PubMed · 10171546
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Y Young, R M Jones. Monitoring neuromuscular function.. https://pubmed.ncbi.nlm.nih.gov/10171546/
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During exercise, changes occur at many sites in the motor pathway, including the muscle fiber, motoneuron, motor cortex, and "upstream" of the motor cortex. Some of the changes result in fatigue, which can be defined as a decrease in ability to produce maximal muscle force voluntarily. Transcranial magnetic stimulation (TMS) over the human motor cortex reveals changes in both motor evoked potentials (MEPs) and the silent period during and after fatiguing voluntary contractions in normal subjects. The relationship of these changes to loss of force or fatigue is unclear. However, during a sustained maximal contraction TMS evokes extra force from the muscle and thus demonstrates the development of suboptimal output from the motor cortex, that is, fatigue at a supraspinal level. In some patients with symptoms of fatigue, the response to TMS after exercise is altered, but the changed MEP behavior is not yet linked to particular symptoms or pathology.
A simple linear formulation for magnetostimulation thresholds specific to MRI gradient coils is derived based on established hyperbolic electrostimulation strength vs. duration relations. Thresholds are derived in terms of the gradient excursion required to cause stimulation, and it is demonstrated that the threshold curve is a linear function of the gradient switching time. A parameter beta is introduced as being fundamental in the evaluation of gradient coil stimulation. beta is a map of the induced electric field per unit gradient slew rate, and can be calculated directly from the gradient coil wire pattern. Consideration of beta alone is sufficient to compare stimulation thresholds between different gradient coil designs, as well as to evaluate the expected dependency of stimulation threshold on position within the gradient coil. The linear gradient threshold curve is characterized by two parameters: SR(min) and DeltaG(min). SR(min) is the slope of the threshold curve and represents the minimum slew rate required to cause stimulation in the limit of infinite gradient strength. DeltaG(min) is the vertical axis intercept of the curve and represents the minimum gradient excursion required to cause stimulation in the limit of infinite slew rate. Both SR(min) and DeltaG(min) are functions of both beta and the standard tissue parameters E(r) (rheobase) and tau(c) (chronaxie time). The ease with which both the gradient system performance and the stimulation thresholds can be plotted on the same axes is noted and is used to introduce the concept of a piece-wise linear operational limit curve for a gradient system.