Ipsilateral corticospinal responses to ballistic training are similar for various intensities and timings of TMS

Acute Effects of Strength and Skill Training on the Cortical and Spinal Circuits of Contralateral Limb

Unilateral strength and skill training increase strength and performance in the contralateral untrained limb, a phenomenon known as cross-education. Recent evidence suggests that similar neural mechanisms might be responsible for the increase in strength and skill observed in the untrained hand after unimanual training. The aims of this study were to: investigate whether a single session of unimanual strength and skill (force-tracking) training increased strength and skill in the opposite hand; measure ipsilateral (untrained) brain (via transcranial magnetic stimulation, TMS) and spinal (via the monosynaptic reflex) changes in excitability occurring after training; measure ipsilateral (untrained) pathway-specific changes in neural excitability (via TMS-conditioning of the monosynaptic reflex) occurring after training. Participants (N = 13) completed a session of unimanual strength (ballistic isometric wrist flexions) and skill (force-tracking wrist flexions) training on two separate days. Strength increased after training in the untrained hand (p = 0.025) but not in the trained hand (p = 0.611). Force-tracking performance increased in both the trained (p = 0.007) and untrained (p = 0.010) hand. Corticospinal excitability increased after force-tracking and strength training (p = 0.027), while spinal excitability was not affected (p = 0.214). TMS-conditioned monosynaptic reflex increased after force-tracking (p = 0.001) but not strength training (p = 0.689), suggesting a possible role of polysynaptic pathways in the increase of cortical excitability observed after training. The results suggest that cross-education of strength and skill at the acute stage is supported by increased excitability of the untrained motor cortex.New & Noteworthy: A single session of isometric wrist flexion strength and skill straining increased strength and skill in the untrained limb. The excitability of the untrained motor cortex increased after strength and skill training. TMS-conditioned H-reflexes increased after skill but not strength training in the untrained hand, indicating that polysynaptic pathways in the increase of cortical excitability observed after skill training.

Corticospinal and spinal adaptations following lower limb motor skill training: a meta-analysis with best evidence synthesis

Motor skill training alters the human nervous system; however, lower limb motor tasks have been less researched compared to upper limb tasks. This meta-analysis with best evidence synthesis aimed to determine the cortical and subcortical responses that occur following lower limb motor skill training, and whether these responses are accompanied by improvements in motor performance. Following a literature search that adhered to the PRISMA guidelines, data were extracted and analysed from six studies (n = 172) for the meta-analysis, and 11 studies (n = 257) were assessed for the best evidence synthesis. Pooled data indicated that lower limb motor skill training increased motor performance, with a standardised mean difference (SMD) of 1.09 being observed. However, lower limb motor skill training had no effect on corticospinal excitability (CSE), Hoffmann's reflex (H-reflex) or muscle compound action potential (M_MAX) amplitude. The best evidence synthesis found strong evidence for improved motor performance and reduced short-interval cortical inhibition (SICI) following lower limb motor skill training, with conflicting evidence towards the modulation of CSE. Taken together, this review highlights the need for further investigation on how motor skill training performed with the lower limb musculature can modulate corticospinal responses. This will also help us to better understand whether these neuronal measures are underpinning mechanisms that support an improvement in motor performance.

Determining the Corticospinal Responses and Cross-Transfer of Ballistic Motor Performance in Young and Older Adults: A Systematic Review and Meta-Analysis

Ballistic motor training induces plasticity changes and imparts a cross-transfer effect. However, whether there are age-related differences in these changes remain unclear. Thus, the purpose of this study was to perform a meta-analysis to determine the corticospinal responses and cross-transfer of motor performance following ballistic motor training in young and older adults. Meta-analysis was performed using a random-effects model. A best evidence synthesis was performed for variables that had insufficient data for meta-analysis. There was strong evidence to suggest that young participants exhibited greater cross-transfer of ballistic motor performance than their older counterparts. This meta-analysis showed no significant age-related differences in motor-evoked potentials (MEPs), short-interval intracortical inhibition (SICI) and surface electromyography (sEMG) for both hands following ballistic motor training.

Neural mechanisms mediating cross education: With additional considerations for the ageing brain

CALVERT, G.H.M., and CARSON, R.G. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2021. - Cross education (CE) is the process whereby a regimen of unilateral limb training engenders bilateral improvements in motor function. The contralateral gains thus derived may impart therapeutic benefits for patients with unilateral deficits arising from orthopaedic injury or stroke. Despite this prospective therapeutic utility, there is little consensus concerning its mechanistic basis. The precise means through which the neuroanatomical structures and cellular processes that mediate CE may be influenced by age-related neurodegeneration are also almost entirely unknown. Notwithstanding the increased incidence of unilateral impairment in later life, age-related variations in the expression of CE have been examined only infrequently. In this narrative review, we consider several mechanisms which may mediate the expression of CE with specific reference to the ageing CNS. We focus on the adaptive potential of cellular processes that are subserved by a specific set of neuroanatomical pathways including: the corticospinal tract, corticoreticulospinal projections, transcallosal fibres, and thalamocortical radiations. This analysis may inform the development of interventions that exploit the therapeutic utility of CE training in older persons.

Acute Strength Training Increases Responses to Stimulation of Corticospinal Axons

PURPOSE

Acute strength training of forearm muscles increases resting twitch forces from motor cortex stimulation. It is unclear if such effects are spinal in origin and if they also occur with training of larger muscles. With the use of subcortical stimulation of corticospinal axons, the current study examined if one session of strength training of the elbow flexor muscles leads to spinal cord changes and if the type of training is important.

METHODS

In experiment 1, 10 subjects completed ballistic isometric training, ballistic concentric training, and no training (control) on separate days. In experiment 2, 13 subjects completed ballistic isometric training and slow-ramp isometric training. Before and after training, transcranial magnetic stimulation over the contralateral motor cortex elicited motor-evoked potentials (MEPs) in the resting biceps brachii, and electrical stimulation of corticospinal tract axons at the cervicomedullary junction elicited cervicomedullary motor-evoked potentials (CMEPs). Motor-evoked potential and CMEP twitch forces were also measured.

RESULTS

In experiment 1, CMEPs and CMEP twitch forces were significantly facilitated after ballistic isometric training compared to control. In experiment 2, MEPs, MEP twitch forces, CMEPs, and CMEP twitch forces increased for 15 to 25 min after ballistic and slow-ramp isometric training.

CONCLUSION

Via processes within the spinal cord, one session of strength training of the elbow flexors increases net output from motoneurons projecting to the trained muscles. Likely mechanisms include increased efficacy of corticospinal-motoneuronal synapses or increased motoneuron excitability. However, the rate of force generation during training is not important for inducing these changes. A concomitant increase in motor cortical excitability is likely. These short-term changes may represent initial neural adaptations to strength training.

Neural Adaptations Associated with Interlimb Transfer in a Ballistic Wrist Flexion Task

Cross education is the process whereby training of one limb gives rise to increases in the subsequent performance of its opposite counterpart. The execution of many unilateral tasks is associated with increased excitability of corticospinal projections from primary motor cortex (M1) to the opposite limb. It has been proposed that these effects are causally related. Our aim was to establish whether changes in corticospinal excitability (CSE) arising from prior training of the opposite limb determine levels of interlimb transfer. We used three vision conditions shown previously to modulate the excitability of corticospinal projections to the inactive (right) limb during wrist flexion movements performed by the training (left) limb. These were: (1) mirrored visual feedback of the training limb; (2) no visual feedback of either limb; and (3) visual feedback of the inactive limb. Training comprised 300 discrete, ballistic wrist flexion movements executed as rapidly as possible. Performance of the right limb on the same task was assessed prior to, at the mid point of, and following left limb training. There was no evidence that variations in the excitability of corticospinal projections (assessed by transcranial magnetic stimulation (TMS)) to the inactive limb were associated with, or predictive of, the extent of interlimb transfer that was expressed. There were however associations between alterations in muscle activation dynamics observed for the untrained limb, and the degree of positive transfer that arose from training of the opposite limb. The results suggest that the acute adaptations that mediate the bilateral performance gains realized through unilateral practice of this ballistic wrist flexion task are mediated by neural elements other than those within M1 that are recruited at rest by single-pulse TMS.

Anterior Corticospinal Tract Revisited: A Study Using Human Fetuses

In the human corticospinal tract (CST), the anterior CST is known to be much thinner than the lateral CST, but fetal development of the CST remains obscure. In this study, we examined horizontal histological sections of the cervical spinal cord from 50 midterm fetuses (crown-rump length, CRL, 70-150 mm; 12-18 weeks) as well as 15 late-stage fetuses (CRL 230-250 mm; 28-30 weeks). While the lateral CST appeared at 14-15 weeks in the cervical cord of the midterm fetuses, we found the anterior CST in only 3 fetuses: CRL 117 mm (15 weeks), and CRL 144 and 150 mm (18 weeks). However, in the late-stage fetuses, the anterior CST exhibited a spectrum of variations, including bilaterally thick tracts (3 fetuses), a unilaterally thick tract (5 fetuses) and a thin or absent tract (7 fetuses). In the group with the thickest anterior CST, the cross-sectional area reached 40% of that of the lateral CST. In contrast to the stable morphology of the lateral CST, the shape of the anterior tract varied slightly between the cervical segments. Immunohistochemical observations demonstrated no difference between the lateral and anterior CSTs: (1) in macrophage infiltration, which suggests apoptosis, and (2) in the arrangement of radial glial fibers. Our findings indicate that the development of the anterior CST starts later than that of the lateral tract, with significant individual variations. The functional relevance of the anterior CST, if present, might not be found in an independent cortical input to motor neurons but in a remodeling of the ascending tracts.

Direct and crossed effects of somatosensory electrical stimulation on motor learning and neuronal plasticity in humans

Purpose

Sensory input can modify voluntary motor function. We examined whether somatosensory electrical stimulation (SES) added to motor practice (MP) could augment motor learning, interlimb transfer, and whether physiological changes in neuronal excitability underlie these changes.

Methods

Participants (18–30 years, n = 31) received MP, SES, MP + SES, or a control intervention. Visuomotor practice included 300 trials for 25 min with the right-dominant wrist and SES consisted of weak electrical stimulation of the radial and median nerves above the elbow. Single- and double-pulse transcranial magnetic stimulation (TMS) metrics were measured in the intervention and non-intervention extensor carpi radialis.

Results

There was 27 % motor learning and 9 % (both p < 0.001) interlimb transfer in all groups but SES added to MP did not augment learning and transfer. Corticospinal excitability increased after MP and SES when measured at rest but it increased after MP and decreased after SES when measured during contraction. No changes occurred in intracortical inhibition and facilitation. MP did not affect the TMS metrics in the transfer hand. In contrast, corticospinal excitability strongly increased after SES with MP + SES showing sharply opposite of these effects.

Conclusion

Motor practice and SES each can produce motor learning and interlimb transfer and are likely to be mediated by different mechanisms. The results provide insight into the physiological mechanisms underlying the effects of MP and SES on motor learning and cortical plasticity and show that these mechanisms are likely to be different for the trained and stimulated motor cortex and the non-trained and non-stimulated motor cortex.

Task-related changes in sensorimotor integration influence the common synaptic input to motor neurones

AIM

The purpose of this investigation was to understand how visual information, when used to guide muscle activity, influences the frequency content of the neural drive to muscles and the gain of afferent feedback.

METHODS

Subjects maintained static, isometric contractions of the tibialis anterior muscle by matching a visual display of their ankle dorsiflexion force to a target set at 10% of their maximum voluntary contraction level. Two visual feedback conditions were studied. The first was a high-sensitivity feedback, in which small changes in force were of large on-screen visual magnitude. The second was a low-sensitivity feedback, in which the on-screen scaling of feedback was reduced by a factor of 10, making small force fluctuations difficult to perceive. Force tremor and Hoffmann reflex (H-reflex) amplitudes were compared between the two conditions, as well as coherence among single motor unit spike trains derived from high-density EMG recordings.

RESULTS

The high-sensitivity feedback condition was associated with lower error, larger force tremor (4-12 Hz) and larger H-reflex amplitudes relative to the low-sensitivity feedback condition. In addition, the use of high-sensitivity feedback was associated with lower 1-5 Hz coherence among pairs of motor units, but larger coherence at high frequencies (6-12, approx. 20, >30 Hz).

CONCLUSION

Alteration of visual feedback influences nearly the entire frequency spectrum of common input to motor neurones, as well the gain of afferent feedback. We speculate that task-related modulation of afferent feedback could be the origin of many of the observed changes in the neural drive to muscles.

Input-output characteristics of soleus homonymous Ia afferents and corticospinal pathways during upright standing differ between young and elderly adults

AIM

This study investigated the effects of ageing on the excitability of soleus homonymous Ia afferents and corticospinal pathways during bipedal upright standing.

METHODS

The input-output relations for the Hoffmann (H) reflex and motor-evoked potential (MEP) were computed for the soleus in response to electrical nerve stimulation and transcranial magnetic stimulation, respectively, in young (n = 16) and elderly (n = 16) adults. In subsets of subjects, the input-output relations were compared between normal and supported upright standing, and corticomotoneuronal excitability was assessed during upright standing with an H-reflex conditioning method. For the H-reflex and MEP threshold, maximal amplitude (Hmax , MEPmax ) and the slope of the input-output relation (Hslope , MEPslope ) were measured and normalized to the corresponding M-wave value.

RESULTS

In normal standing, the Hmax /Mmax [mean (SD); young: 48.3 (14.2)%; elderly: 17.3 (6.4)%] and Hslope /Mslope were significantly (P < 0.05) lower in elderly than in young adults, whereas the MEPmax /Mmax [young: 13.6 (7.5)%; elderly: 24.5 (12.8)%] and MEPslope /Mslope were greater in elderly adults (P < 0.05). The Hslope /Mslope and MEPslope /Mslope decreased and increased, respectively, from supported to normal standing for both age groups but more so in elderly adults. Furthermore, the conditioned H reflex was greater (P < 0.05) in elderly [175.1 (34.3)%] than in young adults [141.8 (29.8)%] during normal standing.

CONCLUSION

This is the first study that clearly indicates lower efficacy of Ia afferents to discharge spinal motor neurones accompanied by greater corticospinal excitability in elderly adults, suggesting an increased contribution of the descending drive in controlling soleus activity during upright standing with ageing.

Neural pathways mediating cross education of motor function

Cross education is the process whereby training of one limb gives rise to enhancements in the performance of the opposite, untrained limb. Despite interest in this phenomenon having been sustained for more than a century, a comprehensive explanation of the mediating neural mechanisms remains elusive. With new evidence emerging that cross education may have therapeutic utility, the need to provide a principled evidential basis upon which to design interventions becomes ever more pressing. Generally, mechanistic accounts of cross education align with one of two explanatory frameworks. Models of the “cross activation” variety encapsulate the observation that unilateral execution of a movement task gives rise to bilateral increases in corticospinal excitability. The related conjecture is that such distributed activity, when present during unilateral practice, leads to simultaneous adaptations in neural circuits that project to the muscles of the untrained limb, thus facilitating subsequent performance of the task. Alternatively, “bilateral access” models entail that motor engrams formed during unilateral practice, may subsequently be utilized bilaterally—that is, by the neural circuitry that constitutes the control centers for movements of both limbs. At present there is a paucity of direct evidence that allows the corresponding neural processes to be delineated, or their relative contributions in different task contexts to be ascertained. In the current review we seek to synthesize and assimilate the fragmentary information that is available, including consideration of knowledge that has emerged as a result of technological advances in structural and functional brain imaging. An emphasis upon task dependency is maintained throughout, the conviction being that the neural mechanisms that mediate cross education may only be understood in this context.