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Biomedical subjects

M C Ridding

Publications and source records attributed to M C Ridding.

At least 19 recordsLinked to original sources

Transient motor evoked potential suppression following a complex sensorimotor task.

OBJECTIVE: To investigate the mechanism involved in the transient suppression of the response to transcranial magnetic stimulation (TMS) following repeated performance of a complex sensorimotor training task (ST). METHODS: A total of 19 healthy subjects participated in 4 experiments, all involving performance of the grooved pegboard test (GPT). The experiments investigated the effect of the ST on corticospinal and intracortical excitability, spinal excitability and maximal pinch grip force. RESULTS: Motor evoked potential amplitude decreased significantly following the ST in both muscles tested and this was associated, but not correlated, with a decrease in the time taken to perform the GPT. There was no change in intracortical inhibition or facilitation (tested at interstimulus intervals of 3 and 10 ms, respectively). M wave amplitude was unchanged, as were F wave amplitude, latency and persistence and there was no evidence of muscle fatigue. CONCLUSIONS: The reduction in corticospinal excitability was short lasting (<10 min) and was not accompanied by changes at the spinal or peripheral level, suggesting that other intracortical circuits may be involved. SIGNIFICANCE: Repeated performance of motor tasks can result in both short- and long-term modulation of motor cortical excitability. However, the relationship between changes in corticospinal excitability and motor performance is complex and critically dependent upon task type and duration.

Adult↗

Induction of plasticity in the dominant and non-dominant motor cortices of humans.

There are clear hemispheric differences in the human motor system. Studies using magnetic resonance morphometry have shown that representation of hand muscles is larger in the dominant hemisphere than the non-dominant hemisphere. There is some limited evidence of electrophysiological differences between hemispheres. For example, it has been reported recently that there is less intracortical inhibition in the dominant hemisphere than the non-dominant hemisphere, and it has been hypothesised that this reduction in inhibition may facilitate use-dependent plasticity in the dominant motor cortex. In the present study we examined this hypothesis in human subjects by examining plasticity induction in both dominant and non-dominant hemispheres using an experimental paradigm known to induce motor cortical plasticity, namely paired associative stimulation (PAS). Additionally, we investigated changes in dominant and non-dominant hand performance on a simple ballistic training task. Short-interval intracortical inhibition (SICI) was also measured for both dominant and non-dominant hands at a range of conditioning intensities. There was significantly less SICI in the dominant motor cortical hand area than in the non-dominant hand area. PAS induced a significant, and similar, increase in motor cortical excitability in both the dominant and non-dominant hemispheres. Motor training resulted in significant performance improvement in both dominant and non-dominant hands. However, there was significantly more improvement in the non-dominant hand. The results from these studies provide some further evidence of electrophysiological differences between the motor cortices of the two hemispheres. Additionally, these findings offer no support for the hypothesis that the dominant hemisphere is positioned more favourably, due to decreased inhibitory tone, than the non-dominant hemisphere for use-dependent plasticity.

Adolescent↗

Afferent stimulation facilitates performance on a novel motor task.

Training on a motor task results in performance improvements that are accompanied by increases in motor cortex excitability. Moreover, periods of afferent stimulation result in increased motor cortex excitability. There is increasing evidence to suggest that raised motor cortical excitability may facilitate movement and learning. Here we examined whether a period of electrical stimulation of hand afferents ("associative stimulation"), known to increase motor cortex excitability, facilitated the performance of a complex sensorimotor task. Three groups of nine normal subjects participated in these studies. All subjects were trained on the grooved pegboard test (GPT). Training consisted of three blocks, each of five trials, of placing pegs as quickly as possible. The time to complete each block was recorded. One group of subjects had a 1-h period of associative stimulation prior to training on the GPT. A second group received non-associative stimulation (which does not change cortical excitability) of the same hand afferents while a third group received no stimulation prior to training. Motor evoked potentials (MEPs) were recorded from the first dorsal interosseous (FDI) and abductor digiti minimus (ADM) muscles both prior to and following stimulation and performance of the GPT. In contrast to non-associative stimulation, associative stimulation increased motor cortical excitability, as evidenced by an increase in the amplitude of MEPs evoked in the FDI, one of the stimulated muscles, but not the ADM. Training on the GPT resulted in significant improvements in the time taken to complete the task for all three groups. However, in subjects who had preconditioning associative stimulation, performance on the GPT improved more rapidly. Additionally, there was a strong trend for the improvement in the performance of the stimulated group to be greater than that of the control group. The results of the present study suggest that increased motor cortical excitability, induced by associative stimulation, may facilitate the performance of a novel complex sensorimotor task.

Adult↗

Modulation of intracortical excitability in human hand motor areas. The effect of cutaneous stimulation and its topographical arrangement.

Changes in afferent input can alter the excitability of intracortical inhibitory systems. For example, using paired transcranial magnetic stimulation (TMS), both electrical digital stimulation and muscle vibration have been shown to reduce short-interval intracortical inhibition (SICI). The effects following muscle vibration are confined to the corticospinal projection to the vibrated muscles. The results following digital stimulation are less clear and the relative timing of the cutaneous stimulation and TMS is critical. Here we investigated further whether changes in SICI following digit stimulation exhibit topographic specificity. Eleven normal subjects were investigated (age 28.2+/-7.5 years, mean+/-SD). Electromyographic recordings were made from the right first dorsal interosseous (FDI), abductor digiti minimi (ADM) and abductor pollicis brevis (APB) muscles. SICI was measured, with and without preceding electrical digit II or digit V cutaneous stimulation. The interval between the digital nerve stimulus and test magnetic stimulus was independently set for each subject and established by subtracting the onset latency of the motor evoked potential (MEP) from the latency of the E2 component of the cutaneomuscular reflex. Therefore, measures of intracortical excitability were made at a time at which it is known that cutaneous input is capable of modulating cortical excitability. Single digital nerve stimuli applied to digit II significantly reduced SICI in FDI but not in ADM. Single digital nerve stimuli applied to digit V significantly reduced SICI in ADM but not in FDI or APB. There was a more generalised effect on intracortical facilitation (ICF) with both digit II and digit V stimulation significantly increasing ICF in FDI and ADM. Digital stimulation (either DII or DV) did not significantly affect SICI/ICF in APB. These findings show that appropriately timed cutaneous stimuli are capable of modulating SICI in a topographically specific manner. We suggest that the selective decrease in SICI seen with cutaneous stimulation may be important for focusing of muscle activation during motor tasks.

Adult↗

Motor cortex excitability after thalamic infarction.

Transcranial magnetic stimulation was used to map hand muscle representations in the motor cortex of a patient in whom infarction of the sensory thalamus deprived the sensorimotor cortex of sensory input. The threshold for activation of the motor cortex on the affected side was higher and the cortical representational maps of individual muscles were less well defined than those on the normal side. It is concluded that electrophysiological changes in cortical organisation can be demonstrated following withdrawal of, or imbalance in sensory afferent activity to the cerebral cortex in humans.

Adult↗

Modification of the human motor cortex by associative stimulation.

Manipulation of afferent input is capable of inducing reorganisation of the motor cortex. For example, following 1 h of paired electrical stimulation to the motor point of two hand muscles ("associative stimulation") the excitability of the corticospinal projection to the stimulated muscles is increased. Here we investigated the mechanisms responsible for such change using transcranial magnetic stimulation (TMS). Cortical excitability changes were investigated by measuring motor evoked potentials (MEPs), intracortical inhibition (ICI), intracortical facilitation (ICF), and short-interval intracortical facilitation (SICF). Following 1 h of associative stimulation MEP amplitudes in the stimulated muscles significantly increased. Additionally, there was a significant increase in ICF and of SICF at interstimulus intervals in the range of 2.3-3.3 ms. There was no significant change in ICI. These findings confirm previous observations that a 1-h period of associative stimulation can increase the excitability of the cortical projection to stimulated muscles. Additionally, these results suggest that the observed modifications of excitability are due to changes in intracortical excitatory circuits.

Adult↗

Does induction of plastic change in motor cortex improve leg function after stroke?

Combined peripheral nerve and brain stimulation ("dual stimulation") induces changes in the excitability of normal motor cortex. The authors sought to establish whether dual stimulation would also induce motor cortex plasticity and associated functional improvements in nine stroke patients with chronic stable hemiparesis. Following 4 weeks of daily dual stimulation, improvements were seen in some neurophysiological and functional measures. This technique may offer therapeutic opportunities in some stroke patients.

Adult↗

Increased cortical excitability induced by transcranial DC and peripheral nerve stimulation.

This study investigated the effect of short periods of simultaneous weak anodal direct current (DC) stimulation and peripheral ulnar nerve (ES) stimulation on corticospinal excitability. The experiments involved repeated testing of ten normal subjects with four different protocols: (1) No Stimulation; (2) DC only; (3) ES only; (4) DC plus ES. Motor evoked potentials (MEP) were recorded from the First Dorsal Interosseous (FDI); Abductor Digiti Minimi (ADM) and Flexor Carpi Ulnaris (FCU). The baseline MEP amplitude was compared with that obtained immediately after the first set of stimulation, after the second set of stimulation, 15 min post stimulation and 30 min after stimulation. No significant change was seen with the No Stimulation and ES Only protocols. FDI showed a significant change in the DC protocol after the second set of stimulation but the changes were not present 15 or 30 min after. The DC plus ES protocol showed FDI changes that were significant after the second set of stimulation with the elevations persisting when tested 15 and 30 min post intervention. These observations show that a period of anodal DC stimulation preceding a period of ulnar nerve stimulation resulted in significant and persistent elevations in cortical excitability.

Adult↗

Changes in motor cortical excitability induced by paired associative stimulation.

OBJECTIVE: Changes in afferent input have been shown to be capable of inducing reorganisations of motor cortex in humans. Using TCMS we examined the efficacy of a new associative afferent stimulation paradigm in inducing motor cortical reorganisation in humans. METHODS: Using TCMS, stimulus response curves were constructed before and following a 1 h period of associative stimulation of two muscles motor points. The effect of an asynchronous peripheral stimulation paradigm was investigated in a separate series of control experiments. RESULTS: One hour of associative stimulation of two muscles motor points resulted in a significant increase in the excitability of the corticospinal projection to those stimulated muscles. The increase in excitability peaked 1 h following the stimulation period. This increase in excitability did not generalise to either adjacent or more remote muscles. The control stimulation paradigm produced no significant change in corticospinal excitability. CONCLUSIONS: These results confirm the importance of associative input for the induction of plasticity in the human motor cortex. SIGNIFICANCE: The findings reported here further elucidate the role of afferent input in motor cortical reorganisation. These findings have implications for our understanding of the mechanisms of motor learning and may also be relevant to the design of new afferent stimulation therapies.

Adult↗

Mechanisms of motor-evoked potential facilitation following prolonged dual peripheral and central stimulation in humans.

1. Repetitive electrical peripheral nerve or muscle stimulation can induce a lasting increase in the excitability of the corticomotor projection. By pairing peripheral stimulation with transcranial magnetic brain stimulation it is possible to shorten the duration of stimulation needed to induce this effect. This ability to induce excitability changes in the motor cortex may be of significance for the rehabilitation of brain-injured patients. The mechanisms responsible for the increases in excitability have not been investigated thoroughly. 2. Using two paired transcranial magnetic stimuli protocols we investigated the excitability of intracortical inhibitory and excitatory systems before and following a period of repetitive dual muscle and brain stimulation. The dual stimulation consisted of motor point stimulation of first dorsal interosseous (FDI; 10 Hz trains of 1 ms square waves for 500 ms) delivered at one train every 10 s, paired with single transcranial magnetic stimulation given 25 ms after the onset of the train. 3. Following 30 min of dual stimulation, motor-evoked potentials (MEPs) were significantly increased in amplitude. During this period of MEP facilitation there was no significant difference in the level of intracortical inhibition. There was, however, a significant increase in the intracortical facilitation demonstrated with paired magnetic stimuli. The increase in facilitation was seen only at short interstimulus intervals (0.8-2.0 ms). These intervals comprised a peak in the time course of facilitation, which is thought to reflect I wave interaction within the motor cortex. 4. The relevance of this finding to the MEP facilitation seen following dual peripheral and central stimulation is discussed.

Adult↗

Changes in corticomotor representations induced by prolonged peripheral nerve stimulation in humans.

OBJECTIVE: Manipulation of afferent input can induce reorganization within the sensorimotor cortex which may have important functional consequences. Here we investigate whether prolonged peripheral nerve stimulation can induce reorganization within the human motor cortex. METHODS: Using transcranial magnetic stimulation, we mapped the scalp representation of the corticospinal projection to hand muscles in 8 normal subjects before and after 2h of simultaneous repetitive electrical stimulation of the ulnar and radial nerves at the wrist. Control mapping experiments were conducted in 6 subjects. RESULTS: Following nerve stimulation, larger motor-evoked potentials were evoked from more scalp sites. The induced changes were most apparent in first dorsal interosseous, but were also seen in other hand muscles. The increases in area of the representational maps were accompanied by changes in the location of the optimal site for evoking responses in first dorsal interosseous, and changes in the centres of gravity of the maps. CONCLUSIONS: Prolonged afferent stimulation induces an increase in excitability of the corticospinal projection. This is accompanied by a significant shift in the centre of gravity of the stimulated muscles which we propose is evidence of a non-uniform expansion in their cortical representation.

Adult↗

Reduced interhemispheric inhibition in musicians.

In vivo magnetic resonance imaging has revealed that the anterior half of the corpus callosum is larger in musicians trained intensively from an early age than in untrained subjects. The corpus callosum is crucial for the coordination of bimanual motor activity, but neurophysiological correlates of morphological differences in the corpus callosum of musicians are not known. In the present study we have used transcranial magnetic stimulation (TMS) to assess interhemispheric inhibition in six adult professional musicians who began musical training at an early age. Conditioning TMS was applied to the hand area of the motor cortex of one hemisphere, followed 4-16 ms later by a test stimulus applied to the other hemisphere. Tests were performed at rest, and with the first dorsal interosseous muscle contralateral to the conditioning hemisphere voluntarily active. Conditioning TMS in musicians was 29% less effective at reducing the size of the test MEP at rest, and 63% less effective in the active condition, compared with control subjects. We conclude that transcallosal interhemispheric inhibitory circuits activated by TMS are less effective in musicians than in controls.

Adult↗

Changes in muscle responses to stimulation of the motor cortex induced by peripheral nerve stimulation in human subjects.

The aim of this study was to determine whether prolonged, repetitive mixed nerve stimulation (duty cycle 1 s, 500 ms on-500 ms off, 10 Hz) of the ulnar nerve leads to a change in excitability of primary motor cortex in normal human subjects. Motor-evoked potentials (MEPs) generated in three intrinsic hand muscles [abductor digiti minimi (ADM), first dorsal interosseous (FDI) and abductor pollicis brevis (APB)] by focal transcranial magnetic stimulation were recorded during complete relaxation before and after a period of prolonged repetitive ulnar nerve stimulation at the wrist. Transcranial magnetic stimuli were applied at seven scalp sites separated by 1 cm: the optimal scalp site for eliciting MEPs in the target muscle (FDI), three sites medial to the optimal site and three sites lateral to the optimal stimulation site. The area of the MEPs evoked in the ulnar-(FDI, ADM) but not the median-innervated (APB) muscles was increased after prolonged ulnar nerve stimulation. Centre of gravity measures demonstrated that there was no significant difference in the distribution of cortical excitability after the peripheral stimulation. F-wave responses in the intrinsic hand muscles were not altered after prolonged ulnar nerve stimulation, suggesting that the changes in MEP areas were not the result of stimulus-induced increases in the excitability of spinal motoneurones. Control experiments employing transcranial electric stimulation provided no evidence for a spinal origin for the excitability changes. These results demonstrate that in normal human subjects the excitability of the cortical projection to hand muscles can be altered in a manner determined by the peripheral stimulus applied.

Adult↗

Afferent input and cortical organisation: a study with magnetic stimulation.

Previously, we had described a technique for investigating probable GABAergic cortical inhibitory circuits in conscious man using transcranial magnetic stimulation. This type of inhibition has been termed intracortical inhibition. During voluntary contraction, activity in the circuits responsible for this inhibition is reduced. The mechanism by which this reduction in activity is brought about is unknown. However, evidence exists to suggest that afferent input may be, at least in part, responsible for the reduction in inhibition. The experiments described here were designed to investigate this possibility further. The results of these experiments showed that afferent input, produced by electrical peripheral-nerve stimulation, reduced the level of intracortical inhibition. Also, motor imagery, which activates similar brain regions as overt movement, but does not result in afferent input, failed to produce significant changes in intracortical inhibition. We conclude from these results that afferent input is capable of altering activity in cortical inhibitory circuits. The relevance of these findings to the mechanisms involved in cortical reorganisation is discussed.

Adult↗

Bilateral cortical control of the human anterior digastric muscles.

Transcranial magnetic stimulation (TCMS) was used to determine the organization of cortical motor projections to the anterior digastric muscles in 12 normal human subjects. Two distinct types of potentials were evoked in anterior digastric with a figure-of-eight coil. A short-latency (3 ms) response appeared bilaterally on the surface electromyogram (EMG), but only ipsilaterally on intramuscular recordings: this was the result of direct stimulation of the ipsilateral trigeminal motor root. Motor evoked potentials (MEPs) were elicited in the anterior digastric muscles at variable onset latencies of around 10 ms by stimulation of scalp areas antero-lateral to the area for the first dorsal interosseous muscle of the hand. These were evoked bilaterally in relaxed anterior digastric muscles in six of the seven subjects. In the other subject, the responses in the relaxed muscle were exclusively ipsilateral. However, when the anterior digastric muscles were contracted, the responses were bilateral in all subjects. TCMS and spike-triggered averaging revealed that the bilateral responses were not due to the branching of axons from individual digastric motoneurones to muscles on each side. Because the digastric motor nucleus may contain separate populations of ipsi- and contralateral projecting motoneurones, it was necessary to study single motor-unit responses to TCMS to demonstrate a bilateral corticobulbar projection. The responses of 17 single motor units in the anterior digastric muscle to TCMS were recorded. All were activated by contralateral stimulation. Approximately 80% were also activated by ipsilateral TCMS, although one well-characterised motor unit was inhibited by ipsilateral TCMS. When bilateral activation was present, the ipsilateral responses were more secure than the contralateral responses, which may indicate an additional interneurone in the pathway to the contralateral motoneurone. The major conclusions from this study are that (1) the cortical representation of the anterior digastric muscle is antero-lateral to hand muscles; (2) the cortical projection to the anterior digastric muscles is bilateral; (3) the corticobulbar projection is stronger contralaterally than ipsilaterally but may involve at least one additional synapse; and (4) anterior digastric motoneurones do not branch to innervate the muscles bilaterally.

Adult↗

Motor cortical control of human masticatory muscles.

The corticotrigeminal projections to masseter and anterior digastric motoneuron pools that are activated by TMS are bilateral, but not symmetrical. This conclusion is supported by whole-muscle data showing larger MEPs in the contralateral muscle with unilateral focal TMS, as well as evidence that TMS stimulation of one hemisphere may produce excitation in a masseter or digastric single motor unit while stimulation of the opposite hemisphere produced inhibition of the same motor unit. The asymmetry is particularly marked for masseter, in which the low-threshold motor units were most commonly excited with contralateral TMS and inhibited with ipsilateral TMS. Spike-triggered averaging of digastric motor unit activity revealed cross-talk in surface EMG recordings from digastric muscles, and no evidence that muscle fibres in both digastric muscles were innervated by a common motor axon. Narrow excitatory peaks in the PSTH of motor unit discharge elicited by TMS in masseter (either hemisphere) and digastric motor units (ipsilateral hemisphere) suggest a direct corticomotoneuronal projection. The contralateral projection to digastric motoneurons may include additional oligosynaptic connections, as judged by the broader peaks in the PSTH with contralateral TMS. The organisation of bilateral corticotrigeminal inputs revealed with TMS suggests that: (a) the contralateral hemisphere provides relatively more of the excitatory input delivered via the fast corticotrigeminal pathway for both masseter and digastric motoneuron pools, and (b) corticotrigeminal projections from either hemisphere are capable of contributing to the voluntary command mediating activation of masseter, and (to a lesser extent) anterior digastric muscles on one side, that is independent of the homologous muscles on the other side.

Adult↗

The effects of transcranial magnetic stimulation over the dorsolateral prefrontal cortex on suppression of habitual counting during random number generation.

Random number generation is an attention-demanding task that engages working memory and executive processes. Random number generation requires holding information 'on line', suppression of habitual counting, internally driven response generation and monitoring of responses. Evidence from PET studies suggests that the dorsolateral prefrontal cortex (DLPFC) is involved in the generation of random responses. We examined the effects of short trains of transcranial magnetic stimulation (TMS) over the left or right DLPFC or medial frontal cortex on random number generation in healthy normal participants. As in previous evidence, in control trials without stimulation participants performed poorly on the random number generation task, showing repetition avoidance and a tendency to count. Brief disruption of processing with TMS over the left DLPFC changed the balance of the individuals' counting bias, increasing the most habitual counting in ones and reducing the lower probability response of counting in twos. This differential effect of TMS over the left DLPFC on the balance of the subject's counting bias was not obtained with TMS over the right DLPFC or the medial frontal cortex. The results suggest that, with disruption of the left DLPFC with TMS, habitual counting in ones that has previously been suppressed is released from inhibition. From these findings a network modulation model of random number generation is proposed, whereby suppression of habitual responses is achieved through the modulatory influence of the left DLPFC over a number-associative network in the superior temporal cortex. To allow emergence of appropriate random responses, the left DLPFC inhibits the superior temporal cortex to prevent spreading activation and habitual counting in ones.

Adult↗

Stimulus/response curves as a method of measuring motor cortical excitability in man.

We investigated whether input/output curves of human motor cortex could provide similar information to cortical mapping under two conditions where the motor maps are known to change dramatically: ischaemic anaesthesia and amputation. Stimulus/response curves were constructed by recording the size of EMG responses evoked in arm muscles with transcranial magnetic stimulation at a single site using a range of intensities. Changes in the slope of this relationship during ischaemic anaesthesia (6 normal subjects) or amputation (two patients) were compared to changes in cortical motor maps produced by stimulating different sites at the same intensity. At rest both interventions increased map areas, as well as the slope of the stimulus/response curves. During voluntary activity they had no effect. We conclude that stimulus/response curves can detect changes in cortical motor maps, and discuss potential mechanisms for this effect.

Adult↗