Elbow angle modulates corticospinal excitability to the resting biceps brachii at both spinal and supraspinal levels.

Abstract

What is the central question of this study? Corticospinal excitability to biceps brachii is known to modulate according to upper-limb posture. Here, cervicomedullary stimulation was used to investigate potential spinal contributions to elbow angle-dependent changes in corticospinal excitability at rest. What is the main finding and its importance? At more extended elbow angles, biceps responses to cervicomedullary stimulation were decreased, whereas cortically evoked responses (normalized to cervicomedullary-evoked responses) were increased. Results suggest decreased spinal excitability but increased cortical excitability as the elbow is placed in a more extended position, an effect that is unlikely to be attributable to cutaneous stretch receptor activation. Corticospinal excitability to biceps brachii is known to modulate according to upper-limb posture. In study1, our aim was to investigate potential spinal contributions to this modulation and the independent effect of elbow angle. Biceps responses to transcranial magnetic stimulation (motor evoked potentials; MEPs) and electrical cervicomedullary stimulation (cervicomedullary motor evoked potentials; CMEPs) were measured at five elbow angles ranging from full extension to 130deg of flexion. In study2, possible contributions of cutaneous stretch receptors to elbow angle-dependent excitability changes were investigated by eliciting MEPs and CMEPs in three conditions of skin stretch about the elbow (stretch to mimic full extension, no stretch or stretch to mimic flexion). Each study had 12 participants. Evoked potentials were acquired at rest, with participants seated, the shoulder flexed 90deg and forearm supinated. The MEPs and CMEPs were normalized to maximal compound muscle action potentials. In study1, as the elbow was moved to more extended positions, there were no changes in MEPs (P=0.963), progressive decreases in CMEPs (P<0.0001; CMEPs at 130deg flexion ∼220% of full extension) and increases in the MEP/CMEP ratio (P=0.019; MEP/CMEP at 130deg flexion ∼20% of full extension). In study2, there were no changes in MEPs (P=0.830) or CMEPs (P=0.209) between skin stretch conditions. Therefore, although results suggest a decrease in spinal and an increase in supraspinal excitability at more extended angles, the mechanism for these changes in corticospinal excitability to biceps is not cutaneous stretch receptor feedback.