Increase In Corticospinal Excitability Research Articles

Motor imagery beyond the joint limits: A transcranial magnetic stimulation study

The processes and neural bases used for motor imagery are also used for the actual execution of correspondent movements. Humans, however, can imagine movements they cannot perform. Here we explored whether plausibility of movements is mapped on the corticospinal motor system and whether the process is influenced by visuomotor vs. kinesthetic-motor first person imagery strategy. Healthy subjects imagined performing possible or biomechanically impossible right index finger movements during single pulse TMS of the left motor cortex. We found an increase of corticospinal excitability during motor imagery which was higher for impossible than possible movements and specific for the muscle involved in the actual execution of the imagined movement. We expand our previous action observation studies, suggesting that the plausibility of a movement is computed in regions upstream the primary motor cortex, and that motor imagery is a higher-order process not fully constrained by the rules that govern motor execution.

Understanding mirror neurons: Evidence for enhanced corticospinal excitability during the observation of transitive but not intransitive hand gestures

Putative measures of mirror neuron activity suggest that mirror neurons respond preferentially to biological motion, but it remains unclear whether enhanced cortical activity occurs during the observation of any behaviour, or whether that behaviour needs to be associated with a particular object or goal. Forty-three healthy adults completed a transcranial magnetic stimulation (TMS) experiment that assessed corticospinal excitability while viewing intransitive and transitive hand gestures (compared with the presentation of a static hand). Visual presentations were designed to control for motoric and stimulus properties. A significant increase in corticospinal excitability (putatively reflecting mirror neuron activation) was seen only during the observation of transitive behaviour. These findings are consistent with the notion that human hand-related mirror neurons are sensitive to object- and goal-directed behaviour, rather than biological motion per se.

Changes in muscle directional tuning parallel feedforward adaptation to a visuomotor rotation

When people learn to reach in a novel sensorimotor environment, there are changes in the muscle activity required to achieve task goals. Here, we assessed the time course of changes in muscle directional tuning during acquisition of a new mapping between visual information and isometric force production in the absence of feedback-based error corrections. We also measured the influence of visuomotor adaptation on corticospinal excitability, to test whether any changes in muscle directional tuning are associated with adaptations in the final output components of the sensorimotor control system. Nine right-handed subjects performed a ballistic, center-out isometric target acquisition task with the right wrist (16 targets spaced every 22.5 degrees in the joint space). Surface electromyography was recorded from four major wrist muscles, and motor evoked potentials induced by transcranial magnetic stimulation were measured at baseline, after task execution in the absence of the rotation (A1), after adaptation to the rotation (B), and after a final block of trials without rotation (A2). Changes in the directional tuning of muscles closely matched the rotation of the directional error in force, indicating that the functional contribution of muscles remained consistent over the adaptation period. In contrast to previous motor learning studies, we found only minor changes in the amount of muscular activity and no increase in corticospinal excitability. These results suggest that increased muscle co-activation occurs only when the dynamics of the limb are perturbed and/or that online error corrections or altered force requirements are necessary to elicit a component of the adaptation in the final steps of the transformation between motor goal and muscle activation.

Response Competition in the Primary Motor Cortex: Corticospinal Excitability Reflects Response Replacement During Simple Decisions

It has been suggested that, during decisions about actions, multiple options are initially specified in parallel and then gradually eliminated in a competition for overt execution. To further test this hypothesis, we studied the modulation of human corticospinal excitability during the reaction time of the Eriksen flanker task. In the task, subjects responded with finger flexion or extension to a central arrow while ignoring congruent or incongruent flanker arrows. Single-pulse transcranial magnetic stimulation (TMS) was applied over primary motor cortex (M1) at one of five different latencies after stimulus onset, and motor-evoked potentials (MEPs) were measured in the contralateral index finger. During the control (no flankers) and congruent conditions, MEP size in the agonist increased gradually over the course of reaction time, indicating an increase in corticospinal excitability. Conversely, when the same muscle acted as an antagonist, MEP size decreased, suggesting inhibition. Critically, in the incongruent condition, MEPs briefly increased in the muscle corresponding to an initial default response to the flanker arrows and were later replaced by MEPs corresponding to the correct response to the central arrow. Finally, we found that the gradually growing MEPs for the three conditions reached a constant maximum level just before movement initiation. We propose that this dynamic modulation in corticospinal excitability reflects the competition process, leading to the selection of one response and the rejection of the other. Our results suggest that response competition influences activity in primary motor cortex and that its timing directly influences motor output latency.

Corticospinal excitability during observation and imagery of simple and complex hand tasks: Implications for motor rehabilitation

Movement observation and imagery are increasingly propagandized for motor rehabilitation. Both observation and imagery are thought to improve motor function through repeated activation of mental motor representations. However, it is unknown what stimulation parameters or imagery conditions are optimal for rehabilitation purposes. A better understanding of the mechanisms underlying movement observation and imagery is essential for the optimization of functional outcome using these training conditions. This study systematically assessed the corticospinal excitability during rest, observation, imagery and execution of a simple and a complex finger-tapping sequence in healthy controls using transcranial magnetic stimulation (TMS). Observation was conducted passively (without prior instructions) as well as actively (in order to imitate). Imagery was performed visually and kinesthetically. A larger increase in corticospinal excitability was found during active observation in comparison with passive observation and visual or kinesthetic imagery. No significant difference between kinesthetic and visual imagery was found. Overall, the complex task led to a higher corticospinal excitability in comparison with the simple task. In conclusion, the corticospinal excitability was modulated during both movement observation and imagery. Specifically, active observation of a complex motor task resulted in increased corticospinal excitability. Active observation may be more effective than imagery for motor rehabilitation purposes. In addition, the activation of mental motor representations may be optimized by varying task-complexity.

Changes in corticospinal excitability evoked by common peroneal nerve stimulation depend on stimulation frequency

The afferent volley generated during neuromuscular electrical stimulation (NMES) can increase the excitability of the human corticospinal (CS) pathway. This study was designed to determine the effect of different frequencies of NMES applied over the common peroneal nerve on changes in CS excitability for the tibialis anterior (TA) muscle. We hypothesized that higher frequencies of stimulation would produce larger increases in CS excitability than lower frequencies. NMES was applied at 10, 50, 100, or 200 Hz during separate sessions held at least 48 h apart. The stimulation was delivered in a 20 s on, 20 s off cycle for 40 min using a 1 ms pulse width. The intensity of stimulation was set to evoke an M-wave in response to a single pulse that was 15% of the maximal M-wave. CS excitability was evaluated by the amplitude of motor-evoked potentials (MEPs) in TA evoked by transcranial magnetic stimulation. MEPs were recorded immediately before and after the 40 min of NMES and in each 20 s "off" period. For each subject, MEPs recorded during three successive "off" periods were averaged together (n = 9 MEPs), providing a temporal resolution of 2 min for assessing changes in CS excitability. When delivering NMES at 100 Hz, MEPs became significantly elevated from those evoked before the stimulation at the 24th min, and there was a twofold increase in MEP amplitude after 40 min. NMES delivered at 10, 50, and 200 Hz did not significantly alter MEP amplitude. The amplitude of MEPs evoked in soleus and vastus medialis followed similar patterns as those evoked simultaneously in TA, but these changes were mostly not of statistical significance. There were no changes in the ratio of maximal H-reflex to maximal M-wave in TA or soleus. These experiments demonstrate a frequency-dependent effect of NMES on CS excitability for TA and show that, under the conditions of the present study, 100-Hz stimulation was more effective than 10, 50, and 200 Hz. This effect of NMES on CS excitability was strongest in the stimulated muscle and may be mediated primarily at a supraspinal level. These results contribute to a growing body of knowledge about how the afferent volley generated during NMES influences the CNS and have implications for identifying optimal NMES parameters to augment CS excitability for rehabilitation of dorsiflexion after CNS injury.

Endogenous control of waking brain rhythms induces neuroplasticity in humans

This study explores the possibility of noninvasively inducing long-term changes in human corticomotor excitability by means of a brain-computer interface, which enables users to exert internal control over the cortical rhythms recorded from the scalp. We demonstrate that self-regulation of electroencephalogram rhythms in quietly sitting, naive humans significantly affects the subsequent corticomotor response to transcranial magnetic stimulation, producing durable and correlated changes in neurotransmission. Specifically, we show that the intrinsic suppression of alpha cortical rhythms can in itself produce robust increases in corticospinal excitability and decreases in intracortical inhibition of up to 150%, which last for at least 20 min. Our observations may have important implications for therapies of brain disorders associated with abnormal cortical rhythms, and support the use of electroencephalogram-based neurofeedback as a noninvasive tool for establishing a causal link between rhythmic cortical activities and their functions.

Late Cortical Disinhibition in Human Motor Cortex: A Triple-Pulse Transcranial Magnetic Stimulation Study

In human motor cortex transcranial magnetic stimulation (TMS) has been used to identify short-interval intracortical inhibition (SICI) corresponding to gamma-aminobutyric acid type A (GABA(A)) effects and long-interval intracortical inhibition (LICI) and the cortical silent period (SP) corresponding to postsynaptic GABA(B) effects. Presynaptic GABA(B) effects, corresponding to disinhibition, can also be identified with TMS and have been shown to be acting during LICI by measuring SICI after a suprathreshold priming stimulus (PS). The duration of disinhibition is not certain and, guided by studies in experimental preparations, we hypothesized that it may be longer-lasting than postsynaptic inhibition, leading to a period of late cortical disinhibition and consequently a net increase in corticospinal excitability. We tested this first by measuring the motor-evoked potential (MEP) to a test stimulus (TS), delivered after a PS at interpulse intervals (IPIs) < or =300 ms that encompassed the period of PS-induced LICI and its aftermath. MEP amplitude was initially decreased, but then increased at IPIs of 190-210 ms, reaching 160 +/- 17% of baseline 200 ms after PS (P < 0.05). SP duration was 181 +/- 5 ms. A second experiment established that the onset of the later period of increased excitability correlated with PS intensity (r(2) = 0.99) and with the duration of the SP (r(2) = 0.99). The third and main experiment demonstrated that SICI was significantly reduced in strength at all IPIs < or =220 ms after PS. We conclude that TMS-induced LICI is associated with a period of disinhibition that is at first masked by LICI, but that outlasts LICI and gives rise to a period during which disinhibition predominates and net excitability is raised. Identification of this late period of disinhibition in human motor cortex may provide an opportunity to explore or modulate the behavior of excitatory networks at a time when inhibitory effects are restrained.

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° 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.

Selective increase in corticospinal excitability in the context of tactile exploration

In this study, we compared changes in corticomotor excitability under various task conditions engaging the index finger of each hand. Functional demands were varied, from simple execution to demanding sensory exploration. In a first experiment, we contrasted facilitation in the first dorsal interosseus (FDI) by monitoring changes in motor evoked potentials (MEPs) when participants (young adults, n = 18) performed either a simple button pressing (BP) task or a more demanding tactile exploration (TE) task (i.e., discrimination of raised letters). This experiment showed a large effect of task conditions (p < 0.01) on MEP amplitude but no effect of “Hand”, while latency measurements were unchanged. In fact, MEPs were on average 40% larger during TE (2410 ± 1358 µV) than during BP (1670 ± 1477 µV). The two tasks produced, however, different patterns of electromyographic (EMG) activity, which could have accounted for some of the differences observed. A second experimental session involved a subset of participants (10/18) tested in third task condition: finger movement (FM). The latter task consisted of scanning a smooth surface with the tip of the index finger to reproduce the movements seen with the TE task. The addition of this third condition task confirmed that MEP facilitation seen during TE reflected task-specific influences and not differences in background EMG activity. These results, altogether, provide further insights into the effect of task conditions on corticomotor excitability. Our findings, in particular, stress the importance of behavioural context and tactile exploration in leading to selective increase in corticomotor excitability during finger movements.

Motor imagery of foot dorsiflexion and gait: Effects on corticospinal excitability

Objective We examined how corticospinal excitability was affected by motor imagery of foot dorsiflexion and motor imagery of gait. Methods Transcranial magnetic stimulation was applied over the primary motor cortex of 16 young healthy subjects while they performed imaginary foot dorsiflexions (Experiment I) and imaginary walking (Experiment II). Motor-evoked potentials (MEPs) were recorded from the tibialis anterior (TA) and first dorsal interosseus (FDI). MEPs recorded during motor imagery were compared to those recorded during a matched visual imagery task. Results Imagined foot dorsiflexions increased MEP areas in both TA and FDI. The increase in TA was stronger than in FDI. Overall, imagined walking did not change MEP areas. However, subjects with larger increases in TA during imagined foot dorsiflexion also showed larger increases in TA during imagined walking. Conclusions Imagined foot dorsiflexions increase corticospinal excitability in both a task-related muscle (TA) and a task-unrelated muscle (FDI), with larger increases in the task-related muscle. Imagined gait only increases corticospinal excitability in those subjects with the largest increments during imagined foot dorsiflexion. Significance Imagery of a simple lower extremity movement evokes increases in corticospinal excitability. Furthermore, corticospinal effects of a simple motor imagery task can predict corticospinal effects of a more complex motor imagery task involving the same muscle.

Electrophysiological correlates of motor conversion disorder

In patients with a functional (psychogenic) paresis, motor conduction tests are, by definition, normal. We investigated whether these patients exhibit an abnormal motor excitability. Four female patients with a functional paresis of the left upper extremity were studied using transcranial magnetic stimulation (TMS). We investigated motor thresholds, intracortical inhibition and intracortical facilitation at rest. Corticospinal excitability was evaluated by single pulse TMS during rest and during imagination of tonic index finger adductions. Data obtained from the affected first dorsal interosseous muscle were compared with the unaffected hand and with a healthy age-matched control group. Three patients demonstrated a flaccid paresis, one patient had a psychogenic dystonia. Motor thresholds, short interval intracortical inhibition and intracortical facilitation recorded from the affected side were normal. In healthy subjects, movement imagination produced an increase of corticospinal excitability. In the patients, motor imagery with the affected index finger resulted in a decrease of corticospinal excitability compared to rest, being significantly different from the unaffected side and from the control group. We suggest that suppression of corticospinal excitability during movement imagination is an electrophysiological correlate of the patients' inability to move voluntarily and provides some insight into the pathophysiology of this disorder.

Corticospinal Facilitation Following Prolonged Proprioceptive Stimulation by Means of Passive Wrist Movement

The purpose of this study was to evaluate the delayed effects of repetitive sensory stimulation with passive wrist movement on corticospinal excitability of the forearm and hand musculature. Motor evoked potential responses to single and double pulse transcranial magnetic stimulation were recorded from the flexor carpi radialis, extensor carpi radialis, and the first dorsal interosseous muscles of the right limb. Data were collected before and after a 1 hour session of passive wrist movement (intervention group, n = 11) or after a same period of rest (control group, n = 9). Motor evoked potential size and area were analyzed to evaluate corticospinal excitability and short interval intracortical inhibition and facilitation. Training with passive movement resulted in a prolonged increase in corticospinal excitability in the flexor carpi radialis and extensor carpi radialis (until at least 1 hour postintervention), but did not evoke significant changes in the levels of short interval intracortical inhibition and facilitation. No such effects were noted in the control group or first dorsal interosseous muscle. Prolonged proprioceptive stimulation with passive wrist movement induces a delayed increase in corticospinal excitability of the forearm muscles. Accordingly, this intervention may promote motor cortical reorganization in the targeted muscles. Results show induced effects from passive movement training that may prove useful for neurorehabilitation therapies.

Motor cortex excitability changes during imagery of simple reaction time

Imagining motor actions is enough to enhance cortical motor excitability. However, the fact that execution of the motor task has to be inhibited should have a correlate on the extent of cortical excitability enhancement. Therefore, we examined the possible differences between real and motor imagery of simple reaction time tasks (SRT) in the facilitation of the motor-evoked potential (MEP) to transcranial magnetic stimulation (TMS) and in the reduction of short-interval intracortical inhibition (SICI) taking place before the movement onset. Thirteen healthy volunteers were requested to perform visual real or imaginary SRT tasks (rSRT and iSRT) with their dominant hand. For rSRT, subjects had to perform a rapid isometric squeeze as soon as possible after the imperative signal. For iSRT they had to imagine the same movement without actually doing it. Electromyographic (EMG) signals were recorded from the first dorsal interosseus (FDI) muscle. The mean EMG onset was calculated for each subject in rSRT trials. Single-and paired-pulse TMS (at an interstimulus interval of 2.5 ms) were applied at rest and at time intervals of -25, -50, -75, -100 and -125 ms before the expected real (rSRT) mean EMG onset. In rSRT there was a significant increase of MEP to single-pulseTMS at the intervals of -50 and -25 ms, and in iSRT at -50 ms in comparison to the rest condition. % SICI changes were significantly reduced at the intervals of -75, -50 and -25 ms, before EMG the onset in rSRT and at -50 and -25 in iSRT (P < 0.05) in comparison to % SICI changes at rest. The differences between MEPs to spTMS and MEP to ppTMS were significantly larger at rest, -125 and -100 ms intervals in rSRT, and at all intervals in iSRT. Imagining to move causes an increase in corticospinal excitability and a decrease in intracortical inhibition that follow a temporal profile similar to those observed with real movements. However, complete removal of SICI happened only in rSRT at the shortest intervals before the EMG onset. Such action may delineate new tool in motor rehabilitation of patients who have limitation to move.

Asymmetric facilitation from repeated paired magnetic stimulation of human motor cortex

Repeated stimulation of human motor cortex with pairs of magnetic pulses separated by 1.5 ms has been shown to increase the amplitude of the motor-evoked potentials in activated muscles, indicating a short-term plastic increase of corticospinal excitability. We show here that this increase is greater in the dominant than the nondominant motor cortex of right-handed participants. This finding is a direct demonstration that the potential for plastic synaptic change is greater in the dominant than the nondominant motor cortex and implies that a greater potential for reorganization within the dominant motor cortex is a mechanism of the greater dexterity of the dominant hand.

Changes in corticomotor excitability following prolonged muscle tendon vibration

The present experiment addressed whether increases in corticospinal excitability following sensory stimulation with muscle tendon vibration are accompanied by reorganization of the forearm musculature representation within the primary motor cortex. Using transcranial magnetic stimulation, we mapped the corticomotor projection to the dominant flexor carpi radialis (FCR) and extensor carpi radialis brevis (ECR) muscle before and after interventional sensory stimulation obtained via muscle tendon vibration (80 Hz, 60 min) to the dominant distal wrist flexor tendons. Following vibration, MEP amplitude at the optimal stimulation position, motor output area, as well as map volume, increased significantly for the ECR. None of these effects reached significance for the FCR. These results suggest that the antagonistic vibratory response (AVR), which is considered to be of cortical origin, induces a delayed facilitation of musculature that is antagonistic to the site of the directly activated Ia afferent pathways. This example demonstrates that peripheral sensory stimulation can induce lasting increases in corticospinal excitability in the absence of actual movements.

Transcranial Magnetic Stimulation and Sleep Deprivation as Experimental Tools: When Sleep Deprivation is Too Exciting

Sleep Deprivation Increases Cortical Excitability in Epilepsy: Syndrome-Specific Effects. Badawy RA, Curatolo JM, Newton M, Berkovic SF, Macdonell RA. Neurology 2006;67(6):1018–1022. OBJECTIVE: To use transcranial magnetic stimulation (TMS) to investigate the hypothesis that sleep deprivation increases cortical excitability in people with epilepsy. METHODS: We performed paired pulse TMS stimulation, using a number of interstimulus intervals (ISIs) on each hemisphere of 30 patients with untreated newly diagnosed epilepsy (15 idiopathic generalized epilepsy [IGE] and 15 focal epilepsy) and on the dominant hemisphere of 13 healthy control subjects, before and after sleep deprivation. RESULTS: Both hemispheres in patients with IGE and the hemisphere ipsilateral to the EEG seizure focus in those with focal epilepsy showed an increase in cortical excitability following sleep deprivation at a number of ISIs. This change in excitability was most prominent in the patients with IGE. Although there were minor changes after sleep deprivation in control subjects and the contralateral hemisphere in the focal epilepsy group seen at the 250-millisecond ISI, it was less than that in the other groups. CONCLUSIONS: Sleep deprivation increases cortical excitability in epilepsy; the pattern of change is syndrome dependent. Effects of Sleep Deprivation on Cortical Excitability in Patients Affected by Juvenile Myoclonic Epilepsy: A Combined Transcranial Magnetic Stimulation and EEG Study. Manganotti P, Bongiovanni LG, Fuggetta G, Zanette G, Fiaschi A. J Neurol Neurosurg Psychiatry 2006;77(1):56–60. OBJECTIVE: To investigate the effect of sleep deprivation on corticospinal excitability in patients affected by juvenile myoclonic epilepsy (JME) using different transcranial magnetic stimulation (TMS) parameters. METHODS: Ten patients with JME and 10 normal subjects underwent partial sleep deprivation. Motor threshold (MT), motor evoked potential amplitude (MEP), and silent period (SP) were recorded from the thenar eminence (TE) muscles. Short latency intracortical inhibition (SICI) and short latency intracortical facilitation (SICF) were studied using paired magnetic stimulation. TMS was performed before and after sleep deprivation; EEG and TMS were performed simultaneously. RESULTS: In patients with JME, sleep deprivation induced a significant decrease in SICI and an increase in SICF, which was associated with increased paroxysmal activity. A significant decrease in the MT was observed. No significant changes in any TMS parameters were noted in normal subjects after sleep deprivation. The F wave was unchanged by sleep deprivation in both control subjects and in patients with JME. CONCLUSIONS: In patients with JME, sleep deprivation produces increases in corticospinal excitability in motor areas as measured by different TMS parameters.

Abnormal plasticity of sensorimotor circuits extends beyond the affected body part in focal dystonia

Objective: To test whether abnormal sensorimotor plasticity in focal hand dystonia is a primary abnormality or is merely a consequence of the dystonic posture. Methods: This study used the paired...

Contribution of Hand Motor Circuits to Counting

The finding that number processing activates a cortical network partly overlapping that recruited for hand movements has renewed interest in the relationship between number and finger representations. Further evidence about a possible link between fingers and numbers comes from developmental studies showing that finger movements play a crucial role in learning counting. However, increased activity in hand motor circuits during counting may unveil unspecific processes, such as shifting attention, reciting number names, or matching items with a number name. To address this issue, we used transcranial magnetic stimulation to measure changes in corticospinal (CS) excitability during a counting task performed silently and using either numbers or letters of the alphabet to enumerate items. We found an increased CS excitability of hand muscles during the counting task, irrespective of the use of numbers or letters, whereas it was unchanged in arm and foot muscles. Control tasks allowed us to rule out a possible influence of attention allocation or covert speech on CS excitability increase of hand muscles during counting. The present results support a specific involvement of hand motor circuits in counting because no CS changes were found in arm and foot muscles during the same task. However, the contribution of hand motor areas is not exclusively related to number processing because an increase in CS excitability was also found when letters were used to enumerate items. This finding suggests that hand motor circuits are involved whenever items have to be put in correspondence with the elements of any ordered series.

Changes in Spinal Excitability After PAS

Repetitive pairing of a peripheral stimulation with a magnetic transcortical stimulation (PAS) is widely used to induce plastic changes in the human motor cortex noninvasively. Based on the contrast between PAS-induced increase of corticospinal excitability and absence of PAS-induced increase of the spinal F wave size, it has been generally accepted that PAS-induced plasticity is cortical in origin. Here, instead of F waves, we used H reflex recruitment curves to assess spinal excitability, and we demonstrate that PAS induces parallel changes in cortical and spinal excitability.