Increase in flexor but not extensor corticospinal motor outputs following ischemic nerve block

Anodal transcranial direct current stimulation enhances time to task failure of a submaximal contraction of elbow flexors without changing corticospinal excitability

Effects of negative autobiographical memories retrieval on corticospinal excitability and sensorimotor integration

Recent transcranial magnetic stimulation studies have shown that the motor output pathway shows a profound inhibition during the preparation of an action. This phenomenon, called “preparatory inhibition”, remains incompletely understood, as it is still unclear which neural structures support it and what function it exactly serves during action preparation. In the current study, we tested this preparatory inhibition in Parkinson’s disease (PD) patients and matched healthy control subjects. The aim was to better understand the role of basal ganglia (which are dysfunctional in PD) and the influence of dopamine replacement therapy on motor inhibition during action preparation.

Delivering transcranial magnetic brain stimulation over the motor cortex during motor imagination leads to enhanced motor output, which is selective for the muscles primarily involved in the imagined movement. This novel protocol may be useful to enhance function after damage to the motor system, such as after stroke. Several paired stimulation paradigms are known to induce plasticity in the motor cortex, reflected by changes in the motor evoked potential (MEP) following the paired stimulation. Motor imagery (MI) is capable of activating the motor system and affecting cortical excitability. We hypothesized that it might be possible to use MI in conjunction with transcranial magnetic stimulation (TMS) to induce plasticity in the human motor system. TMS was delivered to the motor cortex of healthy human subjects, and baseline MEPs recorded from forearm flexor, forearm extensor and intrinsic hand muscles. Subjects were then asked to imagine either wrist flexion or extension movements during TMS delivery (n=90 trials). Immediately after this intervention, MEP measurement was repeated. Control protocols tested the impact of imagination or TMS alone. Flexion imagination with TMS increased MEPs in flexors and an intrinsic hand muscle. Extensor imagination with TMS increased MEPs in extensor muscles only. The control paradigms did not produce significant changes. We conclude that delivering TMS during MI is capable of inducing plastic changes in the motor system. This new protocol may find utility to enhance functional rehabilitation after brain injury.

P 160. The “dormant potential” of the non-dominant hemisphere: In teremispheric a symmetry of cortial plasticity

Changes in corticospinal excitability during motor imagery by physical practice of a force production task: Effect of the rate of force development during practice

This study aimed to assess the effects of thoracic anodal and cathodal transcutaneous spinal direct current stimulation (tsDCS) on upper and lower limb corticospinal excitability. Although there have been studies assessing how thoracic tsDCS influences the spinal ascending tract and reflexes, none has assessed the effects of this technique over upper and lower limb corticomotor neuronal connections. In 14 healthy subjects we recorded motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) from abductor hallucis (AH) and hand abductor digiti minimi (ADM) muscles before (baseline) and at different time points (0 and 30 min) after anodal or cathodal tsDCS (2.5 mA, 20 min, T9-T11 level). In 8 of the 14 subjects we also tested the soleus H reflex and the F waves from AH and ADM before and after tsDCS. Both anodal and cathodal tsDCS left the upper limb MEPs and F wave unchanged. Conversely, while leaving lower limb H reflex unchanged, they oppositely affected lower limb MEPs: whereas anodal tsDCS increased resting motor threshold [(mean ± SE) 107.33 ± 3.3% increase immediately after tsDCS and 108.37 ± 3.2% increase 30 min after tsDCS compared with baseline] and had no effects on MEP area and latency, cathodal tsDCS increased MEP area (139.71 ± 12.9% increase immediately after tsDCS and 132.74 ± 22.0% increase 30 min after tsDCS compared with baseline) without affecting resting motor threshold and MEP latency. Our results show that tsDCS induces polarity-specific changes in corticospinal excitability that last for >30 min after tsDCS offset and selectively affect responses in lower limb muscles innervated by lumbar and sacral motor neurons.

Modulation of Corticospinal Excitability with Contralateral Arm Cycling

Fatiguing intermittent single-joint exercise causes an increase in corticospinal excitability and a decrease in intracortical inhibition when measured with peripherally recorded motor evoked potentials (MEPs) after transcranial magnetic stimulation (TMS). Combined TMS and electroencephalography (TMS-EEG) allows for more direct recording of cortical responses through the TMS-evoked potential (TEP). The aim of this study was to investigate the changes in the excitatory and inhibitory components of the TEP during fatiguing single-joint exercise. Twenty-three young (22 ± 2 yr) healthy subjects performed intermittent 30-s maximum voluntary contractions of the right first dorsal interosseous muscle, followed by a 30-s relaxation period repeated for a total of 15 min. Six single-pulse TMSs and one peripheral nerve stimulation (PNS) to evoke maximal M wave (Mmax) were applied during each relaxation period. A total of 90 TMS pulses and 5 PNSs were applied before and after fatiguing exercise to record MEP and TEP. The amplitude of the MEP (normalized to Mmax) increased during fatiguing exercise ( P < 0.001). There were no changes in local and global P30, N45, and P180 of TEPs during the development of intermittent single-joint exercise-induced fatigue. Global analysis, however, revealed a decrease in N100 peak of the TEP during fatiguing exercise compared with before fatiguing exercise ( P = 0.02). The decrease in N100 suggests a fatigue-related decrease in global intracortical GABAB-mediated inhibition. The increase in corticospinal excitability typically observed during single-joint fatiguing exercise may be mediated by a global decrease in intracortical inhibition. NEW & NOTEWORTHY Fatiguing intermittent single-joint exercise causes an increase in corticospinal excitability and a decrease in intracortical inhibition when measured with transcranial magnetic stimulation (TMS)-evoked potentials from the muscle. The present study provides new and direct cortical evidence, using TMS-EEG to demonstrate that during single-joint fatiguing exercise there is a global decrease in intracortical GABAB-mediated inhibition.

Previous studies with transcranial magnetic stimulation (TMS) have shown that advancing age may influence plasticity induction in human motor cortex (M1), but these changes have been assessed with TMS-induced paradigms or simple motor tasks. The aim of this study was to examine changes in corticospinal excitability and intracortical inhibition as markers of corticomotor plasticity following complex motor training in young and old adults. Electromyographic recordings were obtained from the right first dorsal interosseous (FDI) muscle of 16 young (20-35 years) and 16 older (aged 60-75 years) adults before and after motor skill training. Motor training consisted of three 6-minute blocks of a complex visuomotor task that required matching the metacarpophalangeal (MCP) joint angle of the index finger using abduction-adduction movements. Single- and paired-pulse TMS over the left M1 was used to assess changes in right FDI motor-evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) before and after each training block. Visuomotor tracking performance was diminished in old compared with young adults throughout training. However, improvement in tracking error was similar for young and old adults (7-24% increase in each training block). For young and old adults, motor training increased FDI MEP amplitude (≥ 20%) and reduced the magnitude of SICI (≥ 19%) after each visuomotor training block, reflecting use-dependent plasticity. However, no difference in corticomotor plasticity (change in MEP or SICI) was observed between young and old adults. Further studies are needed to identify the experimental or behavioral factors that might contribute to the maintenance of corticomotor plasticity in older adults.

IntroductionStudies using transcranial magnetic stimulation and electromyography suggest that disrupted functional corticospinal connectivity significantly contributes to difficulty in initiating and controlling voluntary movements such as walking. In individuals with Cerebral Palsy (CP), the corticospinal tract (CST) may therefore be identified as a potential target for improving gait control. Increasing corticospinal excitability may enhance voluntary control of lower-limb muscles and improve selective activation patterns during gait. However, it remains uncertain whether this pathway can be further activated given the damage caused by the brain lesion. Moreover, muscle synergies, a cooperative activation of groups of muscles, play an essential role in efficient and adaptive locomotion. Disrupted CST projections may reduce the specificity and strength of descending commands, which can lead to the fusion or splitting of muscle synergies. This impaired descending modulation could explain the reduced number of synergies and lower variance often reported in people with CP. Understanding and improving the modulation of these synergies could lead to better rehabilitation strategies for individuals with CP. The objective of this study was to assess whether a visuomotor walking task promotes an increase in corticospinal excitability and a modulation of muscle synergies compared to a simple walking task in individuals with CP.MethodsSixteen individuals with CP were initially recruited, muscle synergy analyses were conducted in 14 participants and TMS-based corticospinal excitability assessments in 11 participants, due to contraindications to TMS or technical issues. In addition, 14 control subjects took part in this study. Each participant performed a simple walking task and a visuomotor walking task (i.e., stepping onto virtual targets) at comfortable speed, in counterbalanced order. Transcranial magnetic stimulations were delivered during walking at approximately 40% of the gait cycle (late stance phase), corresponding to minimal tibialis anterior activity. Muscle synergies were extracted from full gait cycles recorded throughout each condition. Motor evoked potentials (MEPs) in the tibialis anterior muscle were induced using transcranial magnetic stimulation. Muscle synergies were extracted from surface electromyography signals acquired from six key lower-limb muscles during both tasks. Values were expressed as (median [Q1–Q3]).ResultsIn the visuomotor task, MEPs increased by 59.4% in the CP group (simple task MEP = 1.89 [1.00–3.09] a.u vs. visuomotor task MEP = 2.70 [1.59–4.80] a.u; p ≤ 0.01) and 113.8% in the control group (simple task MEP = 1.95 [0.99–2.72] a.u vs. visuomotor task MEP = 2.91 [1.97–3.66] a.u; p ≤ 0.01). An increase in the number of synergies was observed during visuomotor task in CP group (p = 0.018).ConclusionThese results suggest that performing a visuomotor walking task allows to enhance the corticospinal excitability in both individuals with CP and control subjects. Moreover, CP individuals showed that either the number or the structure of synergies are modulated by the visuomotor task, in comparison to control subjects. Longitudinal studies are recommended to assess the impact of the integration of complex tasks in gait rehabilitation interventions.

Movement observation (MO) modulates activity of brain regions involved in motor control. It is mentioned that this phenomenon is evoked by the mirror neurons system activity and reflects processes of action understanding, action recognition and covert imitation of observed movements. Desynchronization of sensorimotor EEG oscillations and increase in corticospinal excitability assessed by transcranial magnetic stimulation (TMS) are invasive markers of motor and somatosensory cortices activation. Despite the fact that numerous studies show sensitivity of these markers to movements observation, little is known about the dynamics of the EEG activity and corticospinal excitability during evaluating the anatomically correctness of observed actions. We designed a TMS-EEG experiment with passive observation of simple aimless movements, in which subjects observed natural and unnatural flexions of fingers. Spatially separated sensorimotor EEG oscillations and TMS evoked myographic potentials were studied. The results revealed sensitivity of mu/beta oscillations to the anatomical correctness of movement. No correlations between mu/beta desynchronization and motor evoked potentials (MEPs) were found, but a weak link between beta synchronization and MEPs was shown. It might be proposed that ERD reflects activity of rather somatosensory but not motor cortex. Our findings demonstrate that activity of the sensorimotor cortex is modulated by action observation and action recognition, whereas EEG activity from different frequency ranges is modulated in different ways. Importantly, no significant changes in MEPs amplitude during MO was found. This result is discussed with regard to the impact of experimental instructions and participant's mental state during the MO task.

Effects of supervised progressive resistance training on corticospinal excitability in persons with multiple sclerosis: A randomized controlled trial protocol for the NEXIMS study.

Combined action observation and motor imagery (AOMI) facilitates corticospinal excitability (CSE). This study used single-pulse transcranial magnetic stimulation (TMS) to explore changes in CSE for coordinative AOMI, where the observed and imagined actions are related but not identical, for a single-leg sit-to-stand (SL-STS) movement. Twenty-one healthy adults completed two testing sessions including baseline (BL), action observation (AO), and motor imagery (MI) control conditions, and three experimental conditions where they observed a slow-paced SL-STS while simultaneously imagining a slow- (AOMIHICO), medium- (AOMIMOCO), or fast-paced (AOMILOCO) SL-STS. A TMS pulse was delivered to the right leg representation of the left primary motor cortex at three stimulation timepoints aligned with peak electromyography (EMG) activity of the knee extensor muscle group for the fast- (T1), medium- (T2), and slow-paced (T3) SL-STS during each condition. Motor evoked potential (MEP) amplitudes were recorded from the knee extensor muscle group as a marker of CSE for all stimulation timepoints and conditions. A main effect for experimental condition was reported for all stimulation timepoints. MEP amplitudes were significantly greater for AOMIHICO at T1 and T3, and AOMIMOCO and AOMILOCO at all stimulation timepoints, when compared with control conditions. This study provides neurophysiological evidence supporting the use of coordinative AOMI.

Aging is associated with reduced neuromuscular function, which may be due in part to altered corticospinal excitability. Regular physical activity (PA) may ameliorate these age-related declines, but the influence of PA on corticospinal excitability is unknown. The purpose of this study was to determine the influence of age, sex, and PA on corticospinal excitability by comparing the stimulus-response curves of motor evoked potentials (MEP) in 28 young (22.4 ± 2.2 yr; 14 women and 14 men) and 50 old adults (70.2 ± 6.1 yr; 22 women and 28 men) who varied in activity levels. Transcranial magnetic stimulation was used to elicit MEPs in the active vastus lateralis muscle (10% maximal voluntary contraction) with 5% increments in stimulator intensity until the maximum MEP amplitude. Stimulus-response curves of MEP amplitudes were fit with a four-parameter sigmoidal curve and the maximal slope calculated (slopemax). Habitual PA was assessed with tri-axial accelerometry and participants categorized into either those meeting the recommended PA guidelines for optimal health benefits (>10,000 steps/day, high-PA; n = 21) or those not meeting the guidelines (<10,000 steps/day, low-PA; n = 41). The MEP amplitudes and slopemax were greater in the low-PA compared with the high-PA group (P < 0.05). Neither age nor sex influenced the stimulus-response curve parameters (P > 0.05), suggesting that habitual PA influenced the excitability of the corticospinal tract projecting to the lower limb similarly in both young and old adults. These findings provide evidence that achieving the recommended PA guidelines for optimal health may mediate its effects on the nervous system by decreasing corticospinal excitability.NEW & NOTEWORTHY Transcranial magnetic stimulation was used to determine whether achieving the recommended 10,000 steps/day for optimal health influenced the excitability of the corticospinal tract projecting to the knee extensor muscles. Irrespective of age and sex, individuals who achieved >10,000 steps/day had lower corticospinal excitability than those who performed <10,000 steps/day, possibly representing greater control of inhibitory and excitatory networks. Physical activity involving >10,000 steps/day may mediate its effects on the nervous system by decreasing corticospinal excitability.