Paired Electrical Stimuli Research Articles

Transcranial alternating current stimulation can modulate the blink reflex excitability. Effects of a 10- and 20-Hz tACS session on the blink reflex recovery cycle in healthy subjects.

The blink reflex excitability, assessed through paired electrical stimuli responses, has been modulated using traditional non-invasive neurostimulation techniques. Recently, transcranial Alternating Current Stimulation (tACS) emerged as a tool to modulate brain oscillations implicated in various motor, perceptual, and cognitive functions. This study aims to investigate the influence of 20-Hz and 10-Hz tACS sessions on the primary motor cortex and their impact on blink reflex excitability. Fifteen healthy volunteers underwent 10-min tACS sessions (intensity 1mA) with active/reference electrodes placed over C4/Pz, delivering 20-Hz, 10-Hz, and sham stimulation. The blink reflex recovery cycle (BRrc) was assessed using the R2 amplitude ratio at various interstimulus intervals (ISIs) before (T0), immediately after (T1), and 30min post-tACS (T2). Both 10-Hz and 20-Hz tACS sessions significantly increased R2 ratio at T1 (10-Hz: p = 0.02; 20-Hz: p < 0.001) and T2 (10-Hz: p = 0.01; 20-Hz: p < 0.001) compared to baseline (T0). Notably, 20-Hz tACS induced a significantly greater increase in blink reflex excitability compared to sham at both T1 (p = 0.04) and T2 (p < 0.001). This study demonstrates the modulatory effect of tACS on trigemino-facial reflex circuits, with a lasting impact on BRrc. Beta-band frequency tACS exhibited a more pronounced effect than alpha-band frequency, highlighting the influential role of beta-band oscillations in the motor cortex on blink reflex excitability modulation.

Machine learning-assisted shape morphing design for soft smart beam

Programming the shape of soft smart materials is a challenging task due to the enormous design space involved. In this study, we propose a novel approach to determine applied stimuli that enable the desired actuated shapes of soft smart materials. Our approach combines finite element methods (FEM), deep neural networks (DNN), and particle swarm optimization (PSO). By employing beams made of dielectric elastomer (DE) as models, we partition a DE beam into multiple actuating units, allowing independent actuation through the application of paired electrical stimuli. FEM is subsequently employed to compute the actuated shapes in response to various applied stimuli. The selection of these stimuli is accomplished through the utilization of Latin hypercube sampling. By utilizing the FEM-derived data, we have developed a machine learning (ML) surrogate model that integrates a long short-term memory (LSTM) network with a fully connected neural network (FCNN). Finally, PSO is employed to determine the optimal applied stimulus that yields the desired actuated shape. The LSTM-FCNN surrogate model is utilized to evaluate the fitness of PSO. The ML-PSO framework exhibits remarkable performance and efficiency in the context of the inverse design of soft smart beams.

Vagus nerve stimulation activates nucleus of solitary tract neurons via supramedullary pathways.

Vagus nerve stimulation (VNS) treats patients with drug-resistant epilepsy, depression and heart failure, but the mechanisms responsible are uncertain. The mild stimulus intensities used in chronic VNS suggest activation of myelinated primary visceral afferents projecting to the nucleus of the solitary tract (NTS). Here, we monitored the activity of second and higher order NTS neurons in response to peripheral vagal activation using therapeutic VNS criteria. A bipolar stimulating electrode activated the left cervical vagus nerve, and stereotaxically placed single tungsten electrodes recorded unit activity from the left caudomedial NTS of chloralose-anaesthetized rats. High-intensity single electrical stimuli established vagal afferent conduction velocity (myelinated A-type or unmyelinated C-type) as well as synaptic order (second vs. higher order using paired electrical stimuli) for inputs to single NTS neurons. Then, VNS treatment was applied. A mid-collicular knife cut (KC) divided the brainstem from all supramedullary regions to determine their contribution to NTS activity. Our chief findings indicate that the KC reduced basal spontaneous activity of second-order NTS neurons receiving myelinated vagal input by 85%. In these neurons, acute VNS increased activity similarly in Control and KC animals. Interestingly, the KC interrupted VNS activation of higher order NTS neurons and second-order NTS neurons receiving unmyelinated vagal input, indicating that supramedullary descending projections to NTS are needed to amplify the peripheral neuronal signal from VNS. The present study begins to define the pathways activated during VNS and will help to better identify the central nervous system contributions to the therapeutic benefits of VNS therapy. KEY POINTS: Vagus nerve stimulation is routinely used in the clinic to treat epilepsy and depression, despite our uncertainty about how this treatment works. For this study, the connections between the nucleus of the solitary tract (NTS) and the higher brain regions were severed to learn more about their contribution to activity of these neurons during stimulation. Severing these brain connections reduced baseline activity as well as reducing stimulation-induced activation for NTS neurons receiving myelinated vagal input. Higher brain regions play a significant role in maintaining both normal activity in NTS and indirect mechanisms of enhancing NTS neuronal activity during vagus nerve stimulation.

Contribution of Each Motor Point of Quadriceps Femoris to Knee Extension Torque During Neuromuscular Electrical Stimulation.

Transcutaneous neuromuscular electrical stimulation (NMES) can be used to activate the quadriceps femoris muscle to produce knee extension torque via seven distinct motor points, defined as the most sensitive locations on the muscle belly to electrical stimuli. However, it remains unclear how much individual motor points of the quadriceps femoris muscle contribute to the knee joint torque. Here we systematically investigated the contribution of each motor point of the quadriceps femoris muscle to the knee joint torque produced by paired electrical stimuli. Ten able-bodied individuals participated in this study. Paired electrical stimuli was applied by delivering electrical impulses on the motor points in all combinations among seven motor points (i.e., totaling to 127 combinations) at two different stimulation intensities (i.e., 25% and 50% of the maximum) while recording isometric knee joint torque. The contribution of individual motor points was estimated using statistical analyses. We found that a linear addition of twitch torques induced by single motor point stimulus overestimated the twitch torques induced by multiple motor point stimulations, suggesting overlaps in muscle fibres activated by each motor point. Using multiple linear regressions, we identified the average contribution of each motor point to the knee extension torque during paired electrical stimuli and found significant differences between these torque contributions. We demonstrated that seven distinct motor points can be activated for the quadriceps muscle group using paired electrical stimuli and identified the contribution of each motor point to knee extension torque during twitch muscle contraction; these findings provide useful information to design rehabilitation using NMES on quadriceps femoris muscles.

Quadriceps activation during maximal isometric and isokinetic contractions: The minimal real difference and its implications

BACKGROUND: A method of measurement of voluntary activation (VA, percent of full muscle recruitment) during isometric and isokinetic concentric contractions of the quadriceps femoris (QF) at 60∘/s and 120∘/s was previously validated. OBJECTIVE: This study aimed to quantify the test-retest minimal real difference (MRD) of VA during isometric (ISOM) and isokinetic concentric contractions of QF (100∘/s, ISOK) in a sample of healthy individuals. METHODS: VA was measured through the interpolated twitch technique. Pairs of electrical stimuli were delivered to the QF at 40∘ of knee flexion during maximal voluntary contractions. Twenty-five healthy participants (20–38 years, 12 women, 13 men) completed two testing sessions with a 14-day interval. VA values were linearized through logit transformation (VAl). The MRD was estimated from intraclass correlation coefficients (model 2.1). RESULTS: The VA (median, range) was 84.20% (38.2–99.9%) in ISOM and 94.22% (33.8–100%) in ISOK. MRD was 0.78 and 1.12 logit for ISOM and ISOK, respectively. As an example, in terms of percent VA these values correspond to a change from 76% to 95% and from 79% to 98% in ISOM and in ISOK, respectively. CONCLUSIONS: The provided MRD values allow to detect significant individual changes in VA, as expected after training and rehabilitation programs.

Oxygen availability affects exercise capacity, but not neuromuscular fatigue characteristics of knee extensors, during exhaustive intermittent cycling.

To compare the effects of different hypoxia severities on exercise capacity, cardio-respiratory, tissue oxygenation and neuromuscular fatigue characteristics in response to exhaustive intermittent cycling. Eleven well-trained cyclists, repeated supra-maximal cycling efforts of 15s (30% of anaerobic power reserve, 609 ± 23W), interspersed with 45s of passive rest until task failure. The exercise was performed on separate days in normoxia (SL; simulated altitude/end-exercise arterial oxygen saturation = 0m/~ 96%), moderate (MH; 2200m/~ 90%) and severe (SH; 4200m/~ 79%) hypoxia in a cross-over design. Neuromuscular tests, including brief (5s) and sustained (30s) maximal isometric voluntary contractions of the knee extensors, were performed at baseline and exhaustion. Exercise capacity decreased with hypoxia severity (23 ± 9, 16 ± 6 and 9 ± 3 cycle efforts in SL, MH and SH, respectively; P < 0.001; η2 = 0.72). Both cerebral (P < 0.001; η2 = 0.86) and muscle (P < 0.01; η2 = 0.54) oxygenation decreased throughout the exercise, independent of condition (P ≥ 0.45; η2 ≥ 0.14). Compared to SL, muscle oxygenation was globally lower in MH and SH (P = 0.011; η2 = 0.36). Cardiovascular solicitation neared maximal values at exhaustion in all conditions. Peak twitch amplitude with single and paired electrical stimuli (P < 0.001; η2 ≥ 0.87), maximal torque (P < 0.001; η2 ≥ 0.48) and voluntary activation measured using transcranial magnetic stimulation (P ≤ 0.034; η2 ≥ 0.31) during brief and sustained MVCs were all reduced at exhaustion, independent of condition (P ≥ 0.196; η2 ≥ 0.15). Despite reduced exercise capacity with increasing severity of hypoxia during exhaustive intermittent cycling, neuromuscular fatigue characteristics were not different at task failure and cardiovascular solicitation neared maximum values.

Ischemic Preconditioning Did Not Affect Central and Peripheral Factors of Performance Fatigability After Submaximal Isometric Exercise.

The present study was designed to provide further insight into the mechanistic basis for the improved exercise tolerance following ischemic preconditioning (IPC) by investigating key-determinants of performance and perceived fatigability. Using a randomized, counterbalanced, single-blind, sham-controlled, crossover design, 16 males performed an isometric time-to-exhaustion test with the knee extensors at 20% maximal voluntary torque (MVT) after an IPC and a sham treatment (SHAM). Those who improved their time-to-exhaustion following IPC performed a time-matched IPC trial corresponding to the exercise duration of SHAM (IPCtm). Neuromuscular function was assessed before and after exercise termination during each condition (IPC, IPCtm, and SHAM) to analyze the impact of IPC on performance fatigability and its central and peripheral determinants. Muscle oxygenation (SmO2), muscle activity, and perceptual responses (effort and muscle pain) were recorded during exercise. Performance fatigability as well as its central and peripheral determinants were quantified as percentage pre-post changes in MVT (ΔMVT) as well as voluntary activation (ΔVA) and quadriceps twitch torque evoked by paired electrical stimuli at 100 and 10 Hz (ΔPS100 and ΔPS10⋅PS100–1 ratio), respectively. Time-to-exhaustion, performance fatigability, its determinants, muscle activity, SmO2, and perceptual responses during exercise were not different between IPC and SHAM. However, six participants improved their performance by >10% following IPC (299 ± 71 s) compared to SHAM (253 ± 66 s, d = 3.23). The time-matched comparisons (IPCtm vs. SHAM) indicated that performance fatigability, its determinants, and SmO2 were not affected, while effort perception seemed to be lower (ηp2 = 0.495) in those who improved their time-to-exhaustion. The longer time-to-exhaustion following IPC seemed to be associated with a lower effort perception (ηp2 = 0.380) and larger impairments in neuromuscular function, i.e., larger ΔMVT, ΔVA, and ΔPS10⋅PS100–1 ratio (d = 0.71, 1.0, 0.92, respectively). IPC did neither affect exercise tolerance, performance fatigability, as well as its central and peripheral determinants, nor muscle activity, SmO2, and perceptual responses during submaximal isometric exercise. However, IPC seemed to have an ergogenic effect in a few subjects, which might have resulted from a lower effort perception during exercise. These findings support the assumption that there are ‘responders’ and ‘non-responders’ to IPC.

Impact of Blood Flow Restriction Exercise on Muscle Fatigue Development and Recovery.

The present study was designed to provide mechanistic insight into the time course and etiology of muscle fatigue development and recovery during and after low-intensity exercise when it is combined with blood flow restriction (BFR). Seventeen resistance-trained males completed four sets of low-intensity isotonic resistance exercise under two experimental conditions: knee extension exercise (i) with BFR and (ii) without BFR (CON). Neuromuscular tests were performed before, during (immediately after each set of knee extension exercise), and 1, 2, 4, and 8 min after each experimental condition. Maximal voluntary torque, quadriceps twitch torque in response to paired electrical stimuli at 10 Hz (PS10) and 100 Hz (PS100), PS10·PS100 ratio as an index of low-frequency fatigue, and voluntary activation were measured under isometric conditions. Perceptual and EMG data were recorded during each exercise condition. After the first set of exercise, BFR induced significantly greater reductions in maximal voluntary torque, PS100, and PS10·PS100 ratio compared with CON. These parameters progressively declined throughout the BFR protocol but recovered substantially within 2 min postexercise when blood flow was restored. Neither a progressive decline in the course of the exercise protocol nor a substantial recovery of these parameters occurred during and after CON. Only at exercise termination, voluntary activation differed significantly between BFR and CON with greater reductions during BFR. At the early stage of exercise, BFR exacerbated the development of muscle fatigue mainly due to a pronounced impairment in contractile function. Despite the high level of muscle fatigue during BFR exercise, the effect of BFR on muscle fatigue was diminished after 2 min of reperfusion, suggesting that BFR has a strong but short-lasting effect on neuromuscular function.

Abnormal Temporal Coupling of Tactile Perception and Motor Action in Parkinson's Disease.

Evidence shows altered somatosensory temporal discrimination threshold (STDT) in Parkinson’s disease in comparison to normal subjects. In healthy subjects, movement execution modulates STDT values through mechanisms of sensory gating. We investigated whether STDT modulation during movement execution in patients with Parkinson’s disease differs from that in healthy subjects. In 24 patients with Parkinson’s disease and 20 healthy subjects, we tested STDT at baseline and during index finger abductions (at movement onset “0”, 100, and 200 ms thereafter). We also recorded kinematic features of index finger abductions. Fifteen out of the 24 patients were also tested ON medication. In healthy subjects, STDT increased significantly at 0, 100, and 200 ms after movement onset, whereas in patients with Parkinson’s disease in OFF therapy, it increased significantly at 0 and 100 ms but returned to baseline values at 200 ms. When patients were tested ON therapy, STDT during index finger abductions increased significantly, with a time course similar to that of healthy subjects. Differently from healthy subjects, in patients with Parkinson’s disease, the mean velocity of the finger abductions decreased according to the time lapse between movement onset and the delivery of the paired electrical stimuli for testing somatosensory temporal discrimination. In conclusion, patients with Parkinson’s disease show abnormalities in the temporal coupling between tactile information and motor outflow. Our study provides first evidence that altered temporal processing of sensory information play a role in the pathophysiology of motor symptoms in Parkinson’s disease.

Central Factors Contribute to Knee Extensor Strength Loss after 2000-m Rowing in Elite Male and Female Rowers.

Despite growing interest in task-dependent alterations of central and peripheral fatigue after endurance exercise, little is known about the effect of rowing on quadriceps muscle fatigue. This study aimed to investigate central and peripheral mechanisms of fatigue after a 2000-m rowing time trial. Eight competitive rowers (four males and four females, 20 ± 4 yr) performed a 2000-m time trial on an indoor rower and a control condition (sitting). The neuromuscular function of the knee extensors was analyzed before and 3 min after each experimental condition. Maximal voluntary torque, voluntary activation, and normalized root-mean-square of the EMG signal were measured during isometric and concentric contractions. Furthermore, knee extensor twitch torque and maximal M-wave amplitudes in response to electrical nerve stimulation were assessed. After the 2000-m rowing, there were significant reductions in isometric and concentric maximal voluntary torque of the knee extensors (-20% ± 9% and -18% ± 7%, respectively, P < 0.01). Both the voluntary activation of the knee extensors during isometric and concentric contractions decreased by 18% ± 15% (P < 0.05, respectively). The normalized muscle activity of rectus femoris was significantly reduced after rowing (P = 0.007), whereas vastus medialis and vastus lateralis muscle activities did not significantly differ from baseline values. No significant change was observed for knee extensor twitch torque in response to paired electrical stimuli after rowing. The 2000-m rowing time trial resulted in significant knee extensor strength loss. Quadriceps muscle fatigue after high-intensity rowing exercise was explained primarily by central factors that lead to large reductions in voluntary drive.

Understanding the link between somatosensory temporal discrimination and movement execution in healthy subjects

The somatosensory temporal discrimination threshold (STDT) is the shortest interval at which an individual recognizes paired stimuli as separate in time. We investigated whether and how voluntary movement modulates STDT in healthy subjects. In 17 healthy participants, we tested STDT during voluntary index‐finger abductions at several time‐points after movement onset and during motor preparation. We then tested whether voluntary movement‐induced STDT changes were specific for the body segment moved, depended on movement kinematics, on the type of movement or on the intensity for delivering paired electrical stimuli for STDT. To understand the mechanisms underlying STDT modulation, we also tested STDT during motor imagery and after delivering repetitive transcranial magnetic stimulation to elicit excitability changes in the primary somatosensory cortex (S1). When tested on the moving hand at movement onset and up to 200 msec thereafter, STDT values increased from baseline, but during motor preparation remained unchanged. STDT values changed significantly during fast and slow index‐finger movements and also, though less, during passive index‐finger abductions, whereas during tonic index‐finger abductions they remained unchanged. STDT also remained unchanged when tested in body parts other than those engaged in movement and during imagined movement. Nor did testing STDT at increased intensity influence movement‐induced STDT changes. The cTBS‐induced S1 cortical changes left movement‐induced STDT changes unaffected. Our findings suggest that movement execution in healthy subjects may alter STDT processing.

Electrical Stimulation of the Ear, Head, Cranial Nerve, or Cortex for the Treatment of Tinnitus: A Scoping Review.

Tinnitus is defined as the perception of sound in the absence of an external source. It is often associated with hearing loss and is thought to result from abnormal neural activity at some point or points in the auditory pathway, which is incorrectly interpreted by the brain as an actual sound. Neurostimulation therapies therefore, which interfere on some level with that abnormal activity, are a logical approach to treatment. For tinnitus, where the pathological neuronal activity might be associated with auditory and other areas of the brain, interventions using electromagnetic, electrical, or acoustic stimuli separately, or paired electrical and acoustic stimuli, have been proposed as treatments. Neurostimulation therapies should modulate neural activity to deliver a permanent reduction in tinnitus percept by driving the neuroplastic changes necessary to interrupt abnormal levels of oscillatory cortical activity and restore typical levels of activity. This change in activity should alter or interrupt the tinnitus percept (reduction or extinction) making it less bothersome. Here we review developments in therapies involving electrical stimulation of the ear, head, cranial nerve, or cortex in the treatment of tinnitus which demonstrably, or are hypothesised to, interrupt pathological neuronal activity in the cortex associated with tinnitus.

Somatosensory system hyperexcitability in alternating hemiplegia of childhood.

Alternating hemiplegia of childhood (AHC) is a rare neurological disease characterized by recurrent paroxysmal attacks of hemiplegia. The aim of the study was to assess the recovery cycle of the somatosensory evoked potentials (SEPs) in a group of AHC patients. Seven AHC patients and 10 control age-matched subjects (CS) were recruited. Right and left median nerve SEPs were recorded. The somatosensory system excitability was assessed by calculating the SEP changes after paired electrical stimuli. All patients were studied during the interictal phase, whilst four patients were studied also during the ictal phase. In AHC patients during the interictal phase, the amplitudes of the cervical N13 and of the cortical N20, P24 and N30 responses showed a faster recovery than in CS. In AHC patients during the ictal phase, the cortical N20 recovery cycle was prolonged compared with the interictal phase. A shortened SEP recovery cycle in AHC during the interictal phase suggests multilevel somatosensory system hyperexcitability in AHC. A partial recovery of this phenomenon during the ictal phase possibly reflects a functional reset of the somatosensory system. Overall, there is a disinhibition of the somatosensory system in AHC, a functional change of brain function associated with a possible involvement of the Na(+) /K(+) channels. This abnormality and its partial recovery during the attacks might be linked to the pathophysiological and genetic mechanisms of the disease.

Impaired Temporal Processing of Tactile and Proprioceptive Stimuli in Cerebellar Degeneration

Performance of timed motor sequences relies on the cerebellum and basal ganglia, which integrate proprioceptive information during the motor task and set internal timing mechanisms. Accordingly, these structures are also involved in other temporal processes, such as the discrimination of the different afferent information in the domain of time. In the present study we tested temporal processing of proprioceptive and tactile stimuli in 20 patients with neurodegenerative cerebellar ataxia and 20 age- and sex-matched healthy subjects. Tactile temporal discrimination threshold was defined as the value at which subjects recognized the two stimuli as asynchronous. Temporal discrimination movement threshold of the first dorsal interosseous and flexor carpi radialis was defined as the shortest interval between two paired electrical stimuli in which the subjects blindfolded perceived two separate index finger abductions and wrist flexions. Both tactile and movement temporal discrimination thresholds were higher in patients with cerebellar ataxia. No correlation was found with disease duration and severity. Our study demonstrates that temporal processing of tactile and proprioceptive stimuli is impaired in patients with cerebellar neurodegeneration and highlights the involvement of cerebellum in temporal processing of somatosensory stimuli of different type.

Somatosensory temporal discrimination threshold may help to differentiate patients with multiple system atrophy from patients with Parkinson's disease

Somatosensory temporal discrimination threshold (STDT) is defined as the threshold at which two tactile stimuli applied to the skin are perceived as clearly distinct. The aim of the study was to investigate whether the extent of STDT alterations differs between patients with parkinsonian type multiple system atrophy (MSA-P) and patients with Parkinson's disease (PD). Possible differences between the two groups may help to differentiate MSA-P from PD. STDT was investigated in 20 patients with MSA-P, 21 patients with PD and 18 age-matched healthy subjects. The clinical evaluation included the Mini-Mental State Examination, Hoehn and Yahr Scale, Frontal Assessment Battery, Unified Multiple System Atrophy Rating Scale for patients with MSA-P, and Unified Parkinson's Disease Rating Scale for patients with PD. STDT was investigated by delivering paired electrical stimuli starting with an inter-stimulus interval (ISI) of 0 ms (simultaneous pair), and progressively increasing the ISIs in 10-ms steps. Between-group anova showed that STDT statistically differed in MSA-P versus patients with PD and healthy subjects. Post hoc showed that STDT values in patients with MSA-P were significantly higher than those in patients with PD and healthy subjects. Receiver operating characteristic curve analysis showed that STDT testing yielded high diagnostic specificity and sensitivity. STDT is abnormal in patients with MSA-P and PD. The degree of STDT abnormalities is higher in patients with MSA-P than in patients with PD.

The Abnormal Recovery Cycle of Somatosensory Evoked Potential Components in Children with Migraine can be Reversed by Topiramate

The aim of this study was to compare the recovery cycle of somatosensory evoked potentials (SEPs) in children with migraine without aura before and after treatment with topiramate. Eleven migraine children were studied before and after a 3-month treatment with topiramate at the average dose of 1.3 mg/kg/day. We calculated the SEP latency and amplitude modifications after paired electrical stimuli at 5, 20 and 40 ms interstimulus intervals, comparing them with a single stimulus condition assumed as baseline. In nine patients, who had a significant reduction in headache frequency after treatment, the recovery cycles of the P24 (P = 0.03) and N30 (P < 0.005) potentials were longer after than before topiramate treatment. In two migraineurs who did not show any improvement, the recovery cycles of the cortical SEP components were even shorter after treatment. Our results suggest that topiramate efficacy in paediatric migraine prophylaxis is probably related to restored cortical excitability.

Evidence for reduced efficacy of the Ia-pathway during shortening plantar flexions with increasing effort

To determine whether the soleus (SOL) H-reflex is modulated during shortening contractions in a manner that has been observed for isometric contractions, SOL H-reflexes and M-waves were elicited via percutaneous electrical stimulation to the tibial nerve at an intensity that evoked an H-reflex at 50% of its maximum in 11 healthy subjects. Paired electrical stimuli were delivered as the ankle angle passed through 90 degrees at an interval of 400 ms while the subject performed shortening contractions at levels of plantar flexion torque ranging between 2 and 30% of that during a maximal voluntary contraction (MVC). H-reflexes were also recorded during the performance of isomeric contractions of plantar flexors at similar levels of plantar flexion torque and at the same joint angle (muscle length) in an additional five healthy subjects. Correlations were examined between the peak-to-peak amplitude of the first H-reflexes, M-waves and plantar flexion torques in both protocols. It was revealed that no significant correlation was found between the SOL H-reflex and increasing plantar flexion torque during shortening contractions (rho = -0.07, P = 0.15), while a strong positive correlation was observed for the isometric conditions (rho = 0.99, P < 0.01). No significant change was observed in the SOL M-wave for either contraction type. Furthermore, the H-reflexes elicited via paired stimuli with the same background activity in voluntary shortening contractions showed almost identical amplitudes, suggesting that the level of homosynaptic post-activation depression did not change in response to the varying levels of activation in voluntary shortening contractions. Therefore, the lack of increase in the H-reflex during shortening contractions at increasing intensities is possibly due to a centrally regulated increase in presynaptic inhibition. Such a downward modulation of the reflex suggests that Ia-excitatory input onto the SOL motoneurone pool needs to be reduced during the performance of shortening contractions.

Role of the cerebellum in time perception: A TMS study in normal subjects

The aim of this study was to investigate the role of the cerebellum in a temporal-discrimination task without movement production in healthy subjects. Ten healthy subjects underwent a time-perception task with somatosensory stimuli. Two pairs of electrical stimuli: the first considered the reference pair (rp) with a standard interval of 400 ms and the second, the test pair (tp), with variable intervals ranging from 300 to 500 ms, were applied by surface electrodes on the right forearm. Subjects were instructed to compare time intervals of rp and tp and to estimate whether the tp interval was shorter than, equal to, or longer than that of rp. The task was performed in baseline and after 1 Hz rTMS over the right and left cerebellar hemisphere. The right cerebellar rTMS worsened temporal discrimination of cutaneous somatosensory electrical stimuli on the ipsilateral hand. rTMS of the left cerebellar hemisphere did not determine significant changes in the subjects' performance with respect to the baseline. These findings suggest that the cerebellum plays a role in merely perceptive aspects of temporal information processing.

Multilevel somatosensory system disinhibition in children with migraine

Although migraine is characterised by an abnormal cortical excitability level, whether the central nervous system is hyper- or hypo-excitable in migraine still remains an unsolved problem. The aim of our study was to compare the somatosensory evoked potential (SEP) recovery cycle, a marker of the somatosensory system's excitability, in a group of 15 children suffering from migraine without aura (MO) (mean age 11.7±1.6 years, five males, 10 females) and 10 control age-matched subjects (CS) (mean age 10.9±2.1 years, six males, four females). We calculated the SEP's latency and amplitude modifications after paired electrical stimuli at 5, 20 and 40 ms interstimulus intervals (ISIs), comparing it with a single stimulus condition assumed as the baseline. In MO patients, the amplitudes of the cervical N13 and of the cortical N20, P24 and N30 responses at 20 and 40 ms ISIs showed a higher recovery than in CS (two-way ANOVA, P<0.05). Since, the SEP recovery cycle depends on the inhibitory interneuron function, our findings suggest that a somatosensory system disinhibition takes place in migraine. This is a generalized phenomenon, not limited to the cerebral cortex, but concerning also the cervical grey matter. The SEP recovery cycle reflects the intracellular concentration of Na +, therefore, the shortened recovery cycle in our MO patients suggests a high level of intracellular Na + and a consequent depolarized resting membrane potential, possibly due to an impaired Na +–K + ATPase function in migraine.

Intramuscular sensation in conscious human subjects: a qualitative and quantitative study utilizing signal detection theory methodology

To investigate whether human subjects could consciously perceive different levels of intramuscular sensation, EMG needle electrodes were inserted into the forearm extensor musculature. Qualitative descriptions of the types of sensations evoked at various current intensities were recorded. A series of preliminary experiments was performed in order to determine the optimum waveform, current intensity, duration and separation between adjacent current pairs that could reliably be discriminated by conscious human subjects. The methodology of signal detection theory was utilized to obtain the discrimination measure, d' (d prime). Values of d' were obtained for sequential blocks of trials consisting of randomly delivered blocks of 50 "strong" and 50 "weak" stimuli. The ability to discriminate both noxious and non-noxious stimuli was determined using d'. It was demonstrated that human subjects are able to qualitatively describe non-nociceptive sensations elicited by low levels of intramuscular stimulation. Subjects were able to reliably discriminate pairs of electrical stimuli separated in intensity by 0.4 dB over four sequential blocks of trials on the same day and on different days. This work demonstrates that signal detection theory methods can reliably measure sensory discrimination in skeletal muscle, for both noxious and non-noxious levels of electrical stimulation. A protocol is proposed for appropriate future use of this methodology to investigate alterations in muscle sensation following experimental interventions.