Measured Motor Evoked Potential Amplitude Research Articles

Anesthesia inhibited corticospinal excitability and attenuated the modulation of repetitive transcranial magnetic stimulation

BackgroundLots of studies have measured motor evoked potential (MEP) induced by transcranial magnetic stimulation (TMS) in anesthetized animals. However, in awake animals, the measurement of TMS-induced MEP is scarce as lack of sufficient restraint. So far, the explicit study of anesthesia effects on corticospinal excitability and repetitive TMS (rTMS) induced modulation is still lacking. This study aimed to: (1) measure TMS-induced MEP in both awake restrained and anesthetized rats, (2) investigate the effect of anesthesia on corticospinal excitability, and (3) on rTMS-induced modulation.MethodsMEP of eighteen rats were measured under both wakefulness and anesthesia using flexible binding and surface electrodes. Peak-to-peak MEP amplitudes, resting motor threshold (RMT) and the slope of stimulus response (SR) were extracted to investigate anesthesia effects on corticospinal excitability. Thereafter, 5 or 10 Hz rTMS was applied with 600 pulses, and the increase in MEP amplitude and the decrease in RMT were used to quantify rTMS-induced modulation.ResultsThe RMT in the awake condition was 44.6 ± 1.2% maximum output (MO), the peak-to-peak MEP amplitude was 404.6 ± 48.8 μV at 60% MO. Under anesthesia, higher RMT (55.6 ± 2.9% MO), lower peak-to-peak MEP amplitudes (258.6 ± 32.7 μV) and lower slope of SR indicated that the corticospinal excitability was suppressed. Moreover, under anesthesia, high-frequency rTMS still showed significant modulation of corticospinal excitability, but the modulation of MEP peak-to-peak amplitudes was weaker than that under wakefulness.ConclusionsThis study measured TMS-induced MEP in both awake and anesthetized rats, and provided explicit evidence for the inhibitory effects of anesthesia on corticospinal excitability and on high-frequency rTMS-induced modulation of MEP.

Bypassing use-dependent plasticity in the primary motor cortex to preserve adaptive behavior

Behavioral adaptation, a central feature of voluntary movement, is known to rely on top-down cognitive control. For example, the conflict-adaptation effect on tasks such as the Stroop task leads to better performance (e.g. shorter reaction time) for incongruent trials following an already incongruent one. The role of higher-order cortices in such between-trial adjustments is well documented, however, a specific involvement of the primary motor cortex (M1) has seldom been questioned. Here we studied changes in corticospinal excitability associated with the conflict-adaptation process. For this, we used single-pulse transcranial-magnetic stimulation (TMS) applied between two consecutive trials in an interference flanker task, while measuring motor-evoked potentials (MEPs) after agonistic and antagonistic voluntary movements. In agonist movement, MEP amplitude was modulated by recent movement history with an increase favoring movement repetition, but no significant change in MEP size was observed whether a previous trial was incongruent or congruent. Critically, for an antagonist movement, the relative size of MEPs following incongruent trials correlated positively with the strength of behavioral adaptation measured as the degree of RT shortening across subjects. This post-conflict increase in corticospinal excitability related to antagonist muscle recruitment could compensate for a potential deleterious bias due to recent movement history that favors the last executed action. Namely, it prepares the motor system to rapidly adapt to a changing and unpredictable context by equalizing the preparation for all possible motor responses.

Examining motor evoked potential amplitude and short-interval intracortical inhibition on the up-going and down-going phases of a transcranial alternating current stimulation (tacs) imposed alpha oscillation.

Many brain regions exhibit rhythmical activity thought to reflect the summed behaviour of large populations of neurons. The endogenous alpha rhythm has been associated with phase-dependent modulation of corticospinal excitability. However, whether exogenous alpha rhythm, induced using transcranial alternating current stimulation (tACS) also has a phase-dependent effect on corticospinal excitability remains unknown. Here, we triggered transcranial magnetic stimuli (TMS) on the up- or down-going phase of a tACS-imposed alpha oscillation and measured motor evoked potential (MEP) amplitude and short-interval intracortical inhibition (SICI). There was no significant difference in MEP amplitude or SICI when TMS was triggered on the up- or down-going phase of the tACS-imposed alpha oscillation. The current study provides no evidence of differences in corticospinal excitability or GABAergic inhibition when targeting the up-going (peak) and down-going (trough) phase of the tACS-imposed oscillation.

Probing Context-Dependent Modulations of Ipsilateral Premotor-Motor Connectivity in Relapsing-Remitting Multiple Sclerosis.

Objective: We employed dual-site TMS to test whether ipsilateral functional premotor-motor connectivity is altered in relapsing-remitting Multiple Sclerosis (RR-MS) and is related to central fatigue.Methods: Twelve patients with RR-MS and 12 healthy controls performed a visually cued Pinch-NoPinch task with their right hand. During the reaction time (RT) period of Pinch and No-Pinch trials, single-site TMS was applied to the left primary motor cortex (M1) or dual-site TMS was applied to the ipsilateral dorsal premotor cortex (PMd) and to M1. We traced context-dependent changes of corticospinal excitability and premotor–motor connectivity by measuring Motor-Evoked Potentials (MEPs) in the right first dorsal interosseus muscle. Central fatigue was evaluated with the Fatigue Scale for Motor and Cognitive Functions (FSMS).Results: In both groups, single-pulse TMS revealed a consistent increase in mean MEP amplitude during the Reaction Time (RT) period relative to a resting condition. Task-related corticospinal facilitation increased toward the end of the RT period in Pinch trials, while it decreased in No-Pinch trials. Again, this modulation of MEP facilitation by trial type was comparable in patients and controls. Dual-site TMS showed no significant effect of a conditioning PMd pulse on ipsilateral corticospinal excitability during the RT period in either group. However, patients showed a trend toward a relative attenuation in functional PMd-M1 connectivity at the end of the RT period in No-Pinch trials, which correlated positively with the severity of motor fatigue (r = 0.69; p = 0.007).Conclusions: Dynamic regulation of corticospinal excitability and ipsilateral PMd-M1 connectivity is preserved in patients with RR-MS. MS-related fatigue scales positively with an attenuation of premotor-to-motor functional connectivity during cued motor inhibition.Significance: The temporal, context-dependent modulation of ipsilateral premotor-motor connectivity, as revealed by dual-site TMS of ipsilateral PMd and M1, constitutes a promising neurophysiological marker of fatigue in MS.

Effects of low-gamma tACS on primary motor cortex in implicit motor learning

In the primary motor cortex (M1), rhythmic activity in the gamma frequency band has been found during movement planning, onset and execution. Although the role of high-gamma oscillatory activity in M1 is well established, the contribution of low-gamma activity is still unexplored. In this study, transcranial alternating current stimulation (tACS) was used with the aim to specifically modulate low-gamma frequency band in M1, during an implicit motor learning task. A 40 Hz-tACS was applied over the left M1 while participants performed a serial reaction time task (SRTT) using their right hand. The task required the repetitive execution of sequential movements in response to sequences of visual stimuli. Sequential blocks were interleaved by a random block, which served as interference to sequence learning. Sham and 1 Hz tACS were used as control. Task performance was examined before, during and after tACS (pre-, online- and post-phase, respectively). Furthermore, cortical reactivity of M1 was assessed in the pre- and post-tACS phases, by measuring motor-evoked potentials (MEPs) elicited by single-pulse transcranial magnetic stimulation (TMS).Compared to sham and pre-tACS, the 40 Hz stimulation applied during SRTT slowed down response times in blocks that required retrieving previously learned sequences, after performing the random block. In addition, M1 cortical reactivity was selectively inhibited following 40 Hz-tACS, as quantified by reduced MEP amplitude. These results show that low-gamma tACS delivered over M1 during motor learning enhanced susceptibility to interference generated by the random sequence (i.e., proactive interference effect). Importantly, only low-gamma stimulation produced long-lasting effects on M1 cortical reactivity.

Time course of bilateral corticospinal tract excitability in the motor-learning process

Although it is known that motor learning changes the corticospinal tract excitability, the time course of bilateral corticospinal tract excitability in the motor-learning process has not been clarified. The study aimed to investigate the time course of bilateral corticospinal tract excitability during the motor-learning process. Sixteen subjects performed 10 trials of the visuomotor tracking task by using their right index finger for one minute. The movement intensity of the visuomotor tracking task ranged from 5%–17% of the maximum index finger abduction force and the movement frequency was 0.5 Hz. To assess bilateral corticospinal excitability, we stimulated the bilateral primary motor cortex with transcranial magnetic stimulation between each trial and measured motor-evoked potential (MEP) from the bilateral first dorsal interosseous (FDI) muscle. Motor performance improved rapidly to the sixth trial (P < 0.05), and motor performance did not change from the seventh to the tenth trial. The MEP amplitude of the right FDI increased significantly from the fifth to the ninth trial relative to that before the task (P < 0.05). Conversely, the MEP amplitude of the left FDI did not change during the motor-learning process. This study revealed that primary motor cortex excitability on the contralateral side to the exercising muscle increased in the late motor learning stage and that primary motor cortex excitability on the ipsilateral side to the exercising muscle did not change in the motor-learning process.

Effects of Hand Intrinsic Muscle Facilitation and Functional Task Training on Cerebral Motor Evoked Potential after 1 Hz Low-Frequency rTMS in Stroke Patients

The purpose of this study was to investigate the effects of hand intrinsic muscles facilitation and functional task training with 1 Hz repetitive transcranial magnetic stimulation (rTMS) on cerebral motor cortex activity in stroke patients and to investigate the effectiveness of stroke rehabilitation. In this study, 20 adult stroke patients were randomly selected and divided into two groups of 10 each other. In the experimental group, hand intrinsic muscles facilitation and functional task training were performed after 1 Hz low frequency for 20 minutes and simple upper limb task training was performed in the control group. To investigate the changes of cerebral motor cortex activity after intervention, we measured Motor evoked potential (MEP) amplitude and latency. In both groups, MEP amplitude increased and MEP latency decreased after intervention. There was a significant difference between the two groups in MEP amplitude and latency (p 0.01) (p 0.05). Therefore, hand intrinsic muscles facilitation and functional task training with 1 Hz low frequency (rTMS) of stroke patients showed positive results in MEP amplitude and latency change of the injured cerebral cortex after stroke.

Sensorimotor mu-alpha power is positively related to corticospinal excitability

BackgroundAlpha (8–14 Hz) oscillatory power is linked to cortical excitability and corresponding modulations of sensory evoked potentials and perceptual detection performance. In somatosensory cortex (S1), negative linear and inverted U-shape relationships exist, whereas its effect on the primary motor cortex (M1) is hardly known. ObjectiveWe used real-time EEG-triggered transcranial magnetic stimulation (TMS) of M1 to characterize the relationship between spontaneous sensorimotor mu-alpha power fluctuations at rest and corticospinal excitability. MethodsIn 16 subjects, mu-alpha power was continuously monitored over the left sensorimotor cortex, and each 10%-percentile bin of the individual mu-alpha power distribution was repeatedly targeted in pseudorandomized order by single-pulse TMS of left M1, measuring motor evoked potentials (MEP) in the contralateral hand. ResultsWe found a weak positive relationship between mu-alpha power and MEP amplitude. ConclusionSensorimotor mu-alpha power may reflect a net facilitation or disinhibition of M1, possibly resulting from mu-alpha based suppression of excitatory and inhibitory input from S1.

A reappraisal of pain-paired associative stimulation suggesting motor inhibition at spinal level

Paired associative stimulation (PAS) can modulate motor excitability and consists of delivering repeated pairs of peripheral sensory stimulation combined with transcranial magnetic stimulation (TMS) over the contralateral motor cortex. Our objective was to evaluate the effect of a PAS protocol using a painful stimulation. Ten healthy volunteers underwent pain-PAS protocol consisting of 90 pairs of nociceptive stimulus over the right hand followed by an image-guided navigated TMS of the contralateral motor cortex, delivered at 0.1Hz over 15minutes. Four distinct inter-stimuli intervals (ISI) were assessed: -40ms, +10ms, +30ms and +50ms with respect to the individual pain-related evoked potential (N2 latency). The impact of pain-PAS was assessed by measuring motor evoked potentials (MEPs) amplitudes before and up to 30minutes after the pain-PAS procedure. For the "N2 latency -40ms" ISI condition, a significant decrease of MEP amplitude was observed in the immediate post-pain-PAS period. For longer ISIs, no significant changes were observed. A motor inhibition effect was produced by repetitive pairs of painful peripheral stimulation and TMS pulse delivered to the motor cortex before the afferent volley reaches the somatosensory cortex. This short ISI falls into a period of time corresponding to the cutaneous silent period, suggesting that the motor inhibition effect produced by pain-PAS could occur at spinal level. The repeated interaction of the nociceptive afferent input and the descending motor corticospinal volley could lead to reduced excitability of homonymous spinal motoneurons.

Left hemispheric breakdown of LTP-like cortico-cortical plasticity in schizophrenic patients

ObjectiveAltered cortical connectivity and plasticity seems to be asymmetrical between the hemispheres in patients with schizophrenia (SCZ). We evaluated long-term potentiation (LTP) in parietal-frontal circuits of both hemispheres using a cortico-cortical Paired Associative Stimulation (cc-PAS) protocol testing the rules of Hebbian-like spike timing dependent plasticity (SPTD). Methods12 SCZ and 12 healthy subjects (HS) underwent a cc-PAS protocol to activate, by means of paired pulses of transcranial magnetic stimulation (TMS), the short-latency connection between posterior parietal cortex (PPC) and primary motor cortex (M1) of both hemispheres. Motor-evoked potentials (MEPs) were collected to assess the time course of the after effects of cc-PAS protocol measuring MEP amplitude as index of cortico-cortical associative plasticity. ResultsWhile HS showed a similar time course of LTP-like plasticity in the two hemispheres, SCZ revealed a weaker late-LTP-like plasticity in the left compared to the right hemisphere after cc-PAS protocol. ConclusionsSCZ failed to show the typical long-lasting increase of M1 excitability observed after cc-PAS protocol in both hemispheres, with a greater reduction in the left one. SignificanceOur findings provide novel neurophysiological evidence for an asymmetric impairment of the left parietal-frontal network in SCZ patients.

Effects of Passive Finger Movement on Cortical Excitability.

This study examined the effects of joint angle and passive movement direction on corticospinal excitability. The subjects were 14 healthy adults from whom consent could be obtained. We performed two experiments. In Experiment 1, we measured motor evoked potential (MEP) amplitude, F-wave and M-wave at 0° and 20° adduction during adduction or abduction movement, in the range of movement from 10° abduction to 30° adduction. In Experiment 2, MEPs were measured at static 0° and 20° adduction during passive adduction from 10° adduction to 30° adduction and static 20° adduction. MEP, F-waves and M-waves were recorded from the right first dorsal interosseous (FDI) muscle. Experiment 1 revealed significantly increased MEP amplitude at 0° during passive adduction compared to static 0° (p < 0.01). No other significant differences in MEP, M-wave and F-wave parameters were observed. In Experiment 2, MEP amplitude was significantly higher at 20° adduction during passive adduction compared with static 0° (p < 0.01). Based on these findings, it appears that fluctuations in MEP amplitude values during passive movement are not influenced by joint angle, but rather it is possible that it is due to intracortical afferent facilitation (AF) dependent on afferent input due to the start of movement and interstimulus interval (ISI) of transcranial magnetic stimulation (TMS).

Additive effects of sequential excitatory and inhibitory theta burst stimulation in improving cortical excitability following ischaemic stroke

ABSTRACTPurpose: To study the effects of sequential excitatory and inhibitory theta burst stimulation (TBS) on cortical excitability in patients with subacute ischaemic stroke.Methods: Fifteen patients with first-ever middle cerebral artery ischaemic stroke within last three months were subjected to intermittent TBS over the hand area (M1) of the stroke hemisphere (iTBSSH) followed by continuous TBS over the intact hemisphere M1 (cTBSIH). The study measured motor evoked potential (MEP) amplitude, resting motor threshold (RMT) and contralateral cortical silent period (cCSP) at baseline and after 7 minutes of each TBS session.Results: The mean age of the patients was 62.4 ± 8.0 years. The absolute changes in baseline motor physiological parameters were significantly greater after cTBSIH than after iTBSSH (p = 0.001). Following iTBSSH, there was a significant decrease in mean RMT (7.4%; p < 0.001). Following cTBSIH, there was further 18.3% increase in mean MEP amplitude and decrease in mean RMT (4.7%; p < 0.001) and cCSP (5.6%; p < 0.001) of the stroke hemisphere. Similar changes of smaller magnitude were noted in 12 age-matched controls.Conclusions: The results indicate that combining iTBSSH and cTBSIH can have additive effect in increasing cortical excitability in subacute ischaemic patients with stroke.

Observation-execution matching and action inhibition in human primary motor cortex during viewing of speech-related lip movements or listening to speech

One influential theory posits that language has evolved from gestural communication through observation-execution matching processes in the mirror neuron system (MNS). This theory predicts that observation of speech-related lip movements or even listening to speech would result in effector and task specific increase of the excitability of the corresponding motor representations in the primary motor cortex (M1), since actual movement execution is known be effector and task specific. In addition, effector and task specific inhibitory control mechanisms should be important to prevent overt motor activation during observation of speech-related lip movements or listening to speech. We tested these predictions by applying focal transcranial magnetic stimulation to the left M1 of 12 healthy right-handed volunteers and measuring motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) in a lip muscle, the right orbicularis oris (OO), vs. a hand muscle, the right first dorsal interosseus (FDI). We found that MEP and SICI increased only in the OO but not in the FDI during viewing of speech-related lip movements or listening to speech. These changes were highly task specific because they were absent when lip movements non-related to speech were viewed. Finally, the increase in MEP amplitude in the OO correlated inversely with accuracy of speech perception, i.e. the MEP increase was directly related to task difficulty. The MEP findings support the notion that observation-execution matching is an operating process in the putative human MNS that might have been fundamental for evolution of language. Furthermore, the SICI findings provide evidence that inhibitory mechanisms are recruited to prevent unwanted overt motor activation during action observation.

Stimulus-Response Profile during Single-Pulse Transcranial Magnetic Stimulation to the Primary Motor Cortex

We examined the stimulus-response profile during single-pulse transcranial magnetic stimulation (TMS) by measuring motor-evoked potentials (MEPs) with electromyographic monitoring and hemodynamic responses with functional magnetic resonance imaging (fMRI) at 3 Tesla. In 16 healthy subjects, single TMS pulses were irregularly delivered to the left primary motor cortex at a mean frequency of 0.15 Hz with a wide range of stimulus intensities. The measurement of MEP proved a typical relationship between stimulus intensity and MEP amplitude in the concurrent TMS-fMRI environment. In the population-level analysis of the suprathreshold stimulation conditions, significant increases in hemodynamic responses were detected in the motor/somatosensory network, reflecting both direct and remote effects of TMS, and also the auditory/cognitive areas, perhaps related to detection of clicks. The stimulus-response profile showed both linear and nonlinear components in the direct and remote motor/somatosensory network. A detailed analysis suggested that the nonlinear components of the motor/somatosensory network activity might be induced by nonlinear recruitment of neurons in addition to sensory afferents resulting from movement. These findings expand our basic knowledge of the quantitative relationship between TMS-induced neural activations and hemodynamic signals measured by neuroimaging techniques.

Excitatory and inhibitory processes in primary motor cortex during the foreperiod of a warned reaction time task are unrelated to response expectancy

Reaction time (RT) is shortened when a warning signal precedes the response signal, a finding attributed to response preparation during the foreperiod between the warning and response signals. In a previous experiment, we delivered transcranial magnetic stimulation (TMS) during the short constant foreperiod of a warned RT task and found simultaneous suppression of motor evoked potential (MEP) amplitude and reduction of short-interval intracortical inhibition (SICI) on warned trials (Sinclair and Hammond in Exp Brain Res 186:385-392, 2008). To investigate the extent to which these phenomena are associated with response preparation we measured MEP amplitude and SICI during the foreperiod of a warned RT task in which three different warning signals specified the probability (0, 0.5, or 0.83) of response signal presentation. MEP amplitude was suppressed (Experiment 1) and SICI reduced (Experiment 2) equally in all of the warned conditions relative to when TMS was delivered in the inter-trial interval (ITI) suggesting that the modulation of primary motor cortex excitability during the foreperiod does not depend on momentary response expectancy induced by the warning signal. The reduction of SICI and suppression of MEP amplitude can be explained by assuming that a warning signal induces automatic motor cortical activation which is balanced by a competing inhibition to prevent premature response. A composite measure which weighted both speed and accuracy of response was positively correlated with the MEP amplitude during both the foreperiod and the ITI, suggesting that high motor cortical excitability is associated with optimized preparatory strategies for fast and accurate response.

Changes in Corticospinal Function and Ankle Motor Control during Recovery from Incomplete Spinal Cord Injury

Little is known about the mechanisms that underlie motor recovery after incomplete spinal cord injury (iSCI) in humans. This study assessed changes in corticospinal tract (CST) function by measuring motor-evoked potentials (MEPs) and ankle motor control at 1, 3, and 6 months after acute iSCI. In 12 iSCI patients and matched controls, MEPs (evoked at 20% of maximal voluntary contraction [MVC]) were combined with a comprehensive ankle motor assessment protocol that measured ankle dorsiflexor strength (MVC, manual muscle testing, maximal movement velocity [MMV]), dexterity (the ability to accurately time ankle dorsiflexion movements) and gait (speed, walking aids). In the first 6 months after iSCI, all measures of muscle strength, gait and the MEP amplitudes significantly increased. The level of background electromyography (EMG) at 20% MVC remained stable, although absolute MVC increased. The MEP latencies were significantly delayed and remained unchanged during the first 6 months after iSCI. In addition, dexterity was preserved throughout rehabilitation. The percentage increase in MEP amplitude was significantly related only to the percentage improvement in MMV. The finding of unchanged CST conductivity, as assessed by MEP latencies in acute iSCI patients recovering motor function, is in accordance with previous studies in human SCI on this issue. The increased MEP facilitation at stable background EMG might indicate improved synchronization of the descending volley and/or responsiveness of motoneurons to supra-spinal input. The absence of a relationship between MEP amplitudes and recovery of ambulation and muscle strength implies that plastic changes in spinal neural circuits and preserved motor units might have contributed to the functional improvement.

Reduced intracortical inhibition during the foreperiod of a warned reaction time task

Reaction time (RT) is shortened when the response signal is preceded by a warning signal, a finding that has been attributed to response preparation during the foreperiod between the warning and response signals. Research suggests an increased excitability of cortical movement representations associated with response preparation during the foreperiod of a warned RT task (Davranche et al. in Eur J Neurosci 25:3766-3774, 2007). However when the foreperiod duration is short and constant, the motor evoked potential (MEP) amplitude elicited by transcranial magnetic stimulation (TMS) during the foreperiod is suppressed (Touge et al. in Clin Neurophysiol 111:1216-1226, 1998), suggesting a competing inhibitory process. Three experiments measured MEP amplitude and intracortical inhibition during the foreperiod of a warned RT task in which the response was a flexion of the right index finger. Experiments 1 and 2 measured short-interval intracortical inhibition (SICI) with paired TMS pulses separated by inter-stimulus intervals (ISIs) of 3 (SICI(3)) and 1.5 ms (SICI(1.5)), respectively. Experiment 3 measured long-interval intracortical inhibition (LICI) with paired TMS pulses with an ISI of 100 ms (LICI(100)). In all experiments MEP amplitude was smaller in the warned condition than in the unwarned condition. There was less SICI(3) in the warned condition than in the unwarned condition (Experiment 1) whereas SICI(1.5) was similar in both conditions (Experiment 2). There was less LICI(100) in the warned condition than in the unwarned condition (Experiment 3). The intracortical inhibitory processes measured here cannot explain the suppression of MEP amplitude in the warned condition. We propose that the suppression of MEP amplitude is the result of an inhibitory mechanism, which acts on primary motor cortex to prevent premature response during the foreperiod.

Motorcortical Excitability and Synaptic Plasticity Is Enhanced in Professional Musicians

Musicians not only have extraordinary motor and sensory skills, but they also have an increased ability to learn new tasks compared with non-musicians. We examined how these features are expressed in neurophysiological parameters of excitability and plasticity in the motor system by comparing the results of 11 professional musicians and 8 age-matched non-musicians. Parameters of motor excitability were assessed using transcranial magnetic stimulation (TMS) to measure motor-evoked potentials (MEPs) together with recruitment of corticospinal projections [input-output curve (IOcurve)] and of short-latency intracortical inhibition (SICIcurve). Plasticity, here defined as change of synaptic effectiveness, was tested by measuring MEPs and IOcurves after paired associative stimulation (PAS), which consists of an electric median nerve stimulus repeatedly paired (200 times at 0.25 Hz) with a TMS pulse over the hand motor area. Using an interstimulus interval of 25 ms (PAS25) or 10 ms (PAS10), this leads to long-term potentiation- or long-term depression-like plasticity, respectively. Musicians showed steeper recruitment of MEPs and SICI (IOcurve and SICIcurve). Additionally, PAS25 increased and PAS10 decreased the MEP amplitudes and the slope of the IOcurves significantly more in musicians than in non-musicians. This is consistent with a wider modification range of synaptic plasticity in musicians. Together with the steeper recruitment of corticospinal excitatory and intracortical inhibitory projections, this suggests that they regulate plasticity and excitability with a higher gain than normal. Because some of these changes depend on age at which instrumental playing commenced and on practice intensity, they may reflect an increase in number and modifiability of synapses within the motor area caused by long-term musical practice.

Crossed reduction of human motor cortex excitability by 1-Hz transcranial magnetic stimulation

Electrophysiological studies have shown that 1-Hz repetitive transcranial magnetic stimulation (rTMS) of the primary motor area (M1) can produce a local decrease in excitability. Functional imaging data suggest that this change may be bilateral. In normal subjects, we measured motor evoked potential (MEP) amplitude at a series of stimulation intensities in the contralateral M1 before and after 15 min of active or sham rTMS at just above the MEP threshold. The slope of the curve relating MEP amplitude and stimulation intensity was decreased in the unstimulated hemisphere by active but not sham rTMS. This demonstrates that rTMS can condition cortical excitability at a distance of one or more synapses and suggest that decreased excitability to TMS is a correlate of decreased blood flow and metabolism.