Reproducible measurement of voluntary activation of human elbow flexors with motor cortical stimulation.

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.     

Theta burst stimulation of the human motor cortex

It has been 30 years since the discovery that repeated electrical stimulation of neural pathways can lead to long-term potentiation in hippocampal slices. With its relevance to processes such as learning and memory, the technique has produced a vast literature on mechanisms of synaptic plasticity in animal models. To date, the most promising method for transferring these methods to humans is repetitive transcranial magnetic stimulation (rTMS), a noninvasive method of stimulating neural pathways in the brain of conscious subjects through the intact scalp. However, effects on synaptic plasticity reported are often weak, highly variable between individuals, and rarely last longer than 30 min. Here we describe a very rapid method of conditioning the human motor cortex using rTMS that produces a controllable, consistent, long-lasting, and powerful effect on motor cortex physiology and behavior after an application period of only 20-190 s.     

Different motor learning effects on excitability changes of motor cortex in muscle contraction state

Abstract

We aimed to investigate whether motor learning induces different excitability changes in the human motor cortex (M1) between two different muscle contraction states (before voluntary contraction [static] or during voluntary contraction [dynamic]). For the same, using motor evoked potentials (MEPs) obtained by transcranial magnetic stimulation (TMS), we compared excitability changes during these two states after pinch-grip motor skill learning. The participants performed a force output tracking task by pinch grip on a computer screen. TMS was applied prior to the pinch grip (static) and after initiation of voluntary contraction (dynamic). MEPs of the following muscles were recorded: first dorsal interosseous (FDI), thenar muscle (Thenar), flexor carpi radialis (FCR), and extensor carpi radialis (ECR) muscles. During both the states, motor skill training led to significant improvement of motor performance. During the static state, MEPs of the FDI muscle were significantly facilitated after motor learning; however, during the dynamic state, MEPs of the FDI, Thenar, and FCR muscles were significantly decreased. Based on the results of this study, we concluded that excitability changes in the human M1 are differentially influenced during different voluntary contraction states (static and dynamic) after motor learning.     

Motor responses of the facial muscles to local stimulation of the motor cortex and facial nerve nucleus in the white mouse

The character of motor responses of the facial muscles evoked by stimulation of various regions of the frontal neocortex and of the nucleus of the facial nerve was studied in outbred mice. Motor responses of the vibrissae, of the upper lip and the jaw to monopolar microstimulation in the frontal cortical areas in 55 per cent of the cases had the latencies from 5 to 15 ms. The latencies of the responses to the facial nucleus stimulation ranged from 3 to 12 ms with maximal expressed interval of 4-6 ms. Excitation conduction velocities of the facial nerve estimated on the basis of latencies measurements, were from 1.5 to 12 m/s.     

Functional properties of efferent zones of the motor cortex which project to ipsilateral and contralateral face muscles

In both intact (4 animals) and lesioned (2 preparations with contralateral motor cortex ablation and 1 animal with transection of the rostral two thirds of the corpus callosum) cats, three different types of efferent zones were identified in the face motor cortex by the technique of microstimulation: contralateral, ipsilateral and bilateral efferent zones. The three types of efferent zones had different organizational features such as location, thresholds of effective sites and latencies of motor responses. Mean thresholds of effective sites from ipsilateral and bilateral efferent zones in lesioned animals were not significantly higher than those in intact preparations. In both intact and lesioned animals, neurons endowed with contralateral, bilateral and ipsilateral receptive fields were isolated from the three types of efferent zones.     

Spatial attention changes excitability of human visual cortex to direct stimulation

Conscious perception depends not only on sensory input, but also on attention [1, 2]. Recent studies in monkeys [3-6] and humans [7-12] suggest that influences of spatial attention on visual awareness may reflect top-down influences on excitability of visual cortex. Here we tested this specifically, by providing direct input into human visual cortex via cortical transcranial magnetic stimulation (TMS) to produce illusory visual percepts, called phosphenes. We found that a lower TMS intensity was needed to elicit a conscious phosphene when its apparent spatial location was attended, rather than unattended. Our results indicate that spatial attention can enhance visual-cortex excitability, and visual awareness, even when sensory signals from the eye via the thalamic pathway are bypassed.     

Mechanochemical coupling in muscle: attempts to measure simultaneously shortening and ATPase rates in myofibrils.

We studied the ATPase of shortening myofibrils at 4 degrees C by the rapid flow quench method. The progress curve has three phases: a P(i) burst, a fast linear phase kF of duration tB, and a deceleration to a slow kS. We propose that kF is the ATPase of myofibrils shortening under zero external load; at tB shortening and ATPase rates are reduced by passive resistance. The total ATP consumed during the rapid shortening is ATPc. Our purpose was to obtain information on the myofibrillar shortening velocity from their ATPase progress curves. We tested tB as an indicator of shortening velocity by determining the effects of different probes upon it and the other ATPase parameters. The dependence of tB upon the initial sarcomere length was linear, giving a shortening velocity close to that of muscle fibres (Vo). The Km of ATP was larger for tB than for kF, as found with fibers for Vo and their ATPase. ADP and 2,3-butanedione monoxime, but not P(i), inhibited tB to the same extent as Vo. The delta H for tB and Vo were similar. ATPc was independent of the sarcomere length, implying that the more the myofibrils shorten, the less ATP expended per myosin head per micron shortened. We propose that tB can be used as an indicator for myofibrillar shortening velocities.     

Differential changes in muscle oxygenation between voluntary and stimulated isometric fatigue of human dorsiflexors.

The purpose of this study was to compare fatigue and recovery of maximal voluntary torque [maximal voluntary contraction (MVC)] and muscle oxygenation after voluntary (Vol) and electrically stimulated (ES) protocols of equal torque production. On 1 day, 10 male subjects [25 yr (SD 4)] completed a Vol fatigue protocol and, on a separate day, an ES fatigue protocol of the right dorsiflexors. Each task involved 2 min of intermittent (2-s on, 1-s off) isometric contractions at 50% of MVC. For the ES protocol, stimulation was delivered percutaneously to the common peroneal nerve at a frequency of 25 Hz. Compared with the Vol protocol, the ES protocol caused a greater impairment in MVC (75 vs. 83% prefatigue value; Pre) and greater increase in 50-Hz half relaxation time (165 vs. 117% Pre) postexercise. After acute (1 min) recovery, MVC impairment was similar for both protocols, whereas 50- Hz half relaxation time was still greater in the ES than Vol protocol. Total hemoglobin decreased to a similar extent in both protocols during exercise, but it was elevated above the resting value to a significantly greater extent for the ES protocol in recovery (18 vs. 11 microM). Oxygen saturation was significantly lower in the ES than Vol protocol during exercise (46 vs. 57% Pre), but it was significantly greater during recovery (120 vs. 105% Pre). These findings suggest that despite, equal torque production, ES contractions impose a greater metabolic demand on the muscle that leads to a transient greater impairment in MVC. The enforced synchronization and fixed frequency of excitation inherent to ES are the most likely causes for the exacerbated changes in the ES compared with the Vol protocol.     

Effect of succinylcholine on responses of neurons in the motor cortex to natural activation of muscle spindle primary endings.

In locally anesthetized cats, the effects of intravenous administration of succinylcholine (SCh) in sub-paralytic dosages on the responses of single neurons in motor cortex to small dynamic muscle stretches were studied. A large transient enhancement of these cortical responses with a time course corresponding to the peripheral action of SCh on muscle spindles was observed. This finding is discussed in terms of the hypothesis that muscle spindle primary endings may activate projections to motor cortex.     

Relationship between mechanomyogram signals and changes in force of human forefinger flexor muscles during voluntary contraction

In previous studies on mechanomyogram (MMG) signals no analysis of these signals accompanying force generation has been performed. Therefore, we have recorded MMG signals (previously referred to as muscle sound or acoustomyographic signals) during voluntary contractions of forefinger flexor muscles in 31 young subjects. These subjects made contractions to produce force records of triangular or trapeziform shape. The peak target force amounted to 10, 20 or 40 N which represented less than 40% of maximal voluntary contraction. The MMG signals during the transient phases of force generation at three different rates were analysed. The MMG intensity level calculated for MMG records and the peak-to-peak amplitude of MMG signals correlated with both the velocity of force increase and the contraction force. The occurrence of the strongest MMG signals corresponded to changes in contractile force. Therefore, it is suggested that measurements of these parameters could be a useful tool in studies of changes in contractile force. Accepted: 11 March 1998     

Synchronization of human motor unit firing during voluntary contraction of muscle and the tonic vibration reflex

We constructed cross-correlograms (CCGs) of action potentials of pairs of motor units (MUs) of human soleus, triceps brachii, and the first and second dorsal interosseous muscles. During voluntary muscle contraction, a pronounced peak in the zero bin was found in 21 out of 126 pairs investigated with the aid of the CCG; this indicates that the number of coincidental firings exceeded chance. The width of the peak did not exceed 5 msec (synchronization for a brief interval, i.e., short-term synchronization). When motoneurons of the soleus muscle were activated by vibration, correlations were found in 12 out 89 pairs of MUs investigated. On the CCGs of action potentials of MU pairs in two muscles (the first and second dorsal interosseous muscles), such correlations were found in four out of 10 pairs investigated. In all of these cases, the ratio of above-change coincidences relative to the total number of MU discharges was small, from 3.0 to 6.1%. Synchronization within a brief time interval can be considered a result of simultaneous creation of EPSPs in motoneourons reached by endings of a single pre-motor nerve fiber. In some pairs of MUs, long term synchronization (clustering) occurred, ie., synchronization lasting several tens of milliseconds. The long-term synchronization can be considered a manifestation of fatigue accompanying tremor.Institute for Problems of Information Transmission, Russian Academy of Sciences, Moscow. Translated from Neirofiziologiya, Vol. 23, No. 6, pp. 691–698, November–December, 1991.     

Physiologic changes of compound muscle action potentials related to voluntary contraction and muscle length in carpal tunnel syndrome.

The affect of muscle length and voluntary contraction upon compound muscle action potentials (CMAPs) in subjects with carpal tunnel syndrome (CTS) has been evaluated. Twenty-five hands in a CTS patient group and 29 hands in a normal subject control group were studied. The CMAPs from the abductor pollicis brevis induced by median nerve stimulation at the wrist were obtained for five thumb positions: neutral, abduction for shortening with and without contraction, and adduction for lengthening with and without contraction. Upon muscle shortening with relaxation, CMAP duration decreased in both groups, whereas waveform amplitude increased in the control group and showed no significant change in the CTS group. Muscle shortening with contraction afforded decreased CMAP duration and increased CMAP amplitude in both groups. Upon muscle lengthening with relaxation, both groups showed a reduction in CMAP amplitude and an increase in CMAP duration. Upon lengthening with contraction, CMAP duration decreased in the control group; in contrast, the CTS group showed further amplitude reduction and the waveform duration returned to the neutral value. These results demonstrate that, in patients with CTS, physiologic CMAP summations by muscle shortening or contraction may be less effective, whereas decreases in amplitude and increases in duration may be accentuated by lengthening and contraction.     

Muscle afferent modulation by stimulation of motor and supplementary motor cortex in cats

Local stimulation in the zone of motor representation of the cat hind limb in the postcruciate cortex (area 4) modulates afferent activity of flexor spindles of the foot. An initial pause, connected with contraction of extrafusal fibers, is observed in this activity. After the muscle has returned to its original length, a sharp rise of discharge frequency develops followed by a return to its initial level. Similar phases, but less marked, are observed in secondary afferents. Stimulation of contralateral and ipsilateral regions of the medial precruciate cortex (area 6) causes selective, intensive, and prolonged facilitation of discharge of type Ia units followed by an after-effect, without involving extrafusal muscle fibers. Since influences of the premotor supplementary cortex on lumbar gamma motoneurons are relatively independent of influences coupled with activation of the alpha system on muscle afferents from the motor cortex, a specific role of area 6 in the regulation of segmental excitability of the gamma system can be postulated.     

Electromyographic measures of muscle activation and changes in muscle architecture of human elbow flexors during fatiguing contractions.

The study compared changes in intramuscular and surface recordings of EMG amplitude with ultrasound measures of muscle architecture of the elbow flexors during a submaximal isometric contraction. Ten subjects performed a fatiguing contraction to task failure at 20% of maximal voluntary contraction force. EMG activity was recorded in biceps brachii, brachialis, and brachioradialis muscles using intramuscular and surface electrodes. The rates of increase in the amplitude of the surface EMG for the long and short heads of biceps brachii and brachioradialis were greater than those for the intramuscular recordings measured at different depths. The amplitude of the intramuscular recordings from three muscles increased at a similar rate (P = 0.13), as did the amplitude of the three surface recordings from two muscles (P = 0.83). The increases in brachialis thickness (27.7 +/- 5.7 to 30.9 +/- 3.5 mm; P < 0.05) and pennation angle (10.9 +/- 3.5 to 16.5 +/- 4.8 degrees ; P = 0.003) were not associated with the increase in intramuscular EMG amplitude (P > 0.58). The increase in brachioradialis thickness (22.8 +/- 4.8 to 25.5 +/- 3.4 mm; P = 0.0075) was associated with the increase in the amplitude for one of two intramuscular EMG signals (P = 0.007, r = 0.79). The time to failure was more strongly associated with the rate of increase in the amplitude of the surface EMG than that for the intramuscular EMG, which suggests that the surface measurement provides a more appropriate measure of the change in muscle activation during a fatiguing contraction.     

The site of action of magnetic stimulation of human motor cortex in a patient with motor neuron disease

Cortical and spinal root (C₈-T₁) magnetic stimulation evoked single motor unit potentials in the abductor pollicis brevis and abductor digiti minimi muscles in a patient with chronic motor neuron disease. This patient was unique in that there were few surviving motoneurons in these muscles making it possible to record single motor units. Central motor conduction time was within normal limits. Cortical mapping of motor evoked potentials (MEPs) was carried out using a twin magnetic coil stimulating over the motor cortex at intervals of 1 cm along the coronal axis and 1–2 cm along the sagittal axis. As the site of cortical stimulation was moved from the centre, the latency of the MEPs increased by 0.7–0.8 ms suggesting one synaptic delay. This study provides further data that magnetic stimulation of the human cortex indirectly activates pyramidal cells via interneurons.     

Role of the motor cortex in the control of axial and proximal muscles in learning

Involvement of the motor cortex in the control of the shoulder and the scapula muscles was studied during acquisition of the novel head-forelimb coordination in dogs. The dogs were trained to raise the forelimb fixed to the lever in order to lift a food-containing cup and keep it elevated during eating with the head tilted down to the feeder. At the early stage of learning, the movement of raising the limb occurred with an anticipatory upward head tilt, whereas the head tilt to the feeder was associated with the lowering of the raised limb. Food consumption required a new coordination, i.e., maintaining the raised limb in a posture with the head lowered. This coordination could only be achieved by learning. This new coordination was critically dependent on the intact motor cortex. It was found that in the natural coordination, raise of the limb involved regular activation of the main flexors of shoulder, i.e., deltoid and teres major muscles, and inconstant participation of teres minor, supra- and infraspinatus, trapezius muscles. Muscles of the latter group were often active during standing but ceased their activity before limb raise. The learned limb raise with the head tilted down occurred with activation of all the mentioned muscles, and some of them changed their activity for the opposite pattern. Lesions in the motor cortex (inclusive the main part of the projection area of the "working" limb) led to a restoration of the natural head-fore- limb coordination and the innate muscle pattern of the limb raise. Thus, in the course of learning, the motor cortex rearranges the innate pattern of coordination of phylogenetically old axial and proximal muscles, which begin to work in a new manner.     

A technical method using musculoskeletal model to analyse dynamic properties of muscles during human movement

An effective way to avoid invading or injuring the subjects is to use the musculoskeletal model when studying the dynamic properties of muscles in vivo. So, we put forward a joint coordinate system-based method, which mainly focuses on the coordinate's transformation of corresponding muscle attachment points, respectively, in the model and the subject in order to reproduce the movement of the subject on the model. As muscle moment arm is usually used to evaluate the dynamic properties of muscles, the moment arms in elbow flexion for each of the major muscles crossing the elbow in 50 healthy subjects (25 males and 25 females), ranging in height from 1.50 to 1.80 m (mean 1.6542 m) are calculated and compared with the measured data obtained from anatomical studies reported in the literature. The trends of the value basically coincide with each other. So, this novel method can be valid.