Task-dependent changes in the size of response to magnetic brain stimulation in human first dorsal interosseous muscle

Cortical Contributions to Imagined Power Grip Task: An EEG-Triggered TMS Study

Previous studies have demonstrated that motor imagery leads to desynchronization in the alpha rhythm within the contralateral primary motor cortex. However, the underlying electrophysiological mechanisms responsible for this desynchronization during motor imagery remain unclear. To examine this question, we conducted an investigation using EEG in combination with noninvasive transcranial magnetic stimulation (TMS) during index finger abduction (ABD) and power grip imaginations. The TMS was administered employing diverse coil orientations to selectively stimulate corticospinal axons, aiming to target both early and late synaptic inputs to corticospinal neurons. TMS was triggered based on the alpha power levels, categorized in 20th percentile bins, derived from the individual alpha power distribution during the imagined tasks of ABD and power grip. Our analysis revealed negative correlations between alpha power and motor evoked potential (MEP) amplitude, as well as positive correlations with MEP latency across all coil orientations for each imagined task. Furthermore, we conducted functional network analysis in the alpha band to explore network connectivity during imagined index finger abduction and power grip tasks. Our findings indicate that network connections were denser in the fronto-parietal area during imagined ABD compared to power grip conditions. Moreover, the functional network properties demonstrated potential for effectively classifying between these two imagined tasks. These results provide functional evidence supporting the hypothesis that alpha oscillations may play a role in suppressing MEP amplitude and latency during imagined power grip. We propose that imagined ABD and power grip tasks may activate different populations and densities of axons at the cortical level.

The Interactions Between Primary Somatosensory and Motor Cortex during Human Grasping Behaviors

Afferent inputs to the primary somatosensory cortex (S1) are differentially processed during precision and power grip in humans. However, it remains unclear how S1 interacts with the primary motor cortex (M1) during these two grasping behaviors. To address this question, we measured short-latency afferent inhibition (SAI), reflecting S1-M1 interactions via thalamo-cortical pathways, using paired-pulse transcranial magnetic stimulation (TMS) during precision and power grip. The TMS coil over the hand representation of M1 was oriented in the posterior-anterior (PA) and anterior-posterior (AP) direction to activate distinct sets of corticospinal neurons. We found that SAI increased during precision compared with power grip when AP, but not PA, currents were applied. Notably, SAI tested in the AP direction were similar during two-digit than five-digit precision grip. The M1 receives movement information from S1 through direct cortico-cortical pathways, so intra-hemispheric S1-M1 interactions using dual-site TMS were also evaluated. Stimulation of S1 attenuated M1 excitability (S1-M1 inhibition) during precision and power grip, while the S1-M1 inhibition ratio remained similar across tasks. Taken together,our findings suggest that distinct neural mechanisms for S1-M1 interactions mediate precision and power grip, presumably by modulating neural activity along thalamo-cortical pathways.

Shoulder position and handedness differentially affect excitability and intracortical inhibition of hand muscles

Individuals with stroke show distinct differences in hand function impairment when the shoulder is in adduction, within the workspace compared to when the shoulder is abducted, away from the body. To better understand how shoulder position affects hand control, we tested the corticomotor excitability and intracortical control of intrinsic and extrinsic hand muscles important for grasp in twelve healthy individuals. Motor evoked potentials (MEP) using single and paired-pulse transcranial magnetic stimulation were elicited in extensor digitorum communis (EDC), flexor digitorum superficialis (FDS), first dorsal interosseous (FDI), and abductor pollicis brevis (APB). The shoulder was fully supported in horizontal adduction (ADD) or abduction (ABD). Separate mixed-effect models were fit to the MEP parameters using shoulder position (or upper-extremity [UE] side) as fixed and participants as random effects. In the non-dominant UE, EDC showed significantly greater MEPs in shoulder ABD than ADD. In contrast, the dominant side EDC showed significantly greater MEPs in ADD compared to ABD; %facilitation of EDC on dominant side showed significant stimulus intensity x position interaction, EDC excitability was significantly greater in ADD at 150% of the resting threshold. Intrinsic hand muscles of the dominant UE received significantly more intracortical inhibition (SICI) when the shoulder was in ADD compared to ABD; there was no position-dependent modulation of SICI on the non-dominant side. Our findings suggest that these resting-state changes in hand muscle excitabilities reflect the natural statistics of UE movements, which in turn may arise from as well as shape the nature of shoulder-hand coupling underlying UE behaviors.

Task-dependent modulation of corticospinal excitability and inhibition following strength training

This study determined whether there are task-dependent differences in cortical excitability following different types of strength training. Transcranial magnetic stimulation (TMS) measured corticospinal excitability (CSE) and intracortical inhibition (ICI) of the biceps brachii muscle in 42 healthy subjects that were randomised to either paced-strength-training (PST, n = 11), self-paced strength-training (SPST, n = 11), isometric strength-training (IST, n = 10) or to a control group (n = 10). Single-pulse and paired-pulse TMS were applied prior to and following 4-weeks of strength-training. PST increased CSE compared to SPST, IST and the control group (all P < 0.05). ICI was only reduced (60%) following PST. Dynamic strength increased by 18 and 25% following PST and SPST, whilst isometric strength increased by 20% following IST. There were no associations between the behavioural outcome measures and the change in CSE and ICI. The corticospinal responses to strength-training are task-dependent, which is a new finding. Strength-training that is performed slowly could promote use-dependent plasticity in populations with reduced volitional drive, such as during periods of limb immobilization, musculoskeletal injury or stroke.

The Task at Hand: Fatigue-Associated Changes in Cortical Excitability during Writing

Measures of corticospinal excitability (CSE) made via transcranial magnetic stimulation (TMS) depend on the task performed during stimulation. Our purpose was to determine whether fatigue-induced changes in CSE made during a conventional laboratory task (isometric finger abduction) reflect the changes measured during a natural motor task (writing). We assessed single-and paired-pulse motor evoked potentials (MEPs) recorded from the first dorsal interosseous (FDI) of 19 participants before and after a fatigue protocol (submaximal isometric contractions) on two randomized days. The fatigue protocol was identical on the two days, but the tasks used to assess CSE before and after fatigue differed. Specifically, MEPs were evoked during a writing task on one day and during isometric finger abduction to a low-level target that matched muscle activation during writing on the other day. There was greater variability in MEP amplitude (F (1,18) = 13.55, p < 0.01) during writing compared to abduction. When participants were divided into groups according to writing style (printers, n = 8; cursive writers, n = 8), a task x fatigue x style interaction was revealed for intracortical facilitation (F (1,14) = 9.90, p < 0.01), which increased by 28% after fatigue in printers but did not change in cursive writers nor during the abduction task. This study is the first to assess CSE during hand-writing. Our finding that fatigue-induced changes in intracortical facilitation depend on the motor task used during TMS, highlights the need to consider the task-dependent nature of CSE when applying results to movement outside of the laboratory.

Changes in motor-evoked potential latency during grasping after tetraplegia

The corticospinal pathway contributes to the control of grasping in intact humans. After spinal cord injury (SCI), there is an extensive reorganization in the corticospinal pathway; however, its contribution to the control of grasping after the injury remains poorly understood. We addressed this question by using transcranial magnetic stimulation (TMS) over the hand representation of the motor cortex to elicit motor-evoked potentials (MEPs) in an intrinsic finger muscle during precision grip and power grip with the TMS coil oriented to induce currents in the brain in the latero-medial (LM) direction to activate corticospinal axons directly and in the posterior-anterior (PA) and anterior-posterior (AP) directions to activate the axon indirectly through synaptic inputs in humans with and without cervical incomplete SCI. We found prolonged MEP latencies in all coil orientations in both tasks in SCI compared with control subjects. The latencies of MEPs elicited by AP relative to LM stimuli were consistently longer during power compared with precision grip in controls and SCI subjects. In contrast, PA relative to LM MEP latencies were similar between tasks across groups. Central conduction time of AP MEPs was prolonged during power compared with precision grip in controls and SCI participants. Our results support evidence indicating that inputs activated by AP and PA currents are engaged to a different extent during fine and gross grasping in humans with and without SCI.NEW & NOTEWORTHY The mechanisms contributing to the control of hand function in humans with spinal cord injury (SCI) remain poorly understood. Here, we demonstrate for the first time that the latency of corticospinal responses elicited by transcranial magnetic stimulation anterior-posterior induced currents, relative to latero-medial currents, was prolonged during power compared with precision grip in humans with and without SCI. Gross grasping might represent a stragegy to engage networks activated by anterior-posterior currents after SCI.

Gating of Sensory Input at Subcortical and Cortical Levels during Grasping in Humans

Afferent input from the periphery to the cortex contributes to the control of grasping. How sensory input is gated along the ascending sensory pathway and its functional role during gross and fine grasping in humans remain largely unknown. To address this question, we assessed somatosensory-evoked potential components reflecting activation at subcortical and cortical levels and psychophysical tests at rest, during index finger abduction, precision, and power grip. We found that sensory gating at subcortical level and in the primary somatosensory cortex (S1), as well as intracortical inhibition in the S1, increased during power grip compared with the other tasks. To probe the functional relevance of gating in the S1, we examined somatosensory temporal discrimination threshold by measuring the shortest time interval to perceive a pair of electrical stimuli. Somatosensory temporal discrimination threshold increased during power grip, and higher threshold was associated with increased intracortical inhibition in the S1. These novel findings indicate that humans gate sensory input at subcortical level and in the S1 largely during gross compared with fine grasping. Inhibitory processes in the S1 may increase discrimination threshold to allow better performance during power grip.SIGNIFICANCE STATEMENT Most of our daily life actions involve grasping. Here, we demonstrate that gating of afferent input increases at subcortical level and in the primary somatosensory cortex (S1) during gross compared with fine grasping in intact humans. The precise timing of sensory information is critical for human perception and behavior. Notably, we found that the ability to perceive a pair of electrical stimuli, as measured by the somatosensory temporal discrimination threshold, increased during power grip compared with the other tasks. We propose that reduced afferent input to the S1 during gross grasping behaviors diminishes temporal discrimination of sensory processes related, at least in part, to increased inhibitory processes within the S1.

Distinct Corticocortical Contributions to Human Precision and Power Grip

The corticospinal tract contributes to the control of finger muscles during precision and power grip. The involvement of different sets of cortical interneuronal circuits during these distinct grasping behaviors remains unknown. To examine this question in humans we used noninvasive transcranial magnetic stimulation (TMS) over the hand representation of the primary motor cortex to elicit motor evoked potentials (MEPs) in an intrinsic finger muscle during index finger abduction (control task), precision grip, and power grip. The TMS coil was oriented to induce currents in the brain in the latero-medial (LM), posterior-anterior (PA), and anterior-posterior (AP) direction to preferentially activate corticospinal axons directly and early and late synaptic inputs to corticospinal neurons, respectively. We found that AP-LM MEP latency differences were consistently longer during power grip compared with index finger abduction and precision grip, while PA-LM differences remained similar across tasks. Short-interval intracortical facilitation, targeting AP but not PA inputs, increased during power grip compared with other tasks. Our novel findings suggest that cortical structures activated by PA and AP stimuli are differentially active during precision and power grip. We propose that a preferential recruitment of late synaptic inputs to corticospinal neurons may be achieved when humans perform a power grip.

Interindividual Variability in Use-Dependent Plasticity Following Visuomotor Learning: The Effect of Handedness and Muscle Trained

Motor learning has been linked with increases in corticospinal excitability (CSE). However, the robustness of this link is unclear. In this study, changes in CSE associated with learning a visuomotor tracking task were mapped using transcranial magnetic stimulation (TMS). TMS maps were obtained before and after training with the first dorsal interosseous (FDI) of the dominant and nondominant hand, and for a distal (FDI) and proximal (biceps brachii) muscle. Tracking performance improved following 20 min of visuomotor training, while map area was unaffected. Large individual differences were observed with 18%-36% of the participants revealing an increase in TMS map area. This result highlights the complex relationship between motor learning and use-dependent plasticity of the motor cortex.

Characterization of corticospinal activation of finger motor neurons during precision and power grip in humans

Direct and indirect corticospinal pathways to finger muscles may play a different role in control of the upper extremity. We used transcranial magnetic stimulation (TMS) and coherence analysis to characterize the corticospinal drive to the first dorsal interosseous (FDI) and abductor pollicis brevis (APB) when active during a precision and power grip task. In experiment 1, single motor units were recorded during precision grip and power grip in 20 adults (25.2 ± 7.1 years). Post-stimulus time histograms (PSTH) were obtained following TMS. In experiment 2, coherence and cross-correlation analysis of the FDI and APB surface EMG were used to investigate the temporal organization of corticospinal drive during precision grip and power grip in 15 adults (27.4 ± 8.1 years). We found no significant differences in PSTH peak onset (26.6 ± 1.9 vs. 26.7 ± 2.0 ms, p = 0.75), maximal peak (27.4 ± 1.9 vs. 27.4 ± 1.9 ms, p = 1.0) or peak duration (2.3 ± 1.1 vs. 2.3 ± 1.0 ms, p = 0.75) for the 11 recovered motor units during precision grip and power grip. Also, no significant difference in coherence or the width of the synchronization peaks during precision grip (7.2 ± 3.7 ms) and power grip (7.9 ± 3.1 ms) could be observed (p = 0.59). The short duration of peaks elicited in the PSTH of single motor units following TMS and central synchronization peaks of voluntarily activated motor units during precision and power grip suggests that the direct corticospinal pathway (the corticomotoneuronal system) is equally involved in the control of both tasks. The data do not support that indirect pathways would make a larger contribution to power grip.

Phase-dependent deficits during reach-to-grasp after human spinal cord injury

Most cervical spinal cord injuries result in asymmetrical functional impairments in hand and arm function. However, the extent to which reach-to-grasp movements are affected in humans with incomplete cervical spinal cord injury (SCI) remains poorly understood. Using kinematics and electromyographic (EMG) recordings in hand and arm muscles we studied the different phases of unilateral self-paced reach-to-grasp movements (arm acceleration, hand opening and closing) to a small cylinder in the more and less affected arms of individuals with cervical SCI and in age-matched controls. We found that SCI subjects showed prolonged movement duration in both arms during arm acceleration, and hand opening and closing compared with controls. Notably, the more affected arm showed an additional increase in movement duration at the time to close the hand compared with the less affected arm. Also, the time at which the index finger and thumb contacted the object and the variability of finger movement trajectory were increased in the more compared with the less affected arm of SCI participants. Participants with prolonged movement duration during hand closing were those with more pronounced deficits in sensory function. The muscle activation ratio between the first dorsal interosseous and abductor pollicis brevis muscles decreased during hand closing in the more compared with the less affected arm of SCI participants. Our results suggest that deficits in movement kinematics during reach-to-grasp movements are more pronounced at the time to close the hand in the more affected arm of SCI participants, likely related to deficits in EMG muscle activation and sensory function. NEW & NOTEWORTHY Humans with cervical spinal cord injury usually present asymmetrical functional impairments in hand and arm function. Here, we demonstrate for the first time that deficits in movement kinematics during reaching and grasping movements are more pronounced at the time to close the hand in the more affected arm of spinal cord injury. We suggest that this is in part related to deficits in muscle activation ratios between hand muscles and a decrease in sensory function.

Subcortical control of precision grip after human spinal cord injury

The motor cortex and the corticospinal system contribute to the control of a precision grip between the thumb and index finger. The involvement of subcortical pathways during human precision grip remains unclear. Using noninvasive cortical and cervicomedullary stimulation, we examined motor evoked potentials (MEPs) and the activity in intracortical and subcortical pathways targeting an intrinsic hand muscle when grasping a small (6 mm) cylinder between the thumb and index finger and during index finger abduction in uninjured humans and in patients with subcortical damage due to incomplete cervical spinal cord injury (SCI). We demonstrate that cortical and cervicomedullary MEP size was reduced during precision grip compared with index finger abduction in uninjured humans, but was unchanged in SCI patients. Regardless of whether cortical and cervicomedullary stimulation was used, suppression of the MEP was only evident 1-3 ms after its onset. Long-term (∼5 years) use of the GABAb receptor agonist baclofen by SCI patients reduced MEP size during precision grip to similar levels as uninjured humans. Index finger sensory function correlated with MEP size during precision grip in SCI patients. Intracortical inhibition decreased during precision grip and spinal motoneuron excitability remained unchanged in all groups. Our results demonstrate that the control of precision grip in humans involves premotoneuronal subcortical mechanisms, likely disynaptic or polysynaptic spinal pathways that are lacking after SCI and restored by long-term use of baclofen. We propose that spinal GABAb-ergic interneuronal circuits, which are sensitive to baclofen, are part of the subcortical premotoneuronal network shaping corticospinal output during human precision grip.

Neural coupling of cooperative hand movements: a reflex and fMRI study

The neural control of "cooperative" hand movements reflecting "opening a bottle" was explored in human subjects by electromyographic (EMG) and functional magnetic resonance imaging (fMRI) recordings. EMG responses to unilateral nonnoxious ulnar nerve stimulation were analyzed in the forearm muscles of both sides during dynamic movements against a torque applied by the right hand to a device which was compensated for by the left hand. For control, stimuli were applied while task was performed in a static/isometric mode and during bilateral synchronous pro-/supination movements. During the dynamic cooperative task, EMG responses to stimulations appeared in the right extensor and left flexor muscles, regardless of which side was stimulated. Under the control conditions, responses appeared only on the stimulated side. fMRI recordings showed a bilateral extra-activation and functional coupling of the secondary somatosensory cortex (S2) during the dynamic cooperative, but not during the control, tasks. This activation might reflect processing of shared cutaneous input during the cooperative task. Correspondingly, it is assumed that stimulation-induced unilateral volleys are processed in S2, leading to a release of EMG responses to both forearms. This indicates a task-specific neural coupling during cooperative hand movements, which has consequences for the rehabilitation of hand function in poststroke patients.

Utility of TMS to understand the neurobiology of speech

According to a traditional view, speech perception and production are processed largely separately in sensory and motor brain areas. Recent psycholinguistic and neuroimaging studies provide novel evidence that the sensory and motor systems dynamically interact in speech processing, by demonstrating that speech perception and imitation share regional brain activations. However, the exact nature and mechanisms of these sensorimotor interactions are not completely understood yet. Transcranial magnetic stimulation (TMS) has often been used in the cognitive neurosciences, including speech research, as a complementary technique to behavioral and neuroimaging studies. Here we provide an up-to-date review focusing on TMS studies that explored speech perception and imitation. Single-pulse TMS of the primary motor cortex (M1) demonstrated a speech specific and somatotopically specific increase of excitability of the M1 lip area during speech perception (listening to speech or lip reading). A paired-coil TMS approach showed increases in effective connectivity from brain regions that are involved in speech processing to the M1 lip area when listening to speech. TMS in virtual lesion mode applied to speech processing areas modulated performance of phonological recognition and imitation of perceived speech. In summary, TMS is an innovative tool to investigate processing of speech perception and imitation. TMS studies have provided strong evidence that the sensory system is critically involved in mapping sensory input onto motor output and that the motor system plays an important role in speech perception.

Corticospinal Facilitation of Erector Spinae and Rectus Abdominis Muscles During Graded Voluntary Contractions is Task Specific: A Pilot Study on Healthy Individuals

INTRODUCTION

IN THIS STUDY WE COMPARED TRANSCRANIAL MAGNETIC STIMULATION (TMS) ELICITED MOTOR EVOKED POTENTIALS (MEPS) IN A POSTURAL (BILATERAL LOW BACK EXTENSION: BLBE) and a respiratory (forced expiration during breath holding: FEBH) task.

METHODS

Using TMS of the left motor cortex, simultaneous patterns of corticospinal facilitation of the contralateral erector spinae (ES) and rectus abdominis (RA) muscles during graded voluntary activation were compared in seven healthy subjects.

RESULT

The facilitation pattern demonstrated task dependency by showing that MEP amplitudes in the ES muscle tended to be smaller at any given contraction level in the FEBH task than in the BLBE task.

DISCUSSION

The results suggested a linear-type relationship between the size of MEPs with increasing background contraction of ES and RA in the BLBE task. However, both muscles showed a plateau effect with higher background contractions (>50% of maximum) during the FEBH task. The varied response of ES and RA across these two tasks reinforces the importance of task specific training in clinical settings.

Corticospinal excitability is enhanced after visuomotor adaptation and depends on learning rather than performance or error

We used adaptation to high and low gains in a virtual reality setup of the hand to test competing hypotheses about the excitability changes that accompany motor learning. Excitability was assayed through changes in amplitude of motor evoked potentials (MEPs) in relevant hand muscles elicited with single-pulse transcranial magnetic stimulation (TMS). One hypothesis is that MEPs will either increase or decrease, directly reflecting the effect of low or high gain on motor output. The alternative hypothesis is that MEP changes are not sign dependent but rather serve as a marker of visuomotor learning, independent of performance or visual-to-motor mismatch (i.e., error). Subjects were required to make flexion movements of a virtual forefinger to visual targets. A gain of 1 meant that the excursions of their real finger and virtual finger matched. A gain of 0.25 ("low gain") indicated a 75% reduction in visual versus real finger displacement, a gain of 1.75 ("high gain") the opposite. MEP increases (>40%) were noted in the tonically activated task-relevant agonist muscle for both high- and low-gain perturbations after adaptation reached asymptote with kinematics matched to veridical levels. Conversely, only small changes in excitability occurred in a control task of pseudorandom gains that required adjustments to large errors but in which learning could not accumulate. We conclude that changes in corticospinal excitability are related to learning rather than performance or error.

Visuomotor gain distortion alters online motor performance and enhances primary motor cortex excitability in patients with stroke

OBJECTIVES

Determine if ipsilesional primary motor cortex (M1) in stroke patients processes online visuomotor discordance in gain between finger movement and observed feedback in virtual reality (VR).

MATERIALS AND METHODS

Chronic stroke patients flexed (N= 7) or extended (N= 1) their finger with real-time feedback of a virtual hand presented in VR. Virtual finger excursion was scaled by applying a low-gain (G(0.25) ), high-gain (G(1.75) ), or veridical (G(1.00) ) scaling factor to real-time data streaming from a sensor glove. Effects of visuomotor discordance were assessed through analysis of movement kinematics (joint excursion, movement smoothness, and angular velocity) and amplitude of motor evoked potentials (MEPs) elicited with transcranial magnetic stimulation applied to ipsilesional M1. Data were analyzed with a repeated-measures analysis of variance (significance set at 0.05).

RESULTS

G(0.25) discordance (relative to veridical) leads to significantly larger joint excursion, online visuomotor correction evidenced by decreased trajectory smoothness, and significantly facilitated agonist MEPs. This effect could not be explained by potential differences in motor drive (background electromyographic) or by possible differences related to joint angle or angular velocity, as these variables remained invariant across conditions at the time of MEP assessment. M1 was not significantly facilitated in the G(1.75) condition. MEPs recorded in an adjacent muscle that was not involved in the task were unaffected by visual feedback in either discordance condition. These data suggest that the neuromodulatory effects of visuomotor discordance on M1 were relatively selective.

CONCLUSIONS

 Visuomotor discordance may be used to alter movement performance and augment M1 excitability in patients following stroke. Our data illustrate that visual feedback may be a robust way to selectively modulate M1 activity. These data may have important clinical implications for the development of future VR training protocols.

Task-dependent changes of motor cortical network excitability during precision grip compared to isolated finger contraction

The purpose of this study was to determine whether task-dependent differences in corticospinal pathway excitability occur in going from isolated contractions of the index finger to its coordinated activity with the thumb. Focal transcranial magnetic stimulation (TMS) was used to measure input-output (I/O) curves--a measure of corticospinal pathway excitability--of the contralateral first dorsal interosseus (FDI) muscle in 21 healthy subjects performing two isometric motor tasks: index abduction and precision grip. The level of FDI electromyographic (EMG) activity was kept constant across tasks. The amplitude of the FDI motor evoked potentials (MEPs) and the duration of FDI silent period (SP) were plotted against TMS stimulus intensity and fitted, respectively, to a Boltzmann sigmoidal function. The plateau level of the FDI MEP amplitude I/O curve increased by an average of 40% during the precision grip compared with index abduction. Likewise, the steepness of the curve, as measured by the value of the maximum slope, increased by nearly 70%. By contrast, all I/O curve parameters [plateau, stimulus intensity required to obtain 50% of maximum response (S(50)), and slope] of SP duration were similar between the two tasks. Short- and long-latency intracortical inhibitions (SICI and LICI, respectively) were also measured in each task. Both measures of inhibition decreased during precision grip compared with the isolated contraction. The results demonstrate that the motor cortical circuits controlling index and thumb muscles become functionally coupled when the muscles are used synergistically and this may be due, at least in part, to a decrease of intracortical inhibition and an increase of recurrent excitation.

Descending corticospinal control of intersegmental dynamics

To make an accurate movement, the CNS has to overcome the inherent complexities of the multijoint limb. For example, interaction torques arise when motion of individual arm segments propagates to adjacent segments causing their movement without any muscle contractions. Since these passive joint torques significantly add to the overall torques generated by active muscular contractions, they must be taken into account during planning or execution of goal-directed movements. We investigated the role of the corticospinal tract in compensating for the interaction torques during arm movements in humans. Twelve subjects reached to visual targets with their arm supported by a robotic exoskeleton. Reaching to one target was accompanied by interaction torques that assisted the movement, while reaching to the other target was accompanied by interaction torques that resisted the movement. Corticospinal excitability was assessed at different times during movement using single-pulse transcranial magnetic stimulation (TMS) over the upper-arm region of M1 (primary motor cortex). We found that TMS responses in shoulder monoarticular and elbow-shoulder biarticular muscles changed together with the interaction torques during movements in which the interaction torques were resistive. In contrast, TMS responses did not correlate with assistive interaction torques or with co-contraction. This suggests that the descending motor command includes compensation for passive limb dynamics. Furthermore, our results suggest that compensation for interaction torques involves the biarticular muscles, which span both shoulder and elbow joints and are in a biomechanically advantageous position to provide such compensation.

Task-related variations in the surface EMG of the human first dorsal interosseous muscle

Evidence from human and animal studies suggests that motor neuron pool organization is not uniform for all motor tasks. Groupings of motor units within a muscle may be recruited differentially for a given task based on principles beyond anatomical or architectural features of the muscle alone. This study aimed to determine whether: (1) there was differential activation across locations of the first dorsal interosseous (FDI) muscle during a given task, (2) the differential activation was related to directional requirements and/or end goal of the task, and (3) there was an anatomical pattern to the differential activation. Twenty-six healthy right-handed participants carried out isometric finger/hand contractions in sitting while surface EMG was collected from 4 bipolar sites on the FDI muscle simultaneously. The tasks included: abduction, flexion, diagonal, 30% abduction + 30% flexion, 30% flexion + 30% abduction, key pinch, and power grasp. Mean peak integrated EMG for each task was normalized to site and task specific mean M waves. Differential activation was evident across FDI sites based on movement direction, order of directional components within a combination condition, and end goal of the task. There was greatest activation in the distal ulnar site for all tasks. Additionally there was a trend toward an ordering effect in the amount of activation at each site: distal ulnar > distal radial > proximal radial > proximal ulnar.

Interaction between vestibulo-spinal and corticospinal systems: a combined caloric and transcranial magnetic stimulation study

We investigated the interaction between vestibular and corticospinal stimuli in 8 healthy volunteers. Vestibular stimulation was induced with unilateral ear caloric irrigation (30°C) with subjects supine. Single transcranial magnetic stimulation (TMS) pulses were delivered (double-cone coil, intensities 60-75% maximal output) every 10-20 s during vestibular activation and during baseline. Bilateral surface electromyography (EMG) from splenius capitis, sternocleidomastoid (SCM), obliquus externus abdominis, vastus lateralis, biceps femoris (BF), tibialis anterior and peroneus longus was obtained. During whole-body maximal rotatory voluntary isometric contraction (MRVC), only SCM and BF displayed EMG activation/inhibition patterns indicating axial rotatory action. TMS-induced motor evoked potentials (MEPs) after caloric irrigation revealed that only SCM showed consistent vestibular-mediated excitation/inhibition responses, i.e. an increase in MEP area contralateral to the irrigation and a decrease in MEP area ipsilaterally (+12.7 and -6.3% of the MRVC, respectively). A putative head turn induced by this SCM activity pattern would be in the same direction of the slow-phase eye movement. EMG in the 100 ms preceding TMS showed muscle tone values of approximately 10% of MRVC. After caloric irrigation, these values increased by ca. 2% for all muscles bilaterally and hence cannot explain the direction-specific SCM MEP changes. Thus, SCM MEPs show caloric-induced amplitude modulation indicating that SCM is under both horizontal semicircular canal and corticospinal control. This vestibular modulation of corticospinal SCM control likely occurs at cortical levels. The direction of the MEP modulation indicates a directional coupling between vestibularly induced head and eye movements.

Probing for hemispheric specialization for motor skill learning: a transcranial direct current stimulation study

Convergent findings point to a left-sided specialization for the representation of learned actions in right-handed humans, but it is unknown whether analogous hemispheric specialization exists for motor skill learning. In the present study, we explored this question by comparing the effects of anodal transcranial direct current stimulation (tDCS) over either left or right motor cortex (M1) on motor skill learning in either hand, using a tDCS montage to better isolate stimulation to one hemisphere. Results were compared with those previously found with a montage more commonly used in the field. Six groups trained for three sessions on a visually guided sequential pinch force modulation task with their right or left hand and received right M1, left M1, or sham tDCS. A linear mixed-model analysis for motor skill showed a significant main effect for stimulation group (left M1, right M1, sham) but not for hand (right, left) or their interaction. Left M1 tDCS induced significantly greater skill learning than sham when hand data were combined, a result consistent not only with the hypothesized left hemisphere specialization for motor skill learning but also with possible increased left M1 responsiveness to tDCS. The unihemispheric montage effect size was one-half that of the more common montage, and subsequent power analysis indicated that 75 subjects per group would be needed to detect differences seen with only 12 subjects with the customary bihemispheric montage.

Observation-execution matching and action inhibition in human primary motor cortex during viewing of speech-related lip movements or listening to speech

One influential theory posits that language has evolved from gestural communication through observation-execution matching processes in the mirror neuron system (MNS). This theory predicts that observation of speech-related lip movements or even listening to speech would result in effector and task specific increase of the excitability of the corresponding motor representations in the primary motor cortex (M1), since actual movement execution is known be effector and task specific. In addition, effector and task specific inhibitory control mechanisms should be important to prevent overt motor activation during observation of speech-related lip movements or listening to speech. We tested these predictions by applying focal transcranial magnetic stimulation to the left M1 of 12 healthy right-handed volunteers and measuring motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) in a lip muscle, the right orbicularis oris (OO), vs. a hand muscle, the right first dorsal interosseus (FDI). We found that MEP and SICI increased only in the OO but not in the FDI during viewing of speech-related lip movements or listening to speech. These changes were highly task specific because they were absent when lip movements non-related to speech were viewed. Finally, the increase in MEP amplitude in the OO correlated inversely with accuracy of speech perception, i.e. the MEP increase was directly related to task difficulty. The MEP findings support the notion that observation-execution matching is an operating process in the putative human MNS that might have been fundamental for evolution of language. Furthermore, the SICI findings provide evidence that inhibitory mechanisms are recruited to prevent unwanted overt motor activation during action observation.

Direct corticospinal control of force derivative

During simultaneous generation of static and dynamic forces, motor cortical signals only predict the dynamic components, suggesting a key role in the coding of force changes. However, such a role is obscured by uncertainties regarding the representation of dynamic force signals in corticospinal outputs. We used transcranial magnetic stimulation (TMS) of the motor cortex in humans during a task that dissociated the direction of instantaneous net force and that of force derivative. The direction of TMS-evoked force outputs was closely associated with that of the force derivative, and had no relationship with that of the net force generated simultaneously, even though the magnitude of the instantaneous net force largely exceeded that of the force derivative. This observation supports the hypothesis that during dynamic force generation, the motor cortex and the corticospinal system assume a pivotal role in coding the direction of force changes, through selective recruitment of spinal motoneurons.

Asymmetric Activation of Motor Cortex Controlling Human Anterior Digastric Muscles During Speech and Target-Directed Jaw Movements

Like most of the cranial muscles involved in speech, the trigeminally innervated anterior digastric muscles are controlled by descending corticobulbar projections from the primary motor cortex (M1) of each hemisphere. We hypothesized that changes in corticobulbar M1 excitability during speech production would show a hemispheric asymmetry favoring the left side, which is the dominant hemisphere for language processing in most strongly right handed subjects. Fifteen volunteers aged 24.5 ± 5.3 (SD) yr participated. All subjects were strongly right handed as reported by questionnaire. A surface electromyograph (EMG) was recorded bilaterally from digastrics and jaw movement detected by an accelerometer attached to a lower incisor. Focal transcranial magnetic stimulation (TMS) was used to assess corticomotor excitability of the digastric representation in M1 of both hemispheres during four tasks: 1) static isometric contraction of digastrics; 2) speaking a single word; 3) visually guided, nonspeech jaw movement that matched the jaw kinematics recorded during task 2; and 4) reciting a sentence. Background EMG was well matched in all tasks and jaw kinematics were similar around the time of the TMS pulse for tasks 2–4. TMS resting thresholds and digastric muscle-evoked potential (MEP) size during isometric contraction did not differ for TMS over left versus right M1. MEPs elicited by TMS over left, but not right M1 increased in size during speech and nonspeech jaw movement compared with isometric contraction. We conclude that left corticobulbar M1 is preferentially engaged for descending control of digastric muscles during speech and the performance of a rapid jaw movement to match a target kinematic profile.

Increase in corticospinal excitability of limb and trunk muscles according to maintenance of neck flexion

The effect of maintenance of neck flexion on corticospinal excitability of limb and trunk muscles was investigated using transcranial magnetic stimulation (TMS). Nine healthy young subjects participated in this experiment. Every measurement was performed with subjects sitting on a chair. Target muscles were the first dorsal interosseous (FDI), biceps brachii (BB), triceps brachii (TB), rectus abdominis (RA), erector spinae (ES), rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GcM) on the right side. TMS was applied to the left primary motor cortex, and motor evoked potential (MEP) was measured from the muscles listed above. Optimal stimulus location and resting motor threshold (RMT) were identified for each target muscle, and stimulus intensity used was 120% of RMT. MEPs of the target muscle were recorded with the chin resting on a chin support (chin-on condition) with neck in 20 degrees of flexion, and with voluntary maintenance of the neck flexion posture (chin-off condition). Amplitude and latency of MEP and background activity of target muscles were analyzed. For FDI, BB, TB, ES, and RF, amplitude of MEP increased and latency shortened in the chin-off compared with the chin-on condition. No significant difference in background activity of each target muscle was found between the two conditions. Corticospinal excitability of limb and trunk muscles was selectively enhanced while neck flexion was maintained.

Cortical topography of human first dorsal interroseus during individuated and nonindividuated grip tasks

Neural activity in the motor cortex and its descending projections is modulated in a task-related manner. Several TMS studies have shown that when normal human subjects execute different manual tasks requiring similar contraction levels in first dorsal interroseous (FDI) there is a task-related modulation of the amplitude of FDI motor evoked potentials (MEPs). Not all studies of task-related changes show the same pattern of results, however. One reason for this might be methodological. Studies have assessed task-related changes by stimulating a single site, which can provide information about task-related changes in the excitability of the cortex at that site, but which is not sensitive to excitability changes throughout the muscle's cortical representation. We investigated how the execution of an individuated versus a nonindividuated isometric grasping task affected the excitability of FDI's entire cortical representation. We examined FDI MEP amplitudes while subjects grasped an object between their thumb and index finger, or when they grasped the same object between their thumb and all four fingers, keeping the background level of EMG in FDI constant for the two tasks. We found no overall task-related change in the excitability of FDI or its cortical topography, possibly due to behavioral differences of individual subjects. The stability of FDI's cortical representation during two different manual tasks expands the possibilities for studying cortical reorganization in the context of active muscle contraction, which will enable us to better understand whether changes in the motor system observed when muscles are at rest are also present during voluntary muscle recruitment.

Transcranial magnetic stimulation during voluntary action: directional facilitation of outputs and relationships to force generation

Single-pulse transcranial magnetic stimulation (TMS) of the human motor cortex evokes simple muscle jerks whose physiological significance is unclear. Indeed, in subjects performing a motor task, there is uncertainty as to whether TMS-evoked outputs reflect the ongoing behavior or, alternatively, a disrupted motor plan. Considering force direction and magnitude to reflect qualitative and quantitative features of the motor plan respectively, we studied the relationships between voluntary forces and those evoked by TMS. In five healthy adults, we recorded the isometric forces acting a hand joint and the electromyographic activity in the first dorsal interosseous (FDI) muscle. Responses obtained at rest were highly invariant. Evoked responses obtained while subjects generated static and dynamic contractions were highly codirectional with the voluntary forces. Such directional relationships were independent of stimulation intensity, stimulated cortical volume, or magnitude of voluntary force exerted. Dynamic force generation was associated with a marked increase in the magnitude of the evoked force that was linearly related to the rate of force generation. The timing of central conduction was different depending on functional role of the target muscle, as either agonist or joint fixator. These results indicate that the architecture of motor plans remain grossly undisrupted by cortical stimulation applied during voluntary motor behavior. The significant magnitude modulation of responses during dynamic force generation suggests an essential role of the corticospinal system in the specification of force changes. Finally, the corticospinal activation depends on the functional role assumed by the target muscle, either postural or agonist.

Factors influencing the relation between corticospinal output and muscle force during voluntary contractions

The mechanisms by which voluntary forces of different strengths are produced in human muscles are not clear. We studied the relation between force and surface electromyography (sEMG) variables over a wide range of voluntary contraction strengths of biceps brachii (BIC) and abductor digiti minimi (ADM). The relation between force and motor evoked potentials (MEPs) to transcranial magnetic stimulation of motor cortex was also assessed. The root mean square of sEMG and median frequency (Mf) of the sEMG power spectrum as well as the MEP area of ADM and BIC were calculated up to the maximum voluntary contraction (MVC). The root mean square of ADM and BIC increased with increasing force levels up to the MVC. The Mf of BIC increased with force levels up to 70% MVC after which it rapidly declined. The Mf of ADM peaked at 40% MVC to slowly decline thereafter. The MEP changes with force were similar to Mf changes. Thus, corticospinal output, as tested by the Mf and MEPs, does not parallel force increments across the contraction range. This decline, which is contingent on the relative contribution of motor unit recruitment and rate coding to force production in each muscle, may depend on reduced motoneurone responsiveness at high firing rates. We suggest that, under controlled conditions, the frequency content of the sEMG signal may be taken to indicate motor unit recruitment range. This information may improve the utility of the Mf to enable evaluation of voluntary activation under different conditions.

The origin of activity in the biceps brachii muscle during voluntary contractions of the contralateral elbow flexor muscles

During strong voluntary contractions, activity is not restricted to the target muscles. Other muscles, including contralateral muscles, often contract. We used transcranial magnetic stimulation (TMS) to analyse the origin of these unintended contralateral contractions (termed "associated" contractions). Subjects (n = 9) performed maximal voluntary contractions (MVCs) with their right elbow-flexor muscles followed by submaximal contractions with their left elbow flexors. Electromyographic activity (EMG) during the submaximal contractions was matched to the associated EMG in the left biceps brachii during the right MVC. During contractions, TMS was delivered to the motor cortex of the right or left hemisphere and excitatory motor evoked potentials (MEPs) and inhibitory (silent period) responses recorded from left biceps. Changes at a spinal level were investigated using cervicomedullary stimulation to activate corticospinal paths (n = 5). Stimulation of the right hemisphere produced silent periods of comparable duration in associated and voluntary contractions (218 vs 217 ms, respectively), whereas left hemisphere stimulation caused a depression of EMG but no EMG silence in either contraction. Despite matched EMG, MEPs elicited by right hemisphere stimulation were approximately 1.5-2.5 times larger during associated compared to voluntary contractions (P < 0.005). Similar inhibition of the associated and matched voluntary activity during the silent period suggests that associated activity comes from the contralateral hemisphere and that motor areas in this (right) hemisphere are activated concomitantly with the motor areas in the left hemisphere. Comparison of the MEPs and subcortically evoked potentials implies that cortical excitability was greater in associated contractions than in the matched voluntary efforts.

Transcranial magnetic stimulation during resistance training of the tibialis anterior muscle

During the first few weeks of resistance training, maximal voluntary contraction (MVC) force increases at a faster rate than can be accounted for by increases in protein synthesis. This early increase in MVC force has been attributed to neural mechanisms but the sources have not been identified. The purpose of this study was to measure changes in cortical excitability with transcranial magnetic stimulation during 4 weeks of resistance training of the tibialis anterior muscle. Ten individuals performed 6 sets of 10 MVCs 3 times per week for 4 weeks and ten participated as a control group. There were no changes in any parameters tested in the control group over the 4 weeks. In the training group, TA muscle strength increased significantly by 10% at week 2 and by 18% at week 4. As hypothesized, cortical excitability during resistance training also increased. The amplitude of the TA surface EMG motor evoked potential elicited by TMS during a low-level contraction increased by 32% after training with no change in the M-wave. These data indicate that there may be an increase in cortical excitability during the first few weeks of resistance training of the TA muscle.

Amplitude cancellation reduces the size of motor unit potentials averaged from the surface EMG

The purpose of the study was to evaluate the influence of selected physiological parameters on amplitude cancellation in the simulated surface electromyogram (EMG) and the consequences for spike-triggered averages of motor unit potentials derived from the interference and rectified EMG signals. The surface EMG was simulated from prescribed recruitment and rate coding characteristics of a motor unit population. The potentials of the motor units were detected on the skin over a hand muscle with a bipolar electrode configuration. Averages derived from the EMG signal were generated using the discharge times for each of the 24 motor units with lowest recruitment thresholds from a population of 120 across three conditions: 1) excitation level; 2) motor unit conduction velocity; and 3) motor unit synchronization. The area of the surface-detected potential was compared with potentials averaged from the interference, rectified, and no-cancellation EMGs. The no-cancellation EMG comprised motor unit potentials that were rectified before they were summed, thereby preventing cancellation between the opposite phases of the potentials. The percent decrease in area of potentials extracted from the rectified EMG was linearly related to the amount of amplitude cancellation in the interference EMG signal, with the amount of cancellation influenced by variation in excitation level and motor unit conduction velocity. Motor unit synchronization increased potentials derived from both the rectified and interference EMG signals, although cancellation limited the increase in area for both potentials. These findings document the influence of amplitude cancellation on motor unit potentials averaged from the surface EMG and the consequences for using the procedure to characterize motor unit properties.

Functional demanded excitability changes of human hand motor area

The present study was performed to examine if there are functional differences between the first dorsal interosseous (FDI) and the abductor digit minimi (ADM) muscles during different muscle contractions, namely dynamic and static contractions of the index and little finger abductions. It was also examined whether these functional differences occur at the cortical level. The motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) and force curves, during the muscle contractions, were simultaneously recorded. Rest motor thresholds (RMTs) and active motor thresholds (AMTs), during dynamic and static contractions, were determined in the two muscles. In all trials, the background EMGs (B.EMGs) were kept at the same level in each muscle. Results showed that the target matching errors of dynamic contractions were statistically smaller in the FDI muscle than those in the ADM. In the FDI muscle, the AMT during dynamic contractions was significantly lower than during static ones and the MEPs elicited by TMS were larger during dynamic contractions than those during static ones. However, such results were not found in the ADM muscle. In order to investigate whether the differences were caused by the excitability changes that occurred in the cortical level, the responses elicited by subcortical stimulations were recorded using the same procedures as the experiment of TMS. Responses to subcortical stimulations during dynamic contractions were similar to those during static ones in either muscle. It is concluded that there are differences in the task-dependent MEP facilitations between the FDI and ADM muscles. And the differences are due to the functional demanded excitability changes accompanied by the cortical activation.

Influence of motor unit properties on the size of the simulated evoked surface EMG potential

The purpose of the study was to quantify the influence of selected motor unit properties on the simulated amplitude and area of evoked muscle potentials detected at the skin surface. The study was restricted to a motor unit population simulating a hand muscle whose potentials were recorded on the skin over the muscle. Peak-to-peak amplitude and area of the evoked potential were calculated from the summed motor unit potentials and compared across conditions that simulated variation in different motor unit properties. The simulations involved varying the number of activated motor units, muscle fiber conduction velocities, axonal conduction velocities, neuronal activation times, the shape of the intracellular action potential, and recording configurations commonly used over hand muscles. The results obtained for the default condition simulated in this study indicated that ~7% of the motor unit potentials were responsible for 50% of the size of the evoked potential. Variation in the amplitude and area of the evoked muscle potential was directly related to the number of active motor units only when the stimulus activated motor units randomly, and not when activation was based on a parameter such as motor unit size. Independent adjustments in motor unit properties had variable effects on the size of the evoked muscle potential, including when the stimulus activated only a subpopulation of motor units. These results provide reference information that can be used to assist in the interpretation of experimentally observed changes in the size of evoked muscle potentials.

Motor skill training and strength training are associated with different plastic changes in the central nervous system

Changes in corticospinal excitability induced by 4 wk of heavy strength training or visuomotor skill learning were investigated in 24 healthy human subjects. Measurements of the input-output relation for biceps brachii motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation were obtained at rest and during voluntary contraction in the course of the training. The training paradigms induced specific changes in the motor performance capacity of the subjects. The strength training group increased maximal dynamic and isometric muscle strength by 31% ( P < 0.001) and 12.5% ( P = 0.045), respectively. The skill learning group improved skill performance significantly ( P < 0.001). With one training bout, the only significant change in transcranial magnetic stimulation parameters was an increase in skill learning group maximal MEP level (MEPmax) at rest ( P = 0.02) for subjects performing skill training. With repeated skill training three times per week for 4 wk, MEPmax increased and the minimal stimulation intensity required to elicit MEPs decreased significantly at rest and during contraction ( P < 0.05). In contrast, MEPmax and the slope of the input-output relation both decreased significantly at rest but not during contraction in the strength-trained subjects ( P ≤ 0.01). No significant changes were observed in a control group. A significant correlation between changes in neurophysiological parameters and motor performance was observed for skill learning but not strength training. The data show that increased corticospinal excitability may develop over several weeks of skill training and indicate that these changes may be of importance for task acquisition. Because strength training was not accompanied by similar changes, the data suggest that different adaptive changes are involved in neural adaptation to strength training.

Low-frequency repetitive transcranial magnetic stimulation for seizure suppression in patients with extratemporal lobe epilepsy—A pilot study

We evaluated the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on seizure frequency in adult patients with medically intractable extratemporal lobe epilepsy (ETLE). Seven patients with medically intractable ETLE received low-frequency rTMS at 0.9 Hz, basically two sets of 15 min stimulation per day for five days in a week, with the stimulus intensity of 90% of resting motor threshold (RMT). The number of seizures during two weeks before and after the stimulation of one week was compared. Furthermore, RMT and active motor threshold (AMT) were measured before and after rTMS for each daily session. After low-frequency rTMS of one week, the frequency of all seizure types, complex partial seizures (CPSs) and simple partial seizures was reduced by 19.1, 35.9 and 7.4%, respectively. The patients with smaller difference between RMT and AMT before rTMS had higher reduction rate of CPSs. A favorable tendency of seizure reduction, though not statistically significant, during two weeks after low-frequency rTMS was demonstrated in medically intractable ETLE patients. As far as CPSs are concerned, smaller decrease of motor threshold by voluntary muscle contraction was associated with better response to rTMS.

Age-related differences in corticospinal control during functional isometric contractions in left and right hands

The purpose of the study was to examine age-related differences in electromyographic (EMG) responses to transcranial magnetic stimulation (TMS) during functional isometric contractions in left and right hands. EMG responses were recorded from the first dorsal interosseus muscle following TMS in 10 young (26.6 +/- 1.3 yr) and 10 old (67.6 +/- 2.3 yr) right-handed subjects. Muscle evoked potentials (MEPs) and silent-period durations were obtained in the left and right hands during index finger abduction, a precision grip, a power grip, and a scissor grip, while EMG was held constant at 5% of maximum. For all tasks, MEP area was 30% (P < 0.001) lower in the left hand of old compared with young subjects, whereas there was no age difference in the right hand. The duration of the EMG silent period was 14% (P < 0.001) shorter in old (150.3 +/- 2.9 ms) compared with young (173.9 +/- 3.0 ms) subjects, and the age differences were accentuated in the left hand (19% shorter, P < 0.001). For all subjects, the largest MEP area (10-12% larger) and longest EMG silent period (8-19 ms longer) were observed for the scissor grip compared with the other three tasks, and the largest task-dependent change in these variables was observed in the right hand of older adults. These differences in corticospinal control in the left and right hands of older adults may reflect neural adaptations that occur throughout a lifetime of preferential hand use for skilled (dominant) and unskilled (nondominant) motor tasks.

Timing of cortical excitability changes during the reaction time of movements superimposed on tonic motor activity

Seated subjects were instructed to react to an auditory cue by simultaneously contracting the tibialis anterior (TA) muscle of each ankle isometrically. Focal transcranial magnetic stimulation of the leg area of the motor cortex (MCx) was used to determine the time course of changes in motor-evoked potential amplitude (MEP) during the reaction time (RT). In one condition the voluntary contraction was superimposed on tonic EMG activity maintained at 10% of maximal voluntary contraction. In the other condition the voluntary contraction was made starting from rest. MEPs in the TA contralateral to the stimulation coil were evoked at various times during the RT in each condition. These were compared to the control MEPs evoked during tonic voluntary activity or with the subject at rest. The RT was measured trial by trial from the EMG activity of the TA ipsilateral to the magnetic stimulus, taking into account the nearly constant time difference between the two sides. The MEPs became far greater than control MEPs during the RT (mean = 332%, SD = 44 %, of control MEPs, P < 0.001) without any measurable change in the background level of EMG activity. The onset of this facilitation occurred on average 12.80 ms (SD = 7.55 ms) before the RT. There was no difference in the onset of facilitation between the two conditions. Because MEPs were facilitated without a change in the background EMG activity, it is concluded that this facilitation is specifically due to an increase of MCx excitability just before voluntary muscle activation. This conclusion is further reinforced by the observation that MEPs evoked by near-threshold anodal stimuli to the MCx were not facilitated during the RT, in contrast to those evoked by near-threshold transcranial magnetic stimulation. However, several observations in the present and previous studies indicate that MEP amplitude may be more sensitive to alpha-motoneuron activity than to motor cortical neuron activity, an idea that has important methodological implications.

Enhanced Motor Cortex Excitability During Ipsilateral Voluntary Hand Activation in Healthy Subjects and Stroke Patients

BACKGROUND AND PURPOSE

It is still a matter of debate whether the ipsilateral voluntary hand activation has a facilitatory or inhibitory effect on the nondominant or affected hemisphere. To give an answer to this question is of great importance for the rehabilitation of stroke patients, because they often use the unaffected hand for compensation.

METHODS

Ten healthy volunteers and 11 stroke patients were investigated using transcranial magnetic stimulation (TMS). TMS was applied to the dominant/unaffected hemisphere during performance of different tasks (simple index finger abduction, pinch grip, and power grip) at various force levels (5%, 10%, 50%, and 100% maximal voluntary contraction) with the ipsilateral hand. Peak-to-peak amplitudes of motor-evoked potentials were used as measure for motor cortex excitability.

RESULTS

Both simple and complex tasks led to a facilitation of the contralateral corticospinal system at all levels of applied force. Not only the facilitatory effect in general but also the slope of the relationship between force level and MEP amplitude were significantly lower in stroke patients indicating that both the general activation level of the impaired motor system and the bandwidth of possible activation levels are diminished.

CONCLUSIONS

Voluntary activation of the hand does not exert an inhibitory effect on the excitability of the ipsilateral hemisphere in healthy volunteers or in stroke patients.

Impairment of individual finger movements in patients with hand dystonia

We investigated finger movements in patients with hand dystonia to compare the kinematics of repetitive individual and non-individual finger oppositions. We used an optoelectronic motion analysis system to record movements in 3-D space, and recorded three 5-second trials for each task, counting how many finger oppositions subjects carried out during each trial, and measured the duration and amplitude of flexions, extensions, and pauses. During tasks, normal subjects and patients carried out finger flexions faster than extensions, and invariably they paused longer before extension than before flexion. Patients were slower and paused longer than controls during both individual and non-individual oppositions. During individual finger movements, patients were disproportionately slow during extension and pause before extension. Patients with hand dystonia perform finger movements abnormally; they are affected predominantly during individual oppositions. This finding reflects the finer cortical control needed to promote and sustain this highly fractionated type of motor output, and points toward underactivity of the primary motor cortex in dystonia.

Investigating human motor control by transcranial magnetic stimulation

In this review we discuss the contribution of transcranial magnetic stimulation (TMS) to the understanding of human motor control. Compound motor-evoked potentials (MEPs) may provide valuable information about corticospinal transmission, especially in patients with neurological disorders, but generally do not allow conclusions regarding the details of corticospinal function to be made. Techniques such as poststimulus time histograms (PSTHs) of the discharge of single, voluntarily activated motor units and conditioning of H reflexes provide a more optimal way of evaluating transmission in specific excitatory and inhibitory pathways. Through application of such techniques, several important issues have been clarified. TMS has provided the first real evidence that direct monosynaptic connections from the motor cortex to spinal motoneurons exist in man, and it has been revealed that the distribution of these projections roughly follows the same proximal-distal gradient as in other primates. However, pronounced differences also exist. In particular, the tibialis anterior muscle appears to receive as significant a monosynaptic corticospinal drive as muscles in the hand. The reason for this may be the importance of this muscle in controlling the foot trajectory in the swing phase of walking. Conditioning of H reflexes by TMS has provided evidence of changes in cortical excitability prior to and during various movements. These experiments have generally confirmed information obtained from chronic recording of the activity of corticospinal cells in primates, but information about the corticospinal contribution to movements for which information from other primates is sparse or lacking has also been obtained. One example is walking, where TMS experiments have revealed that the corticospinal tract makes an important contribution to the ongoing EMG activity during treadmill walking. TMS experiments have also documented the convergence of descending corticospinal projections and peripheral afferents on spinal interneurons. Current investigations of the functional significance of this convergence also rely on TMS experiments. The general conclusion from this review is that TMS is a powerful technique in the analysis of motor control, but that care is necessary when interpreting the data. Combining TMS with other techniques such as PSTH and H reflex testing amplifies greatly the power of the technique.

Changes in finger coordination and responses to single pulse TMS of motor cortex during practice of a multifinger force production task

We investigated the changes in finger coordination and in finger force responses to transcranial magnetic stimulation (TMS) applied over the motor cortex associated with a single practice session of an accurate ramp force production task. Subjects pressed with their index, middle and ring fingers onto three force transducers fixed to a rigid platform that was balanced on a narrow pivot under the middle finger. The task was to produce a smoothly increasing ramp of total force from 0 to 25 N over 4 s following a visual target. Subjects performed three brief series of trials without TMS (12 trials each) in the beginning, in the middle, and in the end of the experiment. The main part of the experiment involved 173 trials, and in each of them at random times in the ramp a suprathreshold TMS pulse was applied over the hand area of the contralateral motor cortex in order to evoke a twitch in the finger flexor muscles. At the end of the experiment the subjects also performed 12 constant force production trials, and TMS was unexpectedly applied in each trial. During the ramp force trials the amplitude of the response to TMS was largely independent of the force exerted at the time of stimulation, whereas in static holding trials the amplitude of the response increased with higher levels of background contraction. Over time subjects improved their overall tracking performance: the variance of the force trajectory (VarF(TOT)), as computed over sets of unperturbed trials, declined by 60% after the first 100 trials, but there was little additional improvement after the second 100 trials. Variance in the force finger space related to the total moment with respect to the pivot also showed a decline during the first half of practice and minimal further changes during the second half. In contrast, finger force variance that did not affect either total force or total moment showed no changes after the first 100 trials and a decline during the second 100 trials. This variance component quantified per finger was significantly larger than those related to the total force and total moment. The mean size of the TMS-induced phasic force increment decreased by 12% over the course of the 200 trials. The forces evoked in the index and ring fingers gradually became more equal, reducing the total moment with respect to the pivot and improving balance. We speculate that development of a relatively low twitch force with low total moment on the pivot made it easier for subjects to continue tracking after the TMS pulse. Such changes could well be correlated with the degree of corticospinal involvement in the task. The results suggest task specific, practice-related plastic changes in neural structures involved in the responses to TMS.

Is the long-latency stretch reflex in human masseter transcortical?

A long-latency stretch reflex (LLSR) has been described in the human masseter muscle, but its pathway remains uncertain. To investigate this, the excitability of corticomotoneuronal (CM) cells projecting to masseter motoneurons during the LLSR was assessed with transcranial magnetic stimulation (TMS). A facilitated response to TMS would be evidence of a LLSR pathway that traverses the motor cortex. Surface electromyogram electrodes were placed over the left or right masseter, and subjects ( n=10) bit on bars with their incisor teeth at 10% of maximal electromyographic activity (EMG). Servo-controlled displacements were imposed on the lower jaw to evoke a short- and long-latency stretch reflex in masseter. TMS intensity was just suprathreshold for a response in contralateral masseter. Trials consisted of: (1) stretch alone, (2) TMS alone, and (3) TMS with a preceding conditioning stretch at varied conditioning-testing (C-T) intervals chosen to combine TMS with the short-latency stretch reflex (3 ms, 5 ms) and the LLSR (23-41 ms). Masseter EMG was rectified and averaged. With TMS alone, mean (+/- SE) MEP area above baseline was 56+/-9%. The area of masseter MEPs above baseline in the C-T trials was calculated from each EMG average following subtraction of the response to stretch alone. Conditioning muscle stretch had no significant effect on masseter MEPs evoked by TMS with any C-T interval (ANOVA; P=0.90). In addition, subjects were unable to modify the SLSR or LLSR by voluntary command. It is concluded that the long-latency stretch reflex in the masseter does not involve the motor cortex and is not influenced by "motor set".