Decline in voluntary activation contributes to reduced maximal performance of fatigued human lower limb muscles.
ABSTRACT In upper limb muscles, altered corticospinal excitability and reduction in neural drive are observed in parallel with peripheral fatigue during prolonged and/or repeated contractions. However, the fatigue-induced adaptations of central and peripheral elements and their relative contribution to lower limb muscle performance are yet to be fully explored. In the present study, corticospinal excitability and peripheral contractility of ankle flexor muscles were quantified before, during and after repeated brief unilateral maximal dorsiflexions to fatigue in eleven healthy volunteers. Transcranial magnetic stimulation of the motor cortex area related to lower limb muscles was performed, and the evoked twitch and EMG responses in tibialis anterior (TA) and soleus (SOL) were measured. The motor evoked potentials (MEPs) in fatigued TA during post-exercise maximal dorsiflexions were smaller (-20 ± 6 %, p = 0.026) and remained depressed for at least 5 min. Post-exercise MEPs in fatigued SOL and silent periods in TA and SOL were not different compared to pre-exercise. These changes were accompanied by lower voluntary torque (-8 ± 3 %, p = 0.013), estimated resting twitch (-36 ± 5 %, p = 0.003) and voluntary activation (-17 ± 9 %, p = 0.021) versus pre-exercise. During last versus first maximal contraction in the fatiguing protocol lower voluntary torque (-40 ± 4 %, p = 0.003), higher MEP amplitudes (>+49 %, p < 0.021) and longer silent periods (>+24 %, p < 0.004) were recorded in both muscles. Decreased corticospinal excitability contributes significantly to the reduced maximal performance of fatigued lower limb muscles. During prolonged intermittent maximal dorsiflexions the performance of ankle muscles declines despite enhanced corticospinal excitability presumably due to deficient descending drive and/or spinal motoneuron responsiveness to the cortical drive.
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ABSTRACT: Voluntary activation of muscle is commonly quantified by comparison of the extra force added by motor nerve stimulation during a contraction [superimposed twitch (SIT)] with that produced at rest by the same stimulus (resting twitch). An inability to achieve 100% voluntary activation implies that failure to produce maximal force output from the muscle must have occurred at a site at or above the level of the motoneurons. We have used cortical stimulation to quantify voluntary activation. Here, incomplete activation implies a failure at or above the level of motor cortical output. With cortical stimulation, it is inappropriate to compare extra force evoked during a contraction with the twitch evoked in resting muscle because motor cortical and spinal cord excitability both increase with activity. However, an appropriate "resting twitch" can be estimated. We previously estimated its amplitude by extrapolation of the linear relation between SIT amplitude and voluntary torque calculated from 35 contractions of >50% maximum (Todd G, Taylor JL, and Gandevia SC. J Physiol 551: 661-671, 2003). In this study, we improved the utility of this method to enable evaluation of voluntary activation when it may be changing over time, such as during the development of fatigue, or in patients who may be unable to perform large numbers of contractions. We have reduced the number of contractions required to only three. Estimation of the resting twitch from three contractions was reliable over time with low variability. Furthermore, its reliability and variability were similar to the resting twitch estimated from 30 contractions and to that evoked by conventional motor nerve stimulation.Journal of Applied Physiology 07/2004; 97(1):236-42. · 3.48 Impact Factor
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ABSTRACT: Motor evoked potential (MEP) amplitudes have the disadvantage of a high variability when repeatedly assessed. This affects the reliability of MEP amplitude measurements taken during the course of motor incomplete spinal cord injury (iSCI). The study investigated the reliability of anterior tibial (TA) MEP measures controlled for dorsal flexion torque and motor task. TA MEPs were recorded at 10, 20, 40 and 60% of maximal voluntary contraction (MVC) during a static and dynamic (isometric increase of dorsal flexion torque) motor task. To determine reliability, 20 healthy and five chronic iSCI subjects were tested twice (> or =7 days) by the same investigator. Intraclass correlation coefficients (ICCs) were calculated. MEP amplitudes and latencies were compared between 20 healthy and 29 iSCI subjects. The reliability of MEP amplitude was in general good (ICC > or = 0.52) and was highest during the static task at 40% MVC (ICC = 0.77). The increased facilitation by the dynamic motor task showed the best reliability at 20% MVC (ICC = 0.48). The reliability was good to excellent for MEP latency (0.46 < or = ICC < or = 0.81), MVC (ICC > or = 0.90) and for the TMS threshold required to evoke a MEP response (ICC > or = 0.77). The torque generated by the MEP response ()0.02 < or = ICC < or = 0.55) and the duration of the silent period (0.07 < or = ICC < or = 0.50) were not reliable. Both MEP amplitudes and latencies differed significantly between healthy and iSCI subjects. Controlling for torque generation and motor task establishes a reliability of TA MEP amplitudes that is sufficient for longitudinal assessments in motor incomplete SCI.Journal of Neurology 08/2007; 254(8):1089-98. · 3.58 Impact Factor
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ABSTRACT: Central fatigue is the inability of central commands to recruit maximum evocable muscle force during voluntary contraction. Here, we investigate how fatigue affects the inhibitory circuits of the motor cortex. MEPs, short interval intracortical inhibition (SICI) and intracortical facilitation (ICF) were evaluated using a paired pulse transcranial magnetic stimulation (TMS) paradigm before, during and after a series of 5 isometric contractions of the FDI muscle to 50% maximal voluntary contraction (MVC). Each contraction lasted 2 min and was separated from the next by a pause of 2 min 40 s. Twelve male healthy subjects (range from 22 to 51 years) participated in experiment 1, in which the intensity of test stimulus was constant throughout the experiment. Eight of the same subjects (range from 26 to 51 years) participated in experiment 2, in which the intensity of test stimulus was adjusted so that the amplitude of the test MEP was kept constant throughout the measurement. As expected, test MEPs gradually decreased with progressive fatigue and recovered to control values with 5-10 min of rest. Because of the change in MEP amplitude, changes in percent SICI (reduced inhibition) and percent ICF (increased facilitation) in experiment 1 are difficult to interpret. When the test MEP was maintained at a constant size in experiment 2 there was no change in percent ICF, but the reduction in SICI was still present although it recovered to control values within the first 5-10 min of rest. SICI in FDI decreases transiently after a series of fatiguing isometric contractions. This decrease may compensate to some extent for reduced cortical excitability after muscle fatigue.Clinical Neurophysiology 05/2006; 117(4):864-70. · 3.14 Impact Factor