Corticomotor Facilitation Research Articles

Bilateral Corticomotor Reorganization and Symptom Development in Response to Acute Unilateral Hamstring Pain: A Randomized, Controlled Study

Accumulating evidence demonstrates that pain induces adaptations in the corticomotor representations of affected muscles. However, previous work has primarily investigated the upper limb, with few studies examining corticomotor reorganization in response to lower limb pain. This is important to consider, given the significant functional, anatomical, and neurophysiological differences between upper and lower limb musculature. Previous work has also focused on unilateral corticomotor changes in response to muscle pain, despite an abundance of literature demonstrating that unilateral pain conditions are commonly associated with bilateral motor dysfunction. For the first time, this study investigated the effect of unilateral acute hamstring pain on bilateral corticomotor organization using transcranial magnetic stimulation (TMS) mapping. Corticomotor outcomes (TMS maps), pain, mechanical sensitivity (pressure pain thresholds), and function (maximal voluntary contractions) were recorded from 28 healthy participants at baseline. An injection of pain-inducing hypertonic (n = 14) or pain-free isotonic (n = 14) saline was then administered to the right hamstring muscle, and pain ratings were collected every 30 seconds until pain resolution. Follow-up measures were taken immediately following pain resolution and at 25, 50, and 75 minutes post-pain resolution. Unilateral acute hamstring pain induced bilateral symptom development and changes in corticomotor reorganization. Two patterns of reorganization were observed—corticomotor facilitation and corticomotor depression. Corticomotor facilitation was associated with increased mechanical sensitivity and decreased function bilaterally (all P < .05). These effects persisted for at least 75 minutes after pain resolution. PerspectiveThese findings suggest that individual patterns of corticomotor reorganization may contribute to ongoing functional deficits of either limb following acute unilateral lower limb pain. Further research is required to assess these adaptations and the possible long-term implications for rehabilitation and reinjury risk in cohorts with acute hamstring injury.

Investigating interindividual variability in corticomotor reorganization during sustained hamstring pain: A randomized experimental study.

Increasing evidence suggests that pain drives maladaptive corticomotor changes that may increase susceptibility to injury and promote symptom recurrence. However, few studies have evaluated the influence of interindividual corticomotor responses to musculoskeletal pain. Existing research in this area has also been limited largely to the upper limb. This is a pertinent point, given the functional and neurophysiological differences between upper and lower limb muscles, as well as the fact that most acute sporting injuries occur in the lower limb. Accordingly, this study explored the variability of corticomotor responses to experimentally-induced sustained hamstring pain and whether specific patterns of corticomotor reorganization were associated with poorer outcomes (mechanical sensitivity, pain, or functional limitation). Thirty-six healthy individuals participated. Following random allocation on Day 0, the experimental group performed an eccentric exercise protocol of the right hamstring muscles to induce delayed onset muscle soreness. The control group performed repetition-matched concentric exercise that did not induce soreness. Measures of mechanical sensitivity, pain, function, and corticomotor organization were collected at baseline and on Day 2. Corticomotor responses to sustained hamstring pain were variable. Individuals who developed corticomotor facilitation in response to hamstring pain experienced greater mechanical sensitivity than those who developed corticomotor depression. These novel data could have implications for rehabilitation following lower limb pain or injury.

Enhanced corticospinal excitability in the tibialis anterior during static stretching of the soleus in young healthy individuals.

Corticospinal excitability is known to be affected by afferent inflow arising from the proprioceptors during active or passive muscle movements. Also during static stretching (SS) afferent activity is enhanced, but its effect on corticospinal excitability received limited attention and has only been investigated as a single average value spread over the entire stretching period. Using transcranial magnetic stimulation (TMS) the present study was conducted to explore the time course of corticospinal excitability during 30 seconds SS. Motor evoked potentials (MEPs) after TMS were recorded from soleus (SOL) and tibialis anterior (TA) muscles in 14 participants during: a passive dynamic ankle dorsiflexion (DF), at six different time points during maximal individual SS (3, 6, 9, 18, 21 and 25 seconds into stretching), during a passive dynamic ankle plantar flexion (PF) and following SS. To explore the time course of corticospinal excitability during the static lengthened phase of a muscle stretch, the stretching protocol was repeated several times so that it was possible to collect a sufficient number of stimulations at each specific time point into SS, as well as during DF and PF. During passive DF, MEPs amplitude was greater than baseline in both TA and SOL (p = .001 and p = .005 respectively). During SS, MEPs amplitude was greater than baseline in TA (p = .006), but not in SOL. No differences between the investigated time points were found and no trend was detected throughout the stretching time. No effect in either muscle was observed during passive PF and after SS. These results could suggest that an increased activity of secondary afferents from SOL muscle spindles exert a corticomotor facilitation on TA. The muscle-nonspecific response observed during passive DF could instead be attributed to an increased activation within the sensorimotor cortical areas as a result of the awareness of the foot passive displacements.

Multi-pulse transcranial magnetic stimulation of human motor cortex produces short-latency corticomotor facilitation via two distinct mechanisms.

Background Single-pulse TMS of the precentral hand representation (M1HAND) can elicit indirect waves in the corticospinal tract at a periodicity of ~660 Hz, called I-waves. These descending volleys are produced by transsynaptic excitation of fast-conducting corticospinal axons in M1HAND. Paired-pulse TMS can induce short-interval intracortical facilitation (SICF) of motor evoked potentials (MEPs) at inter-pulse intervals that match I-wave periodicity. Objective To examine whether short-latency corticospinal facilitation engages additional mechanisms independently of I-wave periodicity. Methods In 19 volunteers, one to four biphasic TMS pulses were applied to left M1HAND with inter-pulse intervals adjusted to the first peak or trough of the individual SICF curve at different intensities to probe the intensity-response relationship. Results Multi-pulse TMSHAND at individual peak-latency facilitated MEP amplitudes and reduced resting motor threshold (RMT) compared to single pulses. Multi-pulse TMSHAND at individual trough-latency also produced a consistent facilitation of MEPs and a reduction of RMT. Short-latency facilitation at trough-latency was less pronounced, but the relative difference in facilitation decreased with increasing stimulus intensity. Increasing the pulse number had only a modest effect. Conclusion Two mechanisms underlie short-latency facilitation caused by biphasic multi-pulse TMSHAND. One intracortical mechanism is related to I-wave periodicity and engages fast-conducting direct projections to spinal motoneurons. A second corticospinal mechanism does not rely on I-wave rhythmicity and may be mediated by slower conducting indirect pyramidal tract projections from M1HAND to spinal interneurons. The latter mechanism deserves more attention in studies of the corticomotor system and its link to manual motor control using the MEP.

The Relationship Between Corticomotor Reorganization and Acute Pain Severity: A Randomized, Controlled Study Using Rapid Transcranial Magnetic Stimulation Mapping.

Although acute pain has been shown to reduce corticomotor excitability, it remains unknown whether this response resolves over time or is related to symptom severity. Furthermore, acute pain research has relied upon data acquired from the cranial "hotspot," which do not provide valuable information regarding reorganization, such as changes to the distribution of a painful muscle's representation within M1. Using a novel, rapid transcranial magnetic stimulation (TMS) mapping method, this study aimed to 1) explore the temporal profile and variability of corticomotor reorganization in response to acute pain and 2) determine whether individual patterns of corticomotor reorganization are associated with differences in pain, sensitivity, and somatosensory organization. Corticomotor (TMS maps), pain processing (pain intensity, pressure pain thresholds), and somatosensory (two-point discrimination, two-point estimation) outcomes were taken at baseline, immediately after injection (hypertonic [n = 20] or isotonic saline [n = 20]), and at pain resolution. Follow-up measures were recorded every 15 minutes until 90 minutes after injection. Corticomotor reorganization persisted at least 90 minutes after pain resolution. Corticomotor depression was associated with lower pain intensity than was corticomotor facilitation (r = 0.47 [P = 0.04]). These effects were not related to somatosensory reorganization or peripheral sensitization mechanisms. Individual patterns of corticomotor reorganization during acute pain appear to be related to symptom severity, with early corticomotor depression possibly reflecting a protective response. These findings hold important implications for the management and potential prevention of pain chronicity. However, further research is required to determine whether these adaptations relate to long-term outcomes in clinical populations.

Corticomotor control of airway calibre in obstructive sleep apnoea syndrome.

Corticomotor control of airway calibre in obstructive sleep apnoea syndrome.

Corticomotor Depression is Associated With Higher Pain Severity in the Transition to Sustained Pain: A Longitudinal Exploratory Study of Individual Differences

Aberrant motor cortex plasticity is hypothesized to contribute to chronic musculoskeletal pain, but evidence is limited. Critically, studies have not considered individual differences in motor plasticity or how this relates to pain susceptibility. Here we examined the relationship between corticomotor excitability and an individual's susceptibility to pain as pain developed, was sustained and resolved over 21 days. Nerve growth factor was injected into the right extensor carpi radialis brevis muscle of 20 healthy individuals on day 0, 2, and 4. Corticomotor excitability, pressure pain thresholds and performance on a cognitive conflict task were examined longitudinally (day 0, 2, 4, 6, and 14). Pain and disability were assessed on each alternate day (1,3…21). Two patterns of motor plasticity were observed in response to pain––corticomotor depression or corticomotor facilitation (P = .009). Individuals who displayed corticomotor depression experienced greater pain (P = .027), and had worse cognitive task performance (P = .038), than those who displayed facilitation. Pressure pain thresholds were reduced to a similar magnitude in both groups. Corticomotor depression in the early stage of pain could indicate a higher susceptibility to pain. Further work is required to determine whether corticomotor depression is a marker of pain susceptibility in musculoskeletal conditions. PerspectiveThis article explores individual differences in motor plasticity in the transition to sustained pain. Individuals who developed corticomotor depression experienced higher pain and worse cognitive task performance than those who developed corticomotor facilitation. Corticomotor depression in the early stage of pain could indicate a higher susceptibility to pain.

Mechanical effects of repetitive transcranial magnetic stimulation of upper airway muscles in awake obstructive sleep apnoea subjects.

What is the central question of this study? Can repetitive transcranial magnetic stimulation (rTMS) of the genioglossus enhance the beneficial effects observed with transcranial magnetic stimulation single twitches on upper airway mechanical properties? What is the main finding and its importance? We found that both inspiratory and expiratory rTMS protocols induce a different activation pattern of upper airway muscles, with evidence for an increase in genioglossus corticomotor excitability in response to rTMS. This is of major importance because it might open the door for rTMS protocols with the goal of increasing corticomotor excitability and, thus, possibly increasing the tonic genioglossus activity, which is known to be diminished during sleep in subjects with sleep apnoea. Stimulation of upper airway (UA) muscles during sleep by isolated transcranial magnetic stimulation (TMS) twitch can improve airflow dynamics without arousal, but the effect of repetitive TMS (rTMS) on UA dynamics is unknown. Phrenic nerve magnetic stimulation (PNMS) can be used to produce painless experimental twitch-induced flow limitation during wakefulness. The aim of this study was to quantify the effects of rTMS applied during wakefulness on UA mechanical properties using PNMS in subjects with obstructive sleep apnoea (OSA). Phrenic nerve magnetic stimulation was applied to 10 subjects, with and without simultaneous rTMS, during inspiration and expiration. Flow-limitation characteristics and UA obstruction level were determined [maximal (V̇I,max)and minimal inspiratory airflow (V̇I,min),V̇I,max-V̇I,min flow drop (ΔV̇I),oropharyngeal (POro,peak ) and velopharyngeal peak pressures, oropharyngeal k1 /k2 ratios with k1 and k2 determined by the polynomial regression model between instantaneous flow and pharyngeal pressure and UA resistance]. Both genioglossus and diaphragm root mean squares and motor-evoked potential amplitudes (geniolossus, GGAmp ) and latencies were computed. A flow-limitation pattern always occurred after PNMS. A decrease in V̇I,max and an increase in ΔV̇I occurred following rTMS applied during inspiration, and POro,peak values were more negative with both inspiratory and expiratory rTMS. The GGAmp also increased significantly from the second to the last rTMS expiratory train twitch. All other parameters remained unchanged. These results suggest the following conclusions: (i)rTMS does not improve UA mechanical properties in awake subjects with OSA; (ii)the activation pattern of UA muscles differs following isolated twitch and repetitive cortical stimulation of the genioglossus; and (iii)rTMS applied during expiration induces corticomotor facilitation.

Age-related differences in corticomotor facilitation indicate dedifferentiation in motor planning

Efficient motor control requires motor planning. Age-related changes in motor control are well described, e.g. increased movement variability and greater antagonistic muscle co-activation, as well as less functional and less regional specific brain activation. However, less is known about age-related changes in motor planning. By use of transcranial magnetic stimulation we investigated differences in corticomotor facilitation during motor planning in 17 young (25±3years) and 17 older healthy adults (70±13years) in a delayed movement paradigm for wrist movements. Motor evoked potentials (MEPs) were recorded for the flexor and extensor carpi radialis during movement preparation of wrist flexion and extension as well as during rest. We found that MEPs were less specifically facilitated during planning in older as compared to younger adults, as indicated by an Age×Condition×Muscle interaction. Young participants showed significantly facilitated MEPs in the respective muscle needed for wrist flexion or extension. By contrast MEPs in older participants were less specifically modulated. We conclude that age relates to dedifferentiated activation of the primary motor cortex already during preparation of distinct movements which might contribute to less efficient motor control in older adults.

Corticomotor Facilitation in Vegetative State: Results of a Pilot Study

ObjectiveTo investigate whether corticomotor facilitation induced by transcranial magnetic stimulation (TMS-CF) could evoke a simple purposeful motor behavior in patients with a diagnosis of vegetative state. DesignCross-sectional survey. SettingPost-coma and rehabilitation care unit. ParticipantsPatients (N=6) with a diagnosis of vegetative state. InterventionsA cascade of consecutive motor-evoked potentials (MEPs) was elicited under 3 different conditions: in the first condition, patients were at rest (Rest); in the second, they were asked to open and close the right hand (Execution); in the third, the examiner modeled a movement of abduction of the thumb in front of the patient who was encouraged in advance to imitate the action (Observation to Imitate). Main Outcome MeasuresChanges in MEP values from the abductor pollicis brevis muscle and improvement in scores on the Coma Recovery Scale-Revised. ResultsTMS-CF alone or combined with verbal instructions did not yield any change; only the combination with imitation caused changes in MEPs (shorter latency and increased amplitude) associated with behavioral improvement in 4 patients. ConclusionsEncouraging observation to imitate may favor the transformation of some perceived actions into motor images and performances, probably depending on the activation of mirror motor neurons. In our opinion, combining visual input with TMS-CF might have reinforced the coupling between movement planning and execution, promoting the recovery of elementary motor activities in some patients. The proposed protocol may contribute to unmasking signs of preserved consciousness in patients with latent capacities for recovery.

Asymmetry in corticomotor facilitation revealed in right-handers in the context of haptic discrimination

In this study we asked whether asymmetries related to handedness in right-handers (n=10) and left-handers (n=10) could influence hemispheric motor facilitation when the preferred or less-preferred hand is engaged in haptic sensing. Transcranial magnetic stimulation (TMS) was used to assess corticomotor excitability when young participants performed a precision grip under two conditions, i.e., with or without a haptic sensing component. In the grip condition participants were required to grasp a 5-mm thick plate between thumb and index fingers, whereas in the haptic condition they performed the same action but were also required to make judgements about the plate's thickness, i.e., either thin (5 mm) or thick (10 mm). Analysis of task-related variations in motor evoked potentials (MEP) amplitude recorded in hand muscles revealed a significant task×hand/hemisphere interaction only in the group of right-handers when the left hand/right hemisphere was engaged in haptic sensing as opposed to simply gripping. Collectively, these results are congruent with other TMS reports describing a greater degree of hemispheric asymmetry in right-handers, who are typically more strongly lateralised than left-handers. Our results with regard to a rightward hemispheric asymmetry for MEP facilitation with haptic sensing are also congruent with the predominant role ascribed to the right sensorimotor cortex in the processing of proprioceptive information.

Task-related enhancement in corticomotor excitability during haptic sensing with the contra- or ipsilateral hand in young and senior adults

BackgroundHaptic sensing with the fingers represents a unique class of manipulative actions, engaging motor, somatosensory and associative areas of the cortex while requiring only minimal forces and relatively simple movement patterns. Using transcranial magnetic stimulation (TMS), we investigated task-related changes in motor evoked potential (MEP) amplitude associated with unimanual haptic sensing in two related experiments. In Experiment I, we contrasted changes in the excitability of the hemisphere controlling the task hand in young and old adults under two trial conditions, i.e. when participants either touched a fine grating (smooth trials) or touched a coarse grating to detect its groove orientation (grating trials). In Experiment II, the same contrast between tasks was performed but with TMS applied over the hemisphere controlling the resting hand, while also addressing hemispheric (right vs. left) and age differences.ResultsIn Experiment I, a main effect of trial type on MEP amplitude was detected (p = 0.001), MEPs in the task hand being ~50% larger during grating than smooth trials. No interaction with age was detected. Similar results were found for Experiment II, trial type having a large effect on MEP amplitude in the resting hand (p < 0.001) owing to selective increase in MEP size (~2.6 times greater) for grating trials. No interactions with age or side (right vs. left) were detected.ConclusionsCollectively, these results indicate that adding a haptic component to a simple unilateral finger action can elicit robust corticomotor facilitation not only in the working hemisphere but also in the opposite hemisphere. The fact that this facilitation seems well preserved with age, when task difficulty is adjusted, has some potential clinical implications.

Action Perception in Individuals with Congenital Blindness or Deafness: How Does the Loss of a Sensory Modality from Birth Affect Perception-induced Motor Facilitation?

Seeing or hearing manual actions activates the mirror neuron system, that is, specialized neurons within motor areas which fire when an action is performed but also when it is passively perceived. Using TMS, it was shown that motor cortex of typically developed subjects becomes facilitated not only from seeing others' actions, but also from merely hearing action-related sounds. In the present study, TMS was used for the first time to explore the "auditory" and "visual" responsiveness of motor cortex in individuals with congenital blindness or deafness. TMS was applied over left primary motor cortex (M1) to measure cortico-motor facilitation while subjects passively perceived manual actions (either visually or aurally). Although largely unexpected, congenitally blind or deaf subjects displayed substantially lower resonant motor facilitation upon action perception compared to seeing/hearing control subjects. Moreover, muscle-specific changes in cortico-motor excitability within M1 appeared to be absent in individuals with profound blindness or deafness. Overall, these findings strongly argue against the hypothesis that an increased reliance on the remaining sensory modality in blind or deaf subjects is accompanied by an increased responsiveness of the "auditory" or "visual" perceptual-motor "mirror" system, respectively. Moreover, the apparent lack of resonant motor facilitation for the blind and deaf subjects may challenge the hypothesis of a unitary mirror system underlying human action recognition and may suggest that action perception in blind and deaf subjects engages a mode of action processing that is different from the human action recognition system recruited in typically developed subjects.

Selective increase in motor excitability with intraactive (self) versus interactive touch

Corticomotor facilitation was investigated using transcranial magnetic stimulation in healthy young adults when they actively stroked either their own left palm (intraactive) or the experimenter's palm (interactive touch) with their right index finger. We predicted, based on the sensory cancellation hypothesis, that corticomotor facilitation would be lower with intraactive touch. Motor evoked potential amplitude in the right first dorsal interosseous was affected by mode of touch, but not by sex. In contrast to our prediction, motor evoked potential facilitation was larger (mean 14%) during intraactive touch. The present results are in agreement with recent evidence suggesting that self-touch represents a unique class of sensorimotor experiences that are critical for the elaboration of internal body structure representation.

Tactile-dependant corticomotor facilitation is influenced by discrimination performance in seniors

BackgroundActive contraction leads to facilitation of motor responses evoked by transcranial magnetic stimulation (TMS). In small hand muscles, motor facilitation is known to be also influenced by the nature of the task. Recently, we showed that corticomotor facilitation was selectively enhanced when young participants actively discriminated tactile symbols with the tip of their index or little finger. This tactile-dependant motor facilitation reflected, for the large part, attentional influences associated with performing tactile discrimination, since execution of a concomitant distraction task abolished facilitation. In the present report, we extend these observations to examine the influence of age on the ability to produce extra motor facilitation when the hand is used for sensory exploration.MethodsCorticomotor excitability was tested in 16 healthy seniors (58-83 years) while they actively moved their right index finger over a surface under two task conditions. In the tactile discrimination (TD) condition, participants attended to the spatial location of two tactile symbols on the explored surface, while in the non discrimination (ND) condition, participants simply moved their finger over a blank surface. Changes in amplitude, in latency and in the silent period (SP) duration were measured from recordings of motor evoked potentials (MEP) in the right first dorsal interosseous muscle in response to TMS of the left motor cortex.ResultsHealthy seniors exhibited widely varying levels of performance with the TD task, older age being associated with lower accuracy and vice-versa. Large inter-individual variations were also observed in terms of tactile-specific corticomotor facilitation. Regrouping seniors into higher (n = 6) and lower performance groups (n = 10) revealed a significant task by performance interaction. This latter interaction reflected differences between higher and lower performance groups; tactile-related facilitation being observed mainly in the former group. Latency measurements and SP durations were not affected by task conditions.ConclusionsThe present findings provide further insights into the factors influencing task-dependant changes in corticomotor excitability in the context of aging. Our results, in particular, highlight the importance of adjusting task demands and controlling for attention when attempting to elicit task-specific motor facilitation in older persons engaged in fine manual actions. Such information could be critical in the future for planning interventions to re-educate or maintain hand function in the presence of neurological impairments.

Reduced cortico-motor facilitation in a normal sample with high traits of autism

Recent research in social neuroscience proposes a link between mirror neuron system (MNS) and social cognition. The MNS has been proposed to be the neural mechanism underlying action recognition and intention understanding and more broadly social cognition. Pre-motor MNS has been suggested to modulate the motor cortex during action observation. This modulation results in an enhanced cortico-motor excitability reflected in increased motor evoked potentials (MEPs) at the muscle of interest during action observation. Anomalous MNS activity has been reported in the autistic population whose social skills are notably impaired. It is still an open question whether traits of autism in the normal population are linked to the MNS functioning. We measured TMS-induced MEPs in normal individuals with high and low traits of autism as measured by the autistic quotient (AQ), while observing videos of hand or mouth actions, static images of a hand or mouth or a blank screen. No differences were observed between the two while they observed a blank screen. However participants with low traits of autism showed significantly greater MEP amplitudes during observation of hand/mouth actions relative to static hand/mouth stimuli. In contrast, participants with high traits of autism did not show such a MEP amplitude difference between observation of actions and static stimuli. These results are discussed with reference to MNS functioning.

Corticomotor facilitation associated with observation and imagery of hand actions is impaired in Parkinson’s disease

In the present report, we extend our previous observations on corticomotor facilitation associated with covert (action observed or imagined) and overt (action imitated) action execution in old adults (Leonard and Tremblay in Exp Brain Res 117:167-175, 2007) to investigate the impact of Parkinson's disease (PD). Participants consisted of 22 older adults (age range 58-76 years) of whom 11 were medicated patients diagnosed with PD (patient group) and 11 were age-matched healthy controls (healthy group). Corticomotor facilitation was assessed by monitoring the changes in the amplitude of motor evoked potentials (MEP) in muscles of the right hand (first dorsal interosseous: FDI; and abductor digiti minimi: ADM) in response to transcranial magnetic stimulation of the left motor cortex. In each group, corticomotor facilitation was assessed with participants seated in front of a computer screen under four testing conditions: (1) REST: eyes closed and instructions to relax for 10 s, (2) OBS: observe action, (3) IMAG: imagine action and (4) IMIT: imitate action. The action depicted in the video displayed the hand of a male subject cutting a piece of material with scissors. Comparison of variations in MEP amplitude revealed a significant interaction between groups and conditions. In the healthy group, the OBS and IMAG conditions were both associated with significant facilitation in the FDI and ADM, whereas the same conditions failed to produce facilitation in the PD group. In both groups, the IMIT condition produced the largest facilitation in hand muscles. Further planned comparisons revealed a significant difference between groups in the FDI for the OBS condition. From these findings, we conclude that, even when properly medicated, old adults with PD may experience major difficulties in engaging the motor system for covert actions, particularly when asked to observe another person's action. This failure of corticomotor facilitation for covert actions appears to be linked with the deficit in motor activation associated with basal ganglia dysfunction in PD and in line with the difficulty experienced in general by patients "to energize" the motor system in preparation for action.

Corticomotor facilitation associated with observation, imagery and imitation of hand actions: a comparative study in young and old adults

In the present report, we extent our previous findings (Clark et al. in Neuropsychologia 42:105-122, 2004) on corticomotor facilitation associated with covert (observation and imagery) and overt execution (action imitation) of hand actions to better delineate the selectivity of the effect in the context of an object-oriented action. A second aim was to examine whether the pattern of facilitation would be affected by age. Corticomotor facilitation was determined in two groups of participants (young n = 21, 24 +/- 2 years; old n = 19, 62 +/- 6 years) by monitoring changes in the amplitude and latency of motor evoked potentials (MEPs) elicited in hand muscles by transcranial magnetic stimulation. MEP responses were measured from both the first dorsal interosseous (FDI, task selective muscle) and the abductor digiti minimi (ADM) of the right hand while participants attended to four different video presentations. Each of four videos provided specific instructions for participants to either: (1) close their eyes and relax (REST), (2) observe the action attentively (OBS), (3) close their eyes and mentally simulate the action (IMAG), or (4) imitate the action (IMIT). The action depicted in the videos represented a male subject cutting a piece of material with scissors. In the young group, the pattern of results revealed selective facilitation in the FDI in conditions involving either covert (OBS and IMAG) or overt action execution (IMIT). In the ADM, only overt execution with action imitation was associated with significant MEP facilitation. In the old group, a similar pattern of results was observed, although the modulation was less selective than that seen in the young group. In fact, older individuals often exhibited concomitant facilitation in both the FDI and ADM during either covert (OBS and IMAG conditions) or overt action execution (IMIT condition). Taken together, these results further corroborate the notion that the corticomotor system is selectively active when actions are covertly executed through internal simulation triggered by observation or by motor imagery, as proposed by Jeannerod (Neuroimage 14:S103-S109, 2001). With aging, the ability to produce corticomotor facilitation in association with covert action execution appears to be largely preserved, although there seems to be a loss in selectivity. This lack of selectivity may, in turn, reflect age-related alterations in the function of the corticospinal system, which may impair the ability to individuate finger movements either in the covert or overt stage of action execution.