Comparison of leg muscle responses to transcranial magnetic stimulation during standing on stable and unstable supports

Abstract

The role of supraspinal structures in postural adjustment upon standing on stable and unstable supports was studied in healthy individuals. For this purpose, transcranial magnetic stimulation (TMS) of the motor cortex was used in the region of leg representation. The subject stood with the eyes closed on a firm floor or on an unstable support in the form of a paperweight (20 cm in height, with a base radius of 32 cm) with mobility in the sagittal direction. Electric responses of four muscles—the soleus muscle, the anterior tibial muscle, the femoral biceps muscle, and the femoral rectus muscle—were recorded. It was shown that, in all the muscles, the response to TMS upon standing on an unstable support increased by 1.8–2.7 times as compared with the response upon standing on a firm floor. Since the increase in the tonic activity of the muscles studied was statistically insignificant upon switching over from standing on a firm floor to standing on an unstable support, it is hypothesized that the increase in the amplitude of muscle responses is connected with an increased activity of the supraspinal structures or with an increase in the effectiveness of corticospinal connections. The results are discussed from the point of view of the role of the motor cortex in maintaining balance on an unstable support.