[Show abstract][Hide abstract] ABSTRACT: Transcranial direct current stimulation (tDCS) has been used as a useful interventional brain stimulation technique to improve unilateral upper-limb motor function in healthy humans, as well as in stroke patients. Although tDCS applications are supposed to modify the interhemispheric balance between the motor cortices, the tDCS after-effects on interhemispheric interactions are still poorly understood. To address this issue, we investigated the tDCS after-effects on interhemispheric inhibition (IHI) between the primary motor cortices (M1) in healthy humans. Three types of tDCS electrode montage were tested on separate days; anodal tDCS over the right M1, cathodal tDCS over the left M1, bilateral tDCS with anode over the right M1 and cathode over the left M1. Single-pulse and paired-pulse transcranial magnetic stimulations were given to the left M1 and right M1 before and after tDCS to assess the bilateral corticospinal excitabilities and mutual direction of IHI. Regardless of the electrode montages, corticospinal excitability was increased on the same side of anodal stimulation and decreased on the same side of cathodal stimulation. However, neither unilateral tDCS changed the corticospinal excitability at the unstimulated side. Unilateral anodal tDCS increased IHI from the facilitated side M1 to the unchanged side M1, but it did not change IHI in the other direction. Unilateral cathodal tDCS suppressed IHI both from the inhibited side M1 to the unchanged side M1 and from the unchanged side M1 to the inhibited side M1. Bilateral tDCS increased IHI from the facilitated side M1 to the inhibited side M1 and attenuated IHI in the opposite direction. Sham-tDCS affected neither corticospinal excitability nor IHI. These findings indicate that tDCS produced polarity-specific after-effects on the interhemispheric interactions between M1 and that those after-effects on interhemispheric interactions were mainly dependent on whether tDCS resulted in the facilitation or inhibition of the M1 sending interhemispheric volleys.
PLoS ONE 12/2014; 9(12):e114244. DOI:10.1371/journal.pone.0114244 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: It has been proposed that ipsilateral motor pathways play a role in the control of ipsilateral movements and recovery of function after injury. However, the extent to which ipsilateral motor pathways are engaged in voluntary activity in intact humans remains largely unknown. Using transcranial magnetic stimulation over the arm representation of the primary motor cortex, we examined ipsilateral motor-evoked potentials (iMEPs) in a proximal arm muscle during increasing levels of unilateral and bilateral isometric force in a sitting position. We demonstrate that iMEP area and amplitude decreased during bilateral contraction of homonymous (elbow flexor) muscles and increased during bilateral contraction of heteronymous (elbow flexor and extensor) muscles compared with a unilateral contraction, regardless of the level of force tested. To further understand the neuronal inputs involved in the bilateral effects, we examined the contribution from neck afferents projecting onto ipsilateral motor pathways. Medial (away from the muscle tested) and lateral (toward the muscle tested) rotation of the head enhanced bilateral iMEP effects from homonymous and heteronymous muscles, respectively. In contrast, head flexion and extension exerted nonspecific bilateral effects on iMEPs. Intracortical inhibition, in the motor cortex where iMEPs originated, showed modulation compatible with the changes in iMEPs. We conclude that ipsilateral projections to proximal arm muscles can be selectively modulated by voluntary contraction of contralateral arm muscles, likely involving circuits mediating asymmetric tonic neck reflexes acting, at least in part, at the cortical level. The pattern of bilateral actions may represent a strategy to engage ipsilateral motor pathways in a motor behavior.
The Journal of Neuroscience : The Official Journal of the Society for Neuroscience 10/2014; 34(42):13924-34. DOI:10.1523/JNEUROSCI.1648-14.2014 · 6.75 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A major goal of rehabilitation strategies after spinal cord injury (SCI) is to enhance the recovery of function. One possible avenue to achieve this goal is to strengthen the efficacy of the residual neuronal pathways. Non-invasive repetitive transcranial magnetic stimulation (rTMS) has been used in patients with motor disorders as a tool to modulate activity of residual cortical, subcortical, and the corticospinal pathway to promote functional recovery. Here, we review a series of studies published during the last decade that used rTMS in the acute and chronic stages of para- and tetraplegia in humans with complete and incomplete SCI. rTMS has been applied over the arm and leg representations of the primary motor cortex to treat three main consequences of SCI: sensory and motor function impairments, spasticity, and neuropathic pain. Though some studies demonstrated that consecutive sessions of rTMS improve aspects of particular functions, other studies did not show similar effects. We discuss how rTMS stimulation parameters and post-injury reorganization in the corticospinal tract, motor cortical and spinal cord circuits might be critical factors in understanding the advantages and disadvantages of using rTMS in SCI patients. The available data highlight the limited information on the use of rTMS after SCI and the need to further understand the pathophysiology of neuronal structures affected by rTMS to maximize the potential beneficial effects of this technique in humans with SCI.
Archives of Physical Medicine and Rehabilitation 08/2014; 96(4). DOI:10.1016/j.apmr.2014.07.418 · 2.44 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The motor cortex and the corticospinal system contribute to the control of a precision grip between the thumb and index finger. The involvement of subcortical pathways during human precision grip remains unclear. Using noninvasive cortical and cervicomedullary stimulation, we examined motor evoked potentials (MEPs) and the activity in intracortical and subcortical pathways targeting an intrinsic hand muscle when grasping a small (6 mm) cylinder between the thumb and index finger and during index finger abduction in uninjured humans and in patients with subcortical damage due to incomplete cervical spinal cord injury (SCI). We demonstrate that cortical and cervicomedullary MEP size was reduced during precision grip compared with index finger abduction in uninjured humans, but was unchanged in SCI patients. Regardless of whether cortical and cervicomedullary stimulation was used, suppression of the MEP was only evident 1-3 ms after its onset. Long-term (∼5 years) use of the GABAb receptor agonist baclofen by SCI patients reduced MEP size during precision grip to similar levels as uninjured humans. Index finger sensory function correlated with MEP size during precision grip in SCI patients. Intracortical inhibition decreased during precision grip and spinal motoneuron excitability remained unchanged in all groups. Our results demonstrate that the control of precision grip in humans involves premotoneuronal subcortical mechanisms, likely disynaptic or polysynaptic spinal pathways that are lacking after SCI and restored by long-term use of baclofen. We propose that spinal GABAb-ergic interneuronal circuits, which are sensitive to baclofen, are part of the subcortical premotoneuronal network shaping corticospinal output during human precision grip.
The Journal of Neuroscience : The Official Journal of the Society for Neuroscience 05/2014; 34(21):7341-50. DOI:10.1523/JNEUROSCI.0390-14.2014 · 6.75 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Recent studies indicate that human locomotion is quadrupedal in nature. An automatic rhythm-generating system is thought to play a crucial role in controlling arm and leg movements. In the present study, we attempted to elucidate differences between intrinsic arm and leg automaticity by investigating cadence variability during simultaneous arm and leg (AL) cycling. Participants performed AL cycling with visual feedback of arm or leg cadence. Participants were asked to focus their attention to match the predetermined cadence; this affects the automaticity of the rhythm-generating system. Leg cadence variability was only mildly affected when the participants intended to precisely adjust either their arm or leg cycling cadence to a predetermined value. In contrast, arm cadence variability significantly increased when the participants adjusted their leg cycling cadence to a predetermined value. These findings suggest that different neural mechanisms underlie the automaticities of arm and leg cycling and that the latter is stronger than the former during AL cycling.
[Show abstract][Hide abstract] ABSTRACT: Transcallosal inhibitory interactions between primary motor cortices are important to suppress unintended movements in a resting limb during voluntary activation of the contralateral limb. The functional contribution of transcallosal inhibition targeting the voluntary active limb remains unknown. Using transcranial magnetic stimulation, we examined transcallosal inhibition [by measuring interhemispheric inhibition (IHI) and the ipsilateral silent period (iSP)] in the preparatory and execution phases of isotonic slower self-paced and ballistic movements performed by the ipsilateral index finger into abduction and the elbow into flexion in intact humans. We demonstrate decreased IHI in the preparatory phase of self-paced and ballistic index finger and elbow movements compared to rest; the decrease in IHI was larger during ballistic than self-paced movements. In contrast, in the execution phase, IHI and the iSP increased during ballistic compared to self-paced movements. Transcallosal inhibition was negatively correlated with reaction times in the preparatory phase and positively correlated with movement amplitude in the execution phase. Together, our results demonstrate a widespread contribution of transcallosal inhibition to ipsilateral movements of different speeds with a functional role during rapid movements; at faster speeds, decreased transcallosal inhibition in the preparatory phase may contribute to start movements rapidly, while the increase in the execution phase may contribute to stop the movement. We argue that transcallosal pathways enable signaling of the time of discrete behavioral events during ipsilateral movements, which is amplified by the speed of a movement.
The Journal of Neuroscience : The Official Journal of the Society for Neuroscience 10/2013; 33(41):16178-16188. DOI:10.1523/JNEUROSCI.2638-13.2013 · 6.75 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: To investigate the neural alteration of reflex pathways arising from cutaneous afferents in patients with chronic ankle instability. METHODS: Cutaneous reflexes were elicited by applying non-noxious electrical stimulation to the sural nerve of subjects with chronic ankle instability (n=17) and control subjects (n=17) while sitting. Electromyographic (EMG) signals were recorded from each ankle and thigh muscle. The middle latency response (MLR; latency: 70-120ms) component was analyzed. RESULTS: In the peroneus longus (PL) and vastus lateralis (VL) muscles, linear regression analyses between the magnitude of the inhibitory MLR and background EMG activity showed that, compared to the uninjured side and the control subjects, the gain of the suppressive MLR was increased in the injured side. This was also confirmed by the pooled data for both groups. The degree of MLR alteration was significantly correlated to that of chronic ankle instability in the PL. CONCLUSIONS: The excitability of middle latency cutaneous reflexes in the PL and VL is modulated in subjects with chronic ankle instability. SIGNIFICANCE: Cutaneous reflexes may be potential tools to investigate the pathological state of the neural system that controls the lower limbs in subjects with chronic ankle instability.
Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology 03/2013; DOI:10.1016/j.clinph.2013.01.029 · 2.98 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The corpus callosum is essential for neural communication between the left and right hemispheres. Although spatiotemporal coordination of bimanual movements is mediated by the activity of the transcallosal circuit, it remains to be addressed how transcallosal neural activity is involved in the dynamic control of bimanual force execution in human. To address this issue, we investigated transcallosal inhibition (TCI) elicited by single-pulse transcranial magnetic stimulation (TMS) in association with the coordination condition of bimanual force regulation. During a visually-guided bimanual force tracking task, both thumbs were abducted either in-phase (symmetric condition) or 180° out-of-phase (asymmetric condition). TMS was applied to the left primary motor cortex to elicit the disturbance of ipsilateral left force tracking due to TCI. The tracking accuracy was equivalent between the two conditions, but the synchrony of the left and right tracking trajectories was higher in the symmetric condition than in the asymmetric condition. The magnitude of force disturbance and TCI were larger during the symmetric condition than during the asymmetric condition. Right unimanual force tracking influenced neither the force disturbance nor TCI during tonic left thumb abduction. Additionally, these TMS-induced ipsilateral motor disturbances only appeared when the TMS intensity was strong enough to excite the transcallosal circuit, irrespective of whether the crossed corticospinal tract was activated. These findings support the hypotheses that interhemispheric interactions between the motor cortices play an important role in modulating bimanual force coordination tasks, and that TCI is finely tuned depending on the coordination condition of bimanual force regulation.
European Journal of Neuroscience 11/2012; 37(1). DOI:10.1111/ejn.12026 · 3.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The functional coupling of neural circuits between the upper and lower limbs involving rhythmic movements is of interest to both motor control research and rehabilitation science. This coupling can be detected by examining the effect of remote rhythmic limb movement on the modulation of reflex amplitude in stationary limbs. The present study investigated the extent to which rhythmic leg pedaling modulates the amplitude of an early latency (peak 30-70 ms) cutaneous reflex (ELCR) in the upper limb muscles. Thirteen neurologically intact volunteers performed leg pedaling (60 or 90 rpm) while simultaneously contracting their arm muscles isometrically. Control experiments included isolated isometric contractions and discrete movements of the leg. ELCRs were evoked by stimulation of the superficial radial nerve with a train of rectangular pulses (three pulses at 333 Hz, intensity 2.0- to 2.5-fold perceptual threshold). Reflex amplitudes were significantly increased in the flexor carpi radialis and posterior deltoid and significantly decreased in the biceps brachii muscles during leg pedaling compared with that during stationary isometric contraction of the lower leg muscles. This effect was also sensitive to cadence. No significant modulation was seen during the isometric contractions or discrete movements of the leg. Additionally, there was no phase-dependent modulation of the ELCR. These findings suggest that activation of the rhythm generating system of the legs affects the excitability of the early latency cutaneous reflex pathways in the upper limbs.
Journal of Neurophysiology 05/2010; 104(1):210-7. DOI:10.1152/jn.00774.2009 · 3.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Stretch reflexes and motor-evoked potentials (MEPs) of a muscle are facilitated when performing intensive contraction of muscles located in a different segment (remote effect). We investigated to what extent the remote effect on MEPs in the flexor carpi radialis (FCR) in humans is modulated during sustained maximal and submaximal voluntary contractions of the ipsilateral quadriceps (remote muscle). We found that even when the force of maximal voluntary contraction (MVC) of the remote muscle declined during sustained MVC, the magnitude of the remote effect on MEPs remained constant. Maximal electrical stimulation of the remote muscle and transcranial magnetic stimulation of the corresponding motor cortex revealed that the level of voluntary activation gradually decreased during the sustained MVC. The motor response in the FCR following magnetic stimulation at the level of the foramen magnum, which preferentially elicits muscle response as a direct response of the corticospinal tract, was not modified by the remote effect during the sustained MVC. This finding suggested that the excitability of the spinal motoneuron pool remained constant. In contrast to the sustained MVC, during sustained submaximal contraction of the remote muscle, the magnitude of the remote effect on MEPs gradually increased as muscle fatigue developed. These findings suggest that the remote effect on MEPs was dependent on the level of effort driving the remote muscle, but not on the actual level of force output of the remote muscle, and that the origin of the remote effect was supraspinal, putatively upstream of the primary motor cortex.
European Journal of Neuroscience 09/2009; 30(7):1297-305. DOI:10.1111/j.1460-9568.2009.06895.x · 3.67 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Cutaneous reflexes induced in lower leg muscles by non-noxious electrical stimulation to the foot sole are strongly modified depending on the stimulated location. Little is known, however, about the functional importance of this location-specificity. We examined modulation of cutaneous reflexes in the peroneus longus muscle during co-activation of the peroneus longus (PL), soleus, and tibialis anterior muscles in ten healthy volunteers. We successfully recorded 121 intramuscular single motor units (MU) of cutaneous reflexes in PL elicited by stimulating either fore-medial, fore-lateral, or heel regions of the plantar foot while performing plantarflexion and eversion (PF + EV), dorsiflexion and eversion (DF + EV), or isolated eversion (EV). Firing probability increased following fore-lateral stimulation during the PF + EV and EV tasks, but not during the DF + EV. Fore-medial stimulation, irrespective of the task, suppressed the reflex. Heel stimulation facilitated the reflex only during the PF + EV and DF + EV tasks. In general, cutaneous reflex magnitudes were larger during the PF + EV task than during the others, irrespective of whether the effects were facilitatory or suppressive. These results suggest that the magnitude of the reflex effects on the PL motoneurons strongly depends on activation of plantarflexors and dorsiflexors.
Experimental Brain Research 05/2009; 195(3):403-12. DOI:10.1007/s00221-009-1802-9 · 2.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To determine to what extent tonic contraction of the testing muscle modulates the effect of remote muscle contraction on motor evoked potentials (MEPs) and cortical silent periods (CSPs) in resting and active proximal and distal muscles following transcranial magnetic stimulation (TMS). In addition, we tested whether the remote effect on MEP was observable when the test MEP was small.
While performing tonic abductions of the first dorsal interosseous (FDI), flexor carpi radialis, or anterior deltoid muscles, subjects made phasic dorsiflexions of the right ankle at various forces. MEPs and CSPs were induced by separately optimized TMS intensities and locations in the left motor cortex and recorded electromyographically.
Phasic dorsiflexion increased MEP amplitude and shortened CSP duration in a dorsiflexion intensity-dependent manner in all muscles tested. At test MEPs <10% of Mmax, remote effects on MEP amplitude and CSP duration were significantly attenuated while the testing muscle was active.
Phasic contraction of remote muscles potentiates excitatory- and suppresses inhibitory intracortical neuronal pathways converging on corticospinal tract cells innervating the upper limb muscles even when they are active. However, the magnitude of the remote effect on MEP amplitude strongly depends on the test MEP amplitude.
Although remote effects on MEP amplitude and CSP duration are observed even when the test muscle is active, the magnitude of the remote effect strongly depends on TMS intensity.
[Show abstract][Hide abstract] ABSTRACT: It is well known that monosynaptic spinal reflexes and motor evoked potentials following transcranial magnetic stimulation (TMS) are reinforced during phasic and intensive voluntary contraction in the remote segment (remote effect). However, the remote effect on the cortical silent period (CSP) is less known. The purpose of the present study is to determine to what extent the CSP in the intrinsic hand muscle following TMS is modified by voluntary ankle dorsiflexion and to elucidate the origin of the modulation of CSP by the remote effect. CSP was recorded in the right first dorsal interosseous while subjects performed phasic dorsiflexion in the ipsilateral side under self-paced and reaction-time conditions. Modulation of the peripherally-induced silent period (PSP) induced by electrical stimulation of the ulnar nerve was also investigated under the same conditions. In addition, modulation of the CSP was investigated during ischemic nerve block of the lower limb and during application of vibration to the tibialis anterior tendon. The duration of CSP was significantly shortened by phasic dorsiflexion, and the extent of shortening was proportional to dorsiflexion force. Shortening of the CSP duration was also observed during tonic dorsiflexion. In contrast, the PSP duration following ulnar nerve stimulation was not altered during phasic dorsiflexion. Furthermore, the remote effect on the CSP duration was seen during ischemic nerve block of the lower limb and the pre-movement period in the reaction-time paradigm, but shortening of the CSP was not observed during tendon vibration. These findings suggest that phasic muscle contraction in the remote segment results in a decrease in intracortical inhibitory pathways to the corticospinal tract innervating the muscle involved in reflex testing and that the remote effect on the CSP is predominantly cortical in origin.
Experimental Brain Research 04/2007; 177(3):419-30. DOI:10.1007/s00221-006-0686-1 · 2.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Although there is some evidence showing that neural coupling plays an important role in regulating coordination between the upper and lower limbs during walking, it is unclear how tightly the upper and lower limbs are linked during rhythmic movements in humans. The present study was conducted to investigate how coupling of both limbs is coordinated during independent rhythmic movement of the upper and lower limbs. Ten subjects performed simultaneous arm and leg cycling (AL cycling) at their preferred cadences without feedback for 10 s, and then were asked to voluntarily change the cadence (increase, decrease, or stop) of arm or leg cycling. Leg cycling cadence was not affected by voluntary changes in arm cadence. By contrast, arm cycling cadence was significantly altered when leg cycling cadence was changed. These results suggest the existence of a predominant lumbocervical influence of leg cycling on arm cycling during AL cycling.
Experimental Brain Research 02/2007; 176(1):188-92. DOI:10.1007/s00221-006-0742-x · 2.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: It is known that cutaneous reflexes in human hand muscles show strong location-specificity dependent on the digit stimulated. We hypothesized that in lower leg muscles the cutaneous reflex following tactile sensation of the plantar surface of the foot is also organized in a location-specific manner. The purpose of the present study was to test this hypothesis. Middle latency reflexes (approximately 70-110 ms, MLR) following non-noxious electrical stimulation to different locations on the plantar foot were recorded from 16 neurologically intact volunteers (15 males, 1 female). Electrical stimulation was given to the fore-medial (f-M), fore-lateral (f-L) and heel (HL) regions of the plantar surface of the right foot while the subjects performed isometric dorsiflexion (tibialis anterior, TA), plantarflexion (soleus, Sol and medial gastrocnemius, MG), eversion (peroneus longus, PL) and knee extension (vastus lateralis, VL) while sitting and standing. In the Sol and MG, an excitatory response was observed following HL stimulation, which was switched to an inhibitory response following f-M or f-L stimulation (P < 0.001). A reciprocal pattern in contrast to Sol was observed in the TA. In the PL, MLR exhibited significant excitation following both f-L and HL stimulation, which, however, was switched to an inhibitory response following f-M stimulation (P < 0.001). Moderate inhibition of the MLR was seen in the VL for all stimulated positions. Systematic stimulation along the lateral side of the plantar foot demonstrated that the reflex reversal occurred around the middle of the plantar foot in the Sol and TA. In all muscles tested, the slope of the regression line between the magnitude of the MLR and background electromyographic activity significantly decreased during standing compared with sitting except for the PL following f-L simulation. These results suggest that reflex effects from cutaneous nerves in the plantar foot onto the motoneurons innervating the lower leg muscles are organized in a highly topographic manner in humans. The organization of these reflexes may play an important role in the alteration of limb loading and/or ground contact in response to tactile sensation of the plantar foot while sitting and standing.
Experimental Brain Research 11/2006; 175(3):514-25. DOI:10.1007/s00221-006-0568-6 · 2.17 Impact Factor