached higher levels of force, believed that TENS had been effective and expected to perform better compared with two control groups, who were not influenced about TENS. Moreover, the experimental groups presented enhanced excitability of the corticospinal system in the muscle specifically involved in the task (first dorsal interosseus), as shown by increased amplitude of the motor evoked potentials and decreased duration of the cortical silent period (the latter only in the conditioned group). Crucially, the TMS pulse was delivered when all the subjects exerted the same amount of force, ruling out bottom-up influences. These findings hint at a top-down, cognitive enhancement of corticospinal excitability as a neural signature of placebo modulation of motor performance.

Top-down response suppression mitigates action tendencies triggered by a motivating stimulus

Motivating stimuli provoke action tendencies that sometimes lead to unwanted behavior (e.g., eating chocolate when trying to diet). Implementing control over these provocations is essential to healthy functioning; however, few laboratory-based models of such control exist. Here we developed a novel task in which thirsty human subjects made instrumental responses to obtain a juice reward (Go trials) or were required to withhold responding (NoGo trials) in the presence of a rewarded (CS+) or unrewarded (CS-) conditioned stimulus. For Go trials, single-pulse transcranial magnetic stimulation revealed a rapid increase in motor activity for CS+ versus CS-, preceding more vigorous instrumental responding. Critically, successful NoGo trials resulted in suppression of motor activity for CS+, but not CS-. Moreover, while there was broad excitation in the hand muscles in Go trials, suppression in NoGo trials was selective to the effector that could obtain reward. These results show that response suppression can be triggered by a motivational stimulus, thus providing a richer model of self-control than classic cognitive psychology paradigms.

Top-down inhibitory control exerted by the medial frontal cortex during action selection under conflict

Top-down control is critical to select goal-directed actions in changeable environments, particularly when several conflicting options compete for selection. In humans, this control system is thought to involve an inhibitory mechanism that suppresses the motor representation of unwanted responses to favor selection of the most appropriate action. Here, we aimed to evaluate the role of a region of the medial frontal cortex, the pre-SMA, in this form of inhibition by using a double coil TMS protocol combining repetitive TMS (rTMS) over the pre-SMA and a single-pulse TMS over the primary motor cortex (M1) during a visuomotor task that required participants to choose between a left or right button press according to an imperative cue. M1 stimulation allowed us to assess changes in motor excitability related to selected and nonselected (unwanted) actions, and rTMS was used to produce transient disruption of pre-SMA functioning. We found that when rTMS was applied over pre-SMA, inhibition of the nonselected movement representation was reduced. Importantly, this effect was only observed when the imperative cue produced a substantial amount of competition between the response alternatives. These results are consistent with previous studies pointing to a role of pre-SMA in competition resolution. In addition, our findings indicate that this function of pre-SMA involves the control of inhibitory influences directed at unwanted action representations.

Theta burst stimulation applied over primary motor and somatosensory cortices produces analgesia unrelated to the changes in nociceptive event-related potentials

Continuous theta burst stimulation (cTBS) applied over the primary motor cortex (M1) can alleviate pain although the neural basis of this effect remains largely unknown. Besides, the primary somatosensory cortex (S1) is thought to play a pivotal role in the sensori-discriminative aspects of pain perception but the analgesic effect of cTBS applied over S1 remains controversial. To investigate cTBS-induced analgesia we characterized, in two separate experiments, the effect of cTBS applied either over M1 or S1 on the event-related brain potentials (ERPs) and perception elicited by nociceptive (CO2 laser stimulation) and non-nociceptive (transcutaneous electrical stimulation) somatosensory stimuli. All stimuli were delivered to the ipsilateral and contralateral hand. We found that both cTBS applied over M1 and cTBS applied over S1 significantly reduced the percept elicited by nociceptive stimuli delivered to the contralateral hand as compared to similar stimulation of the ipsilateral hand. In contrast, cTBS did not modulate the perception of non-nociceptive stimuli. Surprisingly, this side-dependent analgesic effect of cTBS was not reflected in the amplitude modulation of nociceptive ERPs. Indeed, both nociceptive (N160, N240 and P360 waves) and late-latency non-nociceptive (N140 and P200 waves) ERPs elicited by stimulation of the contralateral and ipsilateral hands were similarly reduced after cTBS, suggesting an unspecific effect, possibly due to habituation or reduced alertness. In conclusion, cTBS applied over M1 and S1 reduces similarly the perception of nociceptive inputs originating from the contralateral hand, but this analgesic effect is not reflected in the magnitude of nociceptive ERPs.

Top-down suppression of incompatible motor activations during response selection under conflict

Top-down control is critical to select goal-directed actions in changeable environments, particularly when several options compete for selection. This control system is thought to involve a mechanism that suppresses activation of unwanted response representations. We tested this hypothesis, in humans, by measuring motor-evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) in a left finger muscle during motor preparation in an adapted Eriksen flanker task. Subjects reported, by a left or right button-press, the orientation of a left- or right-facing central arrow, flanked by two distractor arrows on each side. Central and peripheral arrows either pointed in the same (congruent trial) or in the opposite direction (incongruent trial). Top-down control was manipulated by changing the probability of congruent and incongruent trials in a given block. In the "mostly incongruent" (MI) blocks, 80% of trials were incongruent, producing a context in which subjects strongly anticipated that they would have to face conflict. In the "mostly congruent" (MC) blocks, 80% of trials were congruent and thus subjects barely anticipated conflict in that context. Thus, we assume that top-down control was stronger in the MI than in the MC condition. Accordingly, subjects displayed a lower error rate and shorter reaction times for the incongruent trials in the MI context than for similar trials in the MC context. More interestingly, we found that top-down control specifically reduced activation of the incompatible motor representation during response selection under high conflict. That is, when the central arrow specified a right hand response, left (non-selected) MEPs became smaller in the MI than in the MC condition, but only for incongruent trials, and this measure was positively correlated with performance. In contrast, MEPs elicited in the non-selected hand during congruent trials, or during all trials in which the left hand was selected, tended to increase more after the imperative signal in the MI than the MC condition. Another important observation was that, overall, MEPs were already strongly suppressed at the onset of the imperative signal and that this effect was particularly pronounced in the MI context. Hence, suppression of motor excitability seems to be a key component of conflict resolution.

Neurophysiological indicators of action quality at solving verbal and nonverbal tasks

Neurophysiological mechanisms of recognition of verbal and nonverbal stimuli have been studied. It was determined that subjects solved nonverbal tasks faster and more effectively with their left hands, while they used two strategies of recognition to solve verbal tasks (fast reactions with right and left hand). Analysis of spectral characteristics of EEG revealed that mechanisms of both anterior and posterior attention systems were simultaneously involved in the process of effective recognition of nonverbal stimuli and ineffective recognition of verbal stimuli. Analysis of the event-related potentials (ERPs) showed that ineffective recognition of verbal and nonverbal stimuli resulted in an increase in the amplitude of sensory components of ERPs (N1m, P1m), while effective recognition increased the amplitude of cognitive components of ERPs (P2m, P3m).