Changes in Bereitschaftspotential during fatiguing and non-fatiguing hand movements

The role of clinical neurophysiology in the definition and assessment of fatigue and fatigability

Though a common symptom, fatigue is difficult to define and investigate, occurs in a wide variety of neurological and systemic disorders, with differing pathological causes. It is also often accompanied by a psychological component. As a symptom of long-term COVID-19 it has gained more attention. In this review, we begin by differentiating fatigue, a perception, from fatigability, quantifiable through biomarkers. Central and peripheral nervous system and muscle disorders associated with these are summarised. We provide a comprehensive and objective framework to help identify potential causes of fatigue and fatigability in a given disease condition. It also considers the effectiveness of neurophysiological tests as objective biomarkers for its assessment. Among these, twitch interpolation, motor cortex stimulation, electroencephalography and magnetencephalography, and readiness potentials will be described for the assessment of central fatigability, and surface and needle electromyography (EMG), single fibre EMG and nerve conduction studies for the assessment of peripheral fatigability. The purpose of this review is to guide clinicians in how to approach fatigue, and fatigability, and to suggest that neurophysiological tests may allow an understanding of their origin and interactions. In this way, their differing types and origins, and hence their possible differing treatments, may also be defined more clearly.

Cued motor processing in autism and typical development: A high-density electrical mapping study of response-locked neural activity in children and adolescents

Motor atypicalities are common in autism spectrum disorder (ASD) and are often evident prior to classical ASD symptoms. Despite evidence of differences in neural processing during imitation in autistic individuals, research on the integrity and spatiotemporal dynamics of basic motor processing is surprisingly sparse. To address this need, we analysed electroencephalography (EEG) data recorded from a large sample of autistic (n = 84) and neurotypical (n = 84) children and adolescents while they performed an audiovisual speeded reaction time (RT) task. Analyses focused on RTs and response-locked motor-related electrical brain responses over frontoparietal scalp regions: the late Bereitschaftspotential, the motor potential and the reafferent potential. Evaluation of behavioural task performance indicated greater RT variability and lower hit rates in autistic participants compared to typically developing age-matched neurotypical participants. Overall, the data revealed clear motor-related neural responses in ASD, but with subtle differences relative to typically developing participants evident over fronto-central and bilateral parietal scalp sites prior to response onset. Group differences were further parsed as a function of age (6-9, 9-12 and 12-15 years), sensory cue preceding the response (auditory, visual and bi-sensory audiovisual) and RT quartile. Group differences in motor-related processing were most prominent in the youngest group of children (age 6-9), with attenuated cortical responses observed for young autistic participants. Future investigations assessing the integrity of such motor processes in younger children, where larger differences may be present, are warranted.

The Influence of Age, Eating a Meal, and Systematic Fatigue on Swallowing and Mealtime Parameters

Fatigue is widely accepted as a clinically relevant factor in the diagnosis, treatment, and management of dysphagia. Despite the relative importance that is placed on swallowing-related fatigue, the occurrence and effects of fatigue during swallowing is unclear. The goal of this study was to explore effects of eating a meal on measures of tongue strength, endurance, and other parameters of swallowing function under normal conditions compared to when the tongue is intentionally fatigued. Thirty healthy females, 15 "Young" (18-35 years old), and 15 "Old" (70 + years old) were seen for two data collection sessions one week apart. On both days, pre-meal measures were collected, then participants consumed a standardized meal based on a previously published protocol (half a bagel with peanut butter and 8 baby carrots) followed by post-meal measures. An additional pre-meal fatigue task was included on one of the test days (counterbalanced), involving maximal tongue presses until participants could not achieve 40% of baseline maximum pressure. Pre- and post-meal measures included anterior and posterior maximum tongue pressures, saliva swallow pressure, tongue endurance, surface electromyography (sEMG), the modified Borg scale, and the Test of Mastication and Swallowing of Solids (TOMASS). Linear mixed effects regressions compared pre- and post-meal outcome measures (1) on the non-fatigue day and (2) between fatigue and non-fatigue days while controlling for participant and age. The fatigue task caused significant reductions in maximum anterior and posterior tongue pressure. After a normal meal (i.e., without fatigue), we found decreased anterior pressures in the older group only. Older participants also had decreased saliva swallow pressures after the meal compared to pre-meal, while this measure increased post-mean in the young participants. When compared to the non-fatigue meal, eating a meal after tongue fatigue resulted in significantly lower post-meal posterior pressures, regardless of age group. The same pattern was observed with posterior functional reserve. Our results demonstrate that a systematic, participant-specific tongue fatigue task induced measurable changes in maximum tongue pressure. A meal by itself was observed to reduce anterior tongue strength and saliva swallow pressures only in older participants. Overall, it appears that older adults may be more vulnerable to fatigue-induced changes in tongue strength, though the relationship between these measures and changes to functional swallowing remains unknown.

The subthalamic nucleus and the placebo effect in Parkinson's disease

The study of the placebo effect, or response, is related to the investigation of the psychologic component of different therapeutic rituals. The high rate of placebo responses in Parkinson's disease clinical trials provided the impetus for investigating the underlying mechanisms. Ruling out spontaneous remission and regression to the mean through the appropriate experimental designs, genuine psychologic placebo effects have been identified, in which both patients' expectations of therapeutic benefit and learning processes are involved. Specifically, placebo effects are associated with dopamine release in the striatum and changes in neuronal activity in the subthalamic nucleus, substantia nigra pars reticulata, and motor thalamus in Parkinson's disease, as assessed through positron emission tomography and single-neuron recording during deep brain stimulation, respectively. Conversely, verbal suggestions of clinical worsening or drug dose reduction induce nocebo responses in Parkinson's disease, which have been detected at both behavioral and electrophysiologic level. Important implications and applications emerge from this new knowledge. These include better clinical trial designs, whereby patients' expectations should always be assessed, as well as better drug dosage in order to reduce drug intake.

Effects of motor style on timing control and EEG waveforms in self-paced and synchronization tapping tasks

We investigated the effects of tapping style on motor performance and neural activity in self-paced and synchronization tapping tasks in three conditions (drum sticking [DS], one-finger tapping [1FT], and four-finger tapping [4FT]). In the synchronization task, participants tapped in synchrony with a metronomic sound. No significant differences were detected in the accuracy of timing control among the tapping styles, whereas larger potentials on EEG waveforms before tap onset were found in 4FT than in DS or 1FT; these may be readiness potentials for the motor commands required to control multiple fingers. As expected, tap intervals were more stable under the synchronization condition than under the selfpaced condition, but no difference was detected in the neural activity evoked before tap onset. Larger neural potentials observed in the early stage after tap onset in DS might be involved in the sensory feedback associated with tool use.

Physical or Cognitive Exertion Does Not Influence Cortical Movement Preparation for Rapid Arm Movements

The contribution of central factors to movement preparation (e.g., the contingent negative variation [CNV]) and the influence of fatigue on such factors are still unclear, even though executive cognitive functions are regarded as key elements in motor control. Therefore, this study examined CNV amplitude with electroencephalography in 22 healthy humans during a rapid arm movement task prior to and following three experimental conditions: (a) a no exertion/control condition, (b) a physical exertion, and (c) a cognitive exertion. CNV amplitude was affected neither by a single bout of physical/cognitive exertion nor by the control condition. Furthermore, no time-on-task effects of the rapid arm movement task on the CNV were found. Exertion did not affect cortical movement preparation, which is in contrast to previous findings regarding time-on-task effects of exertion on CNV. Based on the current findings, the rapid arm movement task is deemed suitable to measure cortical movement preparation, without being affected by learning effects and physical/cognitive exertion.

Verbal communication about drug dosage balances drug reduction in Parkinson's disease: Behavioral and electrophysiological evidences

INTRODUCTION

Changing drug dosage is common in clinical practice. Recent evidence showed that psychological factors may affect the therapeutic outcome. The aim of this study is to test whether verbal communication about drug dosage changes motor performance and fatigue in Parkinson's Disease (PD) patients.

METHODS

We performed clinical (Unified PD Rating Scale), motor (number of finger flexions and perceived fatigue), and electrophysiological measurements (readiness potential, RP) in PD patients during medication-off and medication-on conditions in three groups. The first group got a full dose of l-dopa and was told it was a full dose. The second group got half dose and was told it was half dose. The third group got half dose, but it was told it was a full standard dose.

RESULTS

We found that overt half dose was less effective than the full dose for clinical improvement, motor performance, and readiness potential. However, if half dose was given along with verbal instructions that it was a full dose, clinical improvement, motor performance and readiness potential were not significantly different from the full dose.

CONCLUSIONS

Our findings indicate that verbal communication about dose reduction is as effective as the 50% dose reduction itself, demonstrating that deceptive information about the dose may have an important impact on the therapeutic outcome. Moreover, the supplementary motor area, source of the RP, seems to be involved in this psychological effect.

Effects of Parkinson disease and antiparkinson medication on central adaptations to repetitive grasping

Cortical activity during motor task performance is attenuated in individuals with Parkinson disease (PD) relative to age-matched adults without PD, and this activity is enhanced with antiparkinson medication. It remains unclear, however, whether the relative change in cortical activity over the duration of the task, i.e., central adaptation, is affected individuals with PD, and if so, whether medication corrects for any unique behaviors. Movement-related cortical potentials (MRCPs) were recorded from scalp electrode sites Cz and C1 during 150 repetitive handgrip contractions at 70% of maximal voluntary contraction, in individuals with PD (n = 10) both ON and OFF of their PD medication, and neurologically normal age- and sex-matched controls (n = 10). Repetitions were divided into two Blocks (Block 1 and 2: repetitions 1-60 and 91-150, respectively), and the composite MRCP slopes were calculated during periods representing movement initiation (-2 s to movement onset) and execution (movement onset to 1 s). No significant interactions were noted for either comparison (PD OFF vs. control; PD OFF vs. PD ON), irrespective of electrode site (Cz or C1) or movement period (initiation or execution). Despite similar MRCP slopes and task performance, PD OFF endorsed greater perceived exertion during task performance than controls. In the present study, we observed attenuated task-related cortical activity among individuals with PD OFF relative to controls, but a similar relative adaptive response to a fatiguing task. Additionally, although antiparkinson medication enhanced cortical activity (PD OFF vs. PD ON), central adaptation was similar.

Perceived exertion during muscle fatigue as reflected in movement-related cortical potentials: an event-related potential study

The aim of this study was to explore the mechanism on perceived exertion during muscle fatigue. A total of 15 individuals in the fatigue group and 13 individuals in the nonfatigue group were recruited into this study, performing 200 intermittent handgrip contractions with 30% maximal voluntary contraction. The force, surface electromyography (sEMG), movement-related cortical potentials (MRCPs), and rating perception of effort (RPE) were combined to evaluate the perceived exertion during muscle fatigue. The maximal handgrip force significantly decreased (P<0.01), the root mean square of sEMG over each block significantly increased (P<0.01), and SD of force at plateau increased (P<0.01) during muscle fatigue. The RPE scores reported by the individuals and the motor potential amplitude of MRCPs in the fatigue group significantly increased (P<0.001). However, as for the individuals in the nonfatigue group, the other indexes showed no significant changes except for a little increase in the RPE. The within-subject correlation coefficients showed that there were significant correlations between RPE and motor potential amplitude of MRCPs at the C1 site (r=-0.609, P<0.001) and between RPE and root mean square of sEMG (r=0.541, P<0.001). Our results substantiate that the perceived exertion correlates with the central motor command during movement execution rather than the preparatory process. The perceived exertion not only reflects central fatigue but could also reflect the peripheral local muscle fatigue.

High Amplitude EEG Motor Potential during Repetitive Foot Movement: Possible Use and Challenges for Futuristic BCIs That Restore Mobility after Spinal Cord Injury

Recent advances in neuroprostheses provide us with promising ideas of how to improve the quality of life in people suffering from impaired motor functioning of upper and lower limbs. Especially for patients after spinal cord injury (SCI), futuristic devices that are controlled by thought via brain-computer interfaces (BCIs) might be of tremendous help in managing daily tasks and restoring at least some mobility. However, there are certain problems arising when trying to implement BCI technology especially in such a heterogenous patient group. A plethora of processes occurring after the injuries change the brain's structure as well as its functionality collectively referred to as neuroplasticity. These changes are very different between individuals, leading to an increasing interest to reveal the exact changes occurring after SCI. In this study we investigated event-related potentials (ERPs) derived from electroencephalography (EEG) signals recorded during the (attempted) execution and imagination of hand and foot movements in healthy subjects and patients with SCI. As ERPs and especially early components are of interest for BCI research we aimed to investigate differences between 22 healthy volunteers and 7 patients (mean age = 51.86, SD = 15.49) suffering from traumatic or non-traumatic SCI since 2–314 months (mean = 116,57, SD = 125,55). We aimed to explore differences in ERP responses as well as the general presence of component that might be of interest to further consider for incorporation into BCI research. In order to match the real-life situation of BCIs for controlling neuroprostheses, we worked on small trial numbers (<25), only. We obtained a focal potential over Pz in ten healthy participants but in none of the patients after lenient artifact rejection. The potential was characterized by a high amplitude, it correlated with the repeated movements (6 times in 6 s) and in nine subjects it significantly differed from a resting condition. Furthermore, there are strong arguments against possible confounding factors leading to the potential's appearance. This phenomenon, occurring when movements are repeatedly conducted, might represent a possible potential to be used in futuristic BCIs and further studies should try to investigate the replicability of its appearance.

Movement-Related Cortical Potential Amplitude Reduction after Cycling Exercise Relates to the Extent of Neuromuscular Fatigue

Exercise-induced fatigue affects the motor control and the ability to generate a given force or power. Surface electroencephalography allows researchers to investigate movement-related cortical potentials (MRCP), which reflect preparatory brain activity 1.5 s before movement onset. Although the MRCP amplitude appears to increase after repetitive single-joint contractions, the effects of large-muscle group dynamic exercise on such pre-motor potential remain to be described. Sixteen volunteers exercised 30 min at 60% of the maximal aerobic power on a cycle ergometer, followed by a 10-km all-out time trial. Before and after each of these tasks, knee extensor neuromuscular function was investigated using maximal voluntary contractions (MVC) combined with electrical stimulations of the femoral nerve. MRCP was recorded during 60 knee extensions after each neuromuscular sequence. The exercise resulted in a significant decrease in the knee extensor MVC force after the 30-min exercise (−10 ± 8%) and the time trial (−21 ± 9%). The voluntary activation level (VAL; −6 ± 8 and −12 ± 10%), peak twitch (Pt; −21 ± 16 and −32 ± 17%), and paired stimuli (P100 Hz; −7 ± 11 and −12 ± 13%) were also significantly reduced after the 30-min exercise and the time trial. The first exercise was followed by a decrease in the MRCP, mainly above the mean activity measured at electrodes FC1-FC2, whereas the reduction observed after the time trial was related to the FC1-FC2 and C2 electrodes. After both exercises, the reduction in the late MRCP component above FC1-FC2 was significantly correlated with the reduction in P100 Hz (r = 0.61), and the reduction in the same component above C2 was significantly correlated with the reduction in VAL (r = 0.64). In conclusion, large-muscle group exercise induced a reduction in pre-motor potential, which was related to muscle alterations and resulted in the inability to produce a maximal voluntary contraction.

Movement-related cortical potentials during muscle fatigue induced by upper limb submaximal isometric contractions

The aim of this study was to examine the central neurophysiological mechanisms during fatigue induced by submaximal isometric contractions. A total of 23 individuals participated in the study and were assigned to fatigue and nonfatigue groups. Handgrip force, root mean square (RMS) of surface electromyography (sEMG) signal and movement-related cortical potentials during self-paced submaximal handgrip isometric contractions were assessed for each participant. The experimental data showed significant decreases in both maximal voluntary contraction [-24.3%; F(3, 42)=19.62, P<0.001, ηp=0.48] and RMS [-30.1%; F(3, 42)=19.01, P<0.001, ηp=0.57] during maximal voluntary contractions and a significant increase [F(3, 42)=14.27, P<0.001, ηp=0.50] in the average RMS of sEMG over four blocks in the fatigue group. There was no significant difference in the readiness potential between the fatigue and the nonfatigue groups at early stages, and at late stages, significant differences were observed only at the Fp1 and FC1 sites. Motor potential amplitudes were significantly higher in the fatigue group than in the nonfatigue group irrespective of block or electrode positions. Positive waveforms were observed in the prefrontal cortex in states without muscle fatigue, whereas a negative waveform pattern was observed with muscle fatigue. Significant within-subject correlations were observed between motor potential at the C1 site and RMS of sEMG (r=-0.439, P=0.02, ηp=0.11). Neurophysiological evidence indicates that cortical activity increases in the prefrontal cortex, primary motor cortex and supplementary motor cortex with muscle fatigue. Muscle fatigue appears to have considerable effects on the components of movement-related cortical potentials during movement execution, whereas the readiness potential before movement is sensitive to cognitive demands during prolonged exercise. Our results provide additional evidence for a link between central motor command during movement execution and motor unit recruitment.

Implications of movement-related cortical potential for understanding neural adaptations in muscle strength tasks

This systematic review aims to provide information about the implications of the movement-related cortical potential (MRCP) in acute and chronic responses to the counter resistance training. The structuring of the methods of this study followed the proposals of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). It was performed an electronically search in Pubmed/Medline and ISI Web of Knowledge data bases, from 1987 to 2013, besides the manual search in the selected references. The following terms were used: Bereitschaftspotential, MRCP, strength and force. The logical operator “AND” was used to combine descriptors and terms used to search publications. At the end, 11 studies attended all the eligibility criteria and the results demonstrated that the behavior of MRCP is altered because of different factors such as: force level, rate of force development, fatigue induced by exercise, and the specific phase of muscular action, leading to an increase in the amplitude in eccentric actions compared to concentric actions, in acute effects. The long-term adaptations demonstrated that the counter resistance training provokes an attenuation in the amplitude in areas related to the movement, which may be caused by neural adaptation occurred in the motor cortex.

The neurophysiology of central and peripheral fatigue during sub-maximal lower limb isometric contractions

Fatigue has been defined as an exercise-induced decline in force generation capacity because of changes at both the peripheral and central levels. Movement is preceded and accompanied by brain activities related to the preparation and execution of movement (movement related cortical potentials, MRCP), which have been correlated with the perception of effort (RPE). We combined force measurements, surface electromyography (sEMG), peripheral electrical stimulation (maximal twitch, MT) and MRCP analysis to further our understanding of the neural correlates of peripheral and central changes during a fatiguing task involving the lower limbs. Eighteen healthy volunteers performed 4 blocks of isometric knee extensions at 40% of the maximal voluntary contraction (MVC) for a total of 240 2-s contractions. At the baseline and after each block, we measured RPE, MT and MVC. We simultaneously recorded the force of the knee extensor muscles, root mean square (RMS) of the sEMG of the vastus lateralis muscle, and electroencephalography (EEG) from 64 channels. The MRCPs were extracted from the EEG recordings and averaged in the early (Block 1-2) and late (Block 3-4) blocks. Two cohorts were obtained by cluster analysis based on the RPE (i.e., perception of effort) and MT (i.e., peripheral fatigue). We observed a significant decline in both the MVC (-13%) and RMS (-25%) of the sEMG signal over the course of the task; thus, muscle fatigue had occurred in all of the participants regardless of the cohort. The MRCP amplitude was larger in the fatigued than the non-fatigued MT cohort in the supplementary and premotor areas, whereas the MRCP amplitude was larger in the fatigued than the non-fatigued RPE cohort in the aforementioned areas, and also in the primary motor and prefrontal cortices (PFC). The increase in the positive activity of the PFC, along with the perception of effort, represents a novel result, suggesting that it is modulated more by the perception of effort than peripheral fatigue.

Cortical Activity during a Highly-Trained Resistance Exercise Movement Emphasizing Force, Power or Volume

Cortical activity is thought to reflect the biomechanical properties of movement (e.g., force or velocity of movement), but fatigue and movement familiarity are important factors that require additional consideration in electrophysiological research. The purpose of this within-group quantitative electroencephalogram (EEG) investigation was to examine changes in cortical activity amplitude and location during four resistance exercise movement protocols emphasizing rate (PWR), magnitude (FOR), or volume (VOL) of force production, while accounting for movement familiarity and fatigue. EEG signals were recorded during each complete repetition and were then grouped by functional region, processed to eliminate artifacts, and averaged to compare overall differences in the magnitude and location of cortical activity between protocols over the course of six sets. Biomechanical, biochemical, and exertional data were collected to contextualize electrophysiological data. The most fatiguing protocols were accompanied by the greatest increases in cortical activity. Furthermore, despite non-incremental loading and lower force levels, VOL displayed the largest increases in cortical activity over time and greatest motor and sensory activity overall. Our findings suggest that cortical activity is strongly related to aspects of fatigue during a high intensity resistance exercise movement.

Mechanisms of muscle fatigue: Central factors and task dependency

Muscle fatigue can be caused by a number of different mechanisms that result in an acute reduction in the ability to perform a motor task. These mechanisms include the physiological processes that range from the motivation associated with performing the task through to the force exerted by the contractile proteins once they are activated. Two issues are examined in this brief review. First, the role of mechanisms located in the central nervous system (central factors) in the fatigue experienced by human subjects. Second, the importance of task conditions (task dependency) on the fatigue mechanisms involved in a particular performance. The literature documents a prominent role for central factors in the development of muscle fatigue. This role is examined by considering subject motivation, the descending signals sent by suprasegmental centres (central command) and motor unit behaviour. The significance of these or other mechanisms, however, appears to depend on the details of the task. Variation in such requirements as contraction intensity or duration, speed of movement, or type of muscle contraction alters the role of the different mechanisms in limiting performance. Unfortunately, few studies have examined these effects systematically. The field of muscle fatigue would benefit substantially from studies that determined the boundary conditions for the different fatigue mechanisms.

Central adaptations to repetitive grasping in healthy aging

Augmented cortical activity during repetitive grasping mitigates repetition-related decrease in cortical efficiency in young adults. It is unclear if similar processes occur with healthy aging. We recorded movement-related cortical potentials (MRCP) during 150 repetitive handgrip contractions at 70% of maximal voluntary contraction (MVC) in healthy young (n = 10) and old (n = 10) adults. Repetitions were grouped into two Blocks (Block 1 and 2: repetitions 1-60 and 91-150, respectively) and analyzed separately to assess the effects of aging and block. EMG of the flexor digitorum superficialis and handgrip force were also recorded. No changes in EMG or MVC were observed across blocks for either group. Significant interactions (P < 0.05) were observed for MRCPs recorded from mesial (FCz, Cz, CPz) and motor (C1, C3, Cz) electrode sites, with younger adults demonstrating significant increases in MRCP amplitude. Focal MRCP activity in response to repetitive grasping resulted in minimal changes (i.e. Block 1 versus Block 2) in older adults. Central adaptive processes change across the lifespan, showing increasingly less focal activation in older adults during repetitive grasping. Our findings are consistent with previous paradigms demonstrating more diffuse cortical activation during motor tasks in older adults.

Changes in the alpha and beta amplitudes of the central EEG during the onset, continuation, and offset of long-duration repetitive hand movements

Electroencephalographic alpha and beta activities recorded from central electrodes are known to display movement-related suppression or enhancement. We investigated whether the suppression that is known to occur during the onset of a single movement would persist or otherwise habituate when the movement is continuously repeated for a long period of time. Fourteen subjects took part in the experiments. They performed repetitive simultaneous extension-flexions of the fingers II-V in one hand, continuously for a period of at least 30 s. They then stopped this self-paced movement and rested for at least 30 s. Bipolar recording was made from C3-Cz and C4-Cz. Patterns of amplitude changes in the alpha and beta bands were calculated against a resting baseline. Following a bilateral alpha and beta suppression at the movement onset, alpha amplitude gradually but not fully recovered towards the baseline during the 30 s post-onset. Habituation of afferences and transfer of the cortical function were discussed as the two alternative explanations for this gradual recovery. Beta amplitude, however, displayed no recovery as long as the movement continued. Considering the relatively rapid beta recovery reported for sustained movements, this finding demonstrated that the sustained and continuous movements are conducted through quite different processes. A transient contralateral beta rebound was observed only after the end of the long movement period, strengthening the viewpoint that links the beta rebound with the closure of the cortical processes running throughout a motor sequence. Modulation of the beta amplitude, rather than the changes in alpha amplitude, appeared to be more closely correlated with the execution of a continuous movement.

Central adaptations during repetitive contractions assessed by the readiness potential

Physiological fatigue, a loss of maximal force producing capacity, may originate both from changes at the peripheral and at the central level. The readiness potential (RP) provides a measure to study adaptations to physiological fatigue at the motor cortex. We have studied the RP in the course of repetitive contractions at a high force level. Fourteen female healthy subjects made repetitive force grip contractions at 70% of their maximal voluntary contraction (MVC) for 30 min. Contractions were self-paced and inter-squeeze interval was about 7 s. During the repetitive contractions, the area under the curve of the RP almost doubled at electrode Cz and increased fourfold at electrodes C3' and C4'. The onset of negativity moved forward from 1.5 to 1.9 s before force onset at Cz and from 1.0 to 1.6 s and 1.7 s before force onset at C3' and C4', respectively. EMG amplitude and median frequency did not change significantly and MVC after the fatiguing exercise was 93% of MVC before, indicating relatively little physiological fatigue. The increase of the RP during the repetitive contractions is clearly in excess of the almost absent signs of peripheral fatigue. Because the increase of the RP does not lead to an increased force production, we propose that it is a central adaptation counteracting the decrease of cortical efficiency during repetitive contractions.

Electrophysiological evidence for cortical plasticity with movement repetition

The role of movement repetition and practice has been extensively studied as an aspect of motor skill learning but has rarely been investigated in its own right. As practice is considered a prerequisite for motor learning we expected that even the repetitive execution of a simple movement would rapidly induce changes in neural activations without changing performance. We used 64-channel event-related potential mapping to investigate these effects of movement repetition on corresponding brain activity in humans. Ten healthy right-handed young adults performed a power grip task under visual force control to ensure constant behaviour during the experimental session. The session consisted of two parts intersected by a break. For analysis each part was subdivided into two runs to control for potential attention or fatigue effects, which would be expected to disappear during the break. Microstate analysis revealed that distinct topographies and source configurations during movement preparation, movement execution and feedback integration are responsive to repetition. The observed patterns of changes differed for the three microstates, suggesting that different, repetition-sensitive neural mechanisms are involved. Moreover, this study clearly confirms that movement repetition, in the absence of skill learning, is capable of inducing changes in neural networks.

Fatigue in a simple repetitive motor task: a combined electrophysiological and neuropsychological study

Fatigue is one of the most common psychophysiological symptoms that interact with the control mechanisms regulating task behaviour. The cortical processes involved in preparation and feedback control of voluntary movement are associated with EEG activity time-locked to movement onset: a pre-movement Movement-Related Cortical Potential (MRCP) is followed by a post-movement potential (PMP). The aim of this study was to determine whether changes in subjective fatigue which arise in the course of a simple repetitive motor task affect cortical information processing as measured by MRCPs or PMPs. MRCPs/PMPs were recorded in 33 healthy subjects while they made 100 self-paced unilateral button presses with their left or right index finger, and then continued with the other index finger for another 100 movements. Before and after the motor tasks, subjective fatigue was assessed via questionnaire. (1) Subjects who reported a higher increase of fatigue when they had finished the motor tasks showed smaller (more negative) amplitudes of the PMP. (2) This increase of negativity was strongest during the initial part of the tasks. (3) Physical aspects of perceived fatigue had a stronger effect on PMP amplitude than cognitive aspects. Smaller amplitudes of the PMP in more fatigued subjects might be explained by reduced attention to somatosensory feedback. Adaptation of this effect may result from more automatic performance at later stages of the task when all subjects required a lower degree of attentional control. In conjunction with previous studies, effects of fatigue could be separated from habituation.

Brain electrocortical activity during and after exercise: A quantitative synthesis

Investigators of brain electrocortical responses to exercise have interpreted increased activity, or frontal hemispheric asymmetry, in the alpha frequency band as indicative of relaxation or a change in affect. However, few studies compared alpha activity with other frequencies and within or across hemispheres. To clarify the cumulative evidence in this area, we provide a quantitative review of the effects of exercise on brain electrocortical activity according to frequency bands and recording sites. Fifty-eight effects from 18 studies and 282 participants were retrieved. The mean effect size was moderately large (0.54 SD, 95% CI: 0.43 to 0.65) but heterogeneous. Compared to before exercise, alpha activity was greater immediately after and during exercise when expressed as absolute power but not as relative to power in other frequency bands; delta, theta, and beta activity also increased (0.38 to 0.75 SD). Effects did not differ significantly by recording sites. The cumulative evidence does not indicate that change in brain electrocortical activity after exercise is specific to alpha activity or hemispheric site.

Fatigue in Multiple Sclerosis Is Associated with Abnormal Cortical Activation to Voluntary Movement—EEG Evidence

Converging evidence is consistent with the view that fatigue in Multiple Sclerosis is independent from pyramidal tract involvement, suggesting a possible involvement of frontal areas. During voluntary movement, changes of the EEG rhythms can be observed over sensorimotor areas. Event-related desynchronization (ERD) of the 10 and 20 Hz frequency bands occurs during motor planning and execution and is followed after movement termination by event-related synchronization (ERS), expressing cortical idling or inhibition. We evaluated the pattern of cortical activation to voluntary movement in MS patients complaining of fatigue assessed using the Fatigue Severity Scale. Fifteen MS patients complaining of fatigue, 18 MS patients without fatigue, and 14 normal controls were studied. The two patients groups were similar for age, sex, disease duration, and were not disabled (score <1.5 at the Expanded Disability Status Scale). Twenty-nine channel EEG was recorded during about 60 self-paced extensions of the right thumb. The onset latency and amount of the contralateral sensorimotor (C3 electrode) 10 and 18--22 Hz ERD were similar in the three groups. ERD was more widespread anteriorly in the fatigue group compared with normal controls (P < 0.01 over Fz electrode). Postmovement contralateral sensorimotor 18--22 Hz ERS was significantly lower in fatigue MS patients compared with normal subjects (P < 0.005) and with nonfatigue MS patients (P = 0.02). These findings are consistent with a central origin of fatigue in MS and indicate cortical dysfunction even during a simple motor task, resulting in hyperactivity during movement execution and failure of the inhibitory mechanisms intervening after movement termination.

Movement-related cortical potentials associated with progressive muscle fatigue in a grasping task

OBJECTIVE

The present research was aimed to further address the general empirical question regarding the behavioral and neurophysiological indices and mechanisms that contribute to and/or compensate for muscle fatigue. In particular, we examined isometric force production, EMG, and EEG correlates of progressive muscle fatigue while subjects performed a grasping task.

METHODS

Six neurologically healthy subjects were instructed to produce and maintain 70% of maximum voluntary contraction (MVC) for a total of 5 s in a sequence of 120 trials using a specially designed grip dynamometer. Three components of movement-related potentials (Bereitschaftspotential, BP, Motor potential, MP, and Movement-monitoring potential, MMP) were extracted from continuous EEG records and analyzed with reference to behavioral indicators of muscle fatigue.

RESULTS

Experimental manipulations induced muscle fatigue that was demonstrated by decreases in both MVC values and mean force levels produced concomitant to increases in EMG root mean square (RMS) amplitude with respect to baseline levels, and EMG slope. EEG data revealed a significant increase in MP amplitude at precentral (Cz and FCz) and contralateral (C3) electrode sites, and increases in BP amplitude at precentral (Cz and FCz) electrode sites.

CONCLUSIONS

The increases in EMG amplitude, EMG slope, and MP amplitudes suggest a possible link between the control signal originating in the motor cortex and activity level of the alpha-motoneuron pool as a function of progressive muscle fatigue. Overall, the data demonstrate that progressive muscle fatigue induced a systematic increase in the electrocortical activation over the supplementary motor and contralateral sensorimotor areas as reflected in the amplitude of movement-related EEG potentials.

Slow brain potentials in a visual monitoring task

The purpose of this study was to analyse slow brain potentials (SPs) during visual monitoring, needed to perform the clock-monitoring task (CMT). This task was successfully applied in behavioural studies, in which attention capabilities were investigated in dependence on individual factors. Clearly pronounced preparatory SPs were observed during the CMT reflecting a high level of preparation and attention, necessary for achieving high performance accuracy. The well-known influence of task repetition on SPs and the relation between SP and behaviour were confirmed. The practicability of the CMT, the clear and easily detectable SP components and the sensitivity of the present approach makes it recommendable for further applications, e.g. for the evaluation of the effects of occupational/environmental exposures on processes of information processing.

Differential effects of two motor tasks on ERPs in an auditory classification task: evidence of shared cognitive resources

The aim of the study was to assess cognitive demands and fatigue during the execution of two different motor tasks. Event-related brain potentials (ERPs) were recorded from 15 healthy subjects while they concurrently performed, (1) one of two motor tasks, and (2) a three stimulus (70% standard tones, 15% target tones, 15% novel stimuli) auditory classification task. Both motor tasks required the externally paced adduction of the right thumb with the force task requiring a precise movement (feedback given) with about 50% of maximum force output (6 s on task, 4 s rest) while the displacement task required the same precise movement with only minimal force requirements. In separate sessions, both tasks were performed for about an hour with the subjects concurrently paying attention to the auditory task with button presses required for the target stimuli. This provided a dual task situation with trade-offs in P3b amplitude as a function of difficulty of the primary (motor) task. The P3b to the auditory target stimuli was reduced during the force session compared to the displacement session, indicating that the force-task placed a higher demand on cognitive resources. No differential effect of fatigue (time on task) could be ascertained over six consecutive parts of the session. The P3a component, a putative correlate of orienting of attention, showed a rapid attenuation over time but, attesting to its automatic nature, no effect of concurrent motor task. ERP components recorded timelocked to the movements showed a marked difference between the two tasks with the displacement task giving rise to higher amplitudes. Moreover, only for the force task an influence of time on task (fatigue) on the MP was found. The dual task methodology is a potentially useful tool to disentangle cognitive and motor components of central fatigue.

Focal depression of cortical excitability induced by fatiguing muscle contraction: a transcranial magnetic stimulation study

Motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (TES) of the motor cortex were recorded in separate sessions to assess changes in motor cortex excitability after a fatiguing isometric maximal voluntary contraction (MVC) of the right ankle dorsal flexor muscles. Five healthy male subjects, aged 37.4 +/- 4.2 years (mean +/- SE), were seated in a chair equipped with a load cell to measure dorsiflexion force. TMS or TES was delivered over the scalp vertex before and after a fatiguing MVC, which was maintained until force decreased by 50%. MEPs were recorded by surface electrodes placed over quadriceps, hamstrings, tibialis anterior (TA), and soleus muscles bilaterally. M-waves were elicited from the exercised TA by supramaximal electrical stimulation of the peroneal nerve. H-reflex and MVC recovery after fatiguing, sustained MVC were also studied independently in additional sessions. TMS-induced MEPs were significantly reduced for 20 min following MVC, but only in the exercised TA muscle. Comparing TMS and TES mean MEP amplitudes, we found that, over the first 5 min following the fatiguing MVC, they were decreased by about 55% for each. M-wave responses were unchanged. H-reflex amplitude and MVC force recovered within the 1st min following the fatiguing MVC. When neuromuscular fatigue was induced by tetanic motor point stimulation of the TA, TMS-induced MEP amplitudes remained unchanged. These findings suggest that the observed decrease in MEP amplitude represents a focal reduction of cortical excitability following a fatiguing motor task and may be caused by intracortical and/or subcortical inhibitory mechanisms.

Behaviour of short and long latency reflexes in fatigued human muscles

1. The human abductor pollicis brevis (APB) and first dorsal interosseus (FDI) were fatigued by sustained maximal voluntary contractions and, in the case of the APB also by electrically induced (30 Hz) contractions, until the loss of force reached 50% of control. The short latency or Hoffmann reflex (H reflex) and the long latency reflex (LLR) were evoked during weak voluntary contractions by the electrical stimulation of the median nerve at the wrist in control, during and after the fatigue experiments. 2. As compared to control, the normalized H reflex amplitude in the two fatigue modalities was found to have decreased by 30% without any significant change in the LLR. This finding and the observation that the LLR was enhanced by 46% in simultaneous recordings, in which the APB remained at rest during FDI fatigue, could be explained by a stronger descending fatigue-induced central drive which spreads to neighbouring non-fatigued muscles. 3. A comparison of the H reflex and the LLR behaviour during fatigue indicates that motoneurone activation threshold is not affected but that changes in peripheral drive are present, which possibly induce presynaptic inhibition of Ia afferents and/or inhibition of interneurones in the oligosynaptic pathways. Our observation of a rather slow time course for the H reflex decrease during fatigue supports the point of view that these inhibitions are activated by metabolic and/or chemical changes in the fatigued muscle. 4. It is concluded from the results of this study that muscle fatigue induces an enhanced descending supraspinal drive which compensates for a loss of excitation from the peripheral afferents on motoneurones.

Multistable visual perception induces a slow positive EEG wave

Seven subjects observed a multistable pattern (stroboscopic alternative motion: SAM), and were instructed to press the button immediately after perceptual switching with the aim of detecting some neurophysiological parameters of EEG activity. Our results indicate that the EEG changes observed during multistable perception are similar to the family of event related potentials which we called perceptual switching related positivity. Furthermore, the frequency component of this potential has a similarity to the frequency content of stimulus locked P300.

Co-activation of ipsi- and contralateral muscle groups during contraction of ankle dorsiflexors

Seventeen adult, healthy subjects, age 38.4 +/- 0.24 years (mean +/- SEM) 7 of which were females, were studied. Each subject was seated on a specially designed chair with trunk and legs fixed and the foot strapped to a rigid plate that was attached to a load cell. The position of the strap was adjusted so as to lie across the foot at the level of the metatarsal bones. The knee and ankle joints were adjusted to 90 degrees. To record EMG activity, pairs of surface electrodes were placed over the belly of both the right and left tibialis anterior, quadriceps, hamstring and contralateral triceps surae muscles. Two experimental paradigms were used, A and B. In A the subject was asked to sustain maximum voluntary contraction (MVC) of the ankle dorsiflexors until the force decreased to 50% of the initial value; in B the subject was asked to carry out contractions of the ankle dorsiflexors for 6 seconds followed by 4 sec relaxation periods. The initial contraction was 20% of MVC followed by 40, 60, 80 and 100% of MVC which represented one cycle. The subject was asked to repeat this cycle 10 times. Voluntary contraction of ankle dorsiflexors was regularly accompanied by activation of other muscles, usually first in the same leg, later in the contralateral leg during MVC of ankle dorsiflexors. When intermittent contractions with step wise increments of force developed by the ankle dorsiflexors were carried out, co-activation of ipsilateral and contralateral muscle groups occurred before the force of the contracting muscles decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

The Bereitschaftspotential in preparation to mental activities

Earlier studies had investigated the Bereitschaftspotential (Bp) under different aspects of muscular activities. The present experiments were designed to test whether the Bp will be affected by the degree of mental load while motor activity is kept constant. Fourteen healthy male subjects had to solve arithmetical tasks under a graduated time pressure (3 categories of tasks). The subjects had to indicate by pressing one of three keys (trigger), which category of task they wanted to solve next. As soon as a key had been pressed, a task appeared on the computer display and disappeared after the time interval corresponding to the selected category. The results had to be entered into a computer via a keyboard. The EEG signals (5 s time constant, 15 Hz upper frequency cut-off) were averaged time-locked to the movement onset, starting 1.5 s before the pressing of the key. Trials with artefacts were rejected from averaging. The Bp was found to be significantly higher when the tasks were to be solved under higher time pressure. We assume that this might be rather an expression of an appropriate self-activation for the expected mental task than due to a different motor preparation.