No relation between afferent facilitation induced by digital nerve stimulation and the latency of cutaneomuscular reflexes and somatosensory evoked magnetic fields

Cutaneous information processing differs with load type during isometric finger abduction

During submaximal isometric contraction, there are two different load types: maintenance of a constant limb angle while supporting an inertial load (position task) and maintenance of a constant force by pushing against a rigid restraint (force task). Previous studies demonstrated that performing the position task requires more proprioceptive information. The purpose of this study was to investigate whether there would be a difference in cutaneous information processing between the position and force tasks by assessing the gating effect, which is reduction of amplitude of somatosensory evoked potentials (SEPs), and cutaneomuscular reflex (CMR). Eighteen healthy adults participated in this study. They contracted their right first dorsal interosseous muscle by abducting their index finger to produce a constant force against a rigid restraint that was 20% maximum voluntary contraction (force task), or to maintain a target position corresponding to 10° abduction of the metacarpophalangeal joint while supporting a load equivalent to 20% maximum voluntary contraction (position task). During each task, electrical stimulation was applied to the digital nerves of the right index finger, and SEPs and CMR were recorded from C3' of the International 10-20 system and the right first dorsal interosseous muscle, respectively. Reduction of the amplitude of N33 component of SEPs was significantly larger during the force than position task. In addition, the E2 amplitude of CMR was significantly greater for the force than position task. These findings suggest that cutaneous information processing differs with load type during static muscle contraction.

Clinical neurophysiology of Parkinson's disease and parkinsonism

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This review is part of the series on the clinical neurophysiology of movement disorders and focuses on Parkinson’s disease and parkinsonism.

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The pathophysiology of cardinal parkinsonian motor symptoms and myoclonus are reviewed.

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The recordings from microelectrode and deep brain stimulation electrodes are reported in detail.

This review is part of the series on the clinical neurophysiology of movement disorders. It focuses on Parkinson’s disease and parkinsonism. The topics covered include the pathophysiology of tremor, rigidity and bradykinesia, balance and gait disturbance and myoclonus in Parkinson’s disease. The use of electroencephalography, electromyography, long latency reflexes, cutaneous silent period, studies of cortical excitability with single and paired transcranial magnetic stimulation, studies of plasticity, intraoperative microelectrode recordings and recording of local field potentials from deep brain stimulation, and electrocorticography are also reviewed. In addition to advancing knowledge of pathophysiology, neurophysiological studies can be useful in refining the diagnosis, localization of surgical targets, and help to develop novel therapies for Parkinson’s disease.

The Number or Type of Stimuli Used for Somatosensory Stimulation Affected the Modulation of Corticospinal Excitability

Motor evoked potentials (MEPs) evoked by transcranial magnetic stimulation (TMS) a few milliseconds after this cortical activity following electrical stimulation (ES) result in an inhibition comparable to that by TMS alone; this is called short-latency afferent inhibition (SAI). Cortical activity is observed after mechanical tactile stimulation (MS) and is affected by the number of stimuli by ES. We determined the effects of somatosensory stimulus methods and multiple conditioning stimuli on SAI in 19 participants. In experiment 1, the interstimulus intervals between the conditioning stimulation and TMS were 25, 27 and 29 ms for ES and 28, 30 and 32 ms for MS. In experiment 2, we used 1, 2, 3 and 4 conditioning stimulations of ES and MS. The interstimulus interval between the ES or MS and TMS was 27 or 30 ms, respectively. In experiment 1, MEPs were significantly decreased in both the ES and MS conditions. In experiment 2, MEPs after ES were significantly decreased in all conditions. Conversely, MEPs after MS were significantly decreased after one stimulus and increased after four stimulations, indicating the SAI according to the number of stimuli. Therefore, the somatosensory stimulus methods and multiple conditioning stimuli affected the SAI.

Statistical Inter-stimulus Interval Window Estimation for Transient Neuromodulation via Paired Mechanical and Brain Stimulation

For achieving motor recovery in individuals with sensorimotor deficits, augmented activation of the appropriate sensorimotor system, and facilitated induction of neural plasticity are essential. An emerging procedure that combines peripheral nerve stimulation and its associative stimulation with central brain stimulation is known to enhance the excitability of the motor cortex. In order to effectively apply this paired stimulation technique, timing between central and peripheral stimuli must be individually adjusted. There is a small range of effective timings between two stimuli, or the inter-stimulus interval window (ISI-W). Properties of ISI-W from neuromodulation in response to mechanical stimulation (Mstim) of muscles have been understudied because of the absence of a versatile and reliable mechanical stimulator. This paper adopted a combination of transcranial magnetic stimulation (TMS) and Mstim by using a high-precision robotic mechanical stimulator. A pneumatically operated robotic tendon tapping device was applied. A low-friction linear cylinder achieved high stimulation precision in time and low electromagnetic artifacts in physiological measurements. This paper describes a procedure to effectively estimate an individual ISI-W from the transiently enhanced motor evoked potential (MEP) with a reduced number of paired Mstim and sub-threshold TMS trials by applying statistical sampling and regression technique. This paper applied a total of four parametric and non-parametric statistical regression methods for ISI-W estimation. The developed procedure helps to reduce time for individually adjusting effective ISI, reducing physical burden on the subject.

Cortical excitability following passive movement

In brain injury rehabilitation, passive movement exercises are frequently used to maintain or improve mobility and range of motion. They can also induce beneficial and sustained neuroplastic changes. Neuroimaging studies have revealed that passive movements without motor commands activate not only the primary somatosensory cortex but also the primary motor cortex, supplementary motor area, and posterior parietal cortex as well as the secondary somatosensory cortex (S2) in healthy subjects. Repetitive passive movement has also been reported to induce increases or decreases in cortical excitability. In this review, we focused on the following: cortical activity following passive movement; cortical excitability during passive movement; and changes in cortical excitability after repetitive passive movement.

Somatosensory Inputs Induced by Passive Movement Facilitate Primary Motor Cortex Excitability Depending on the Interstimulus Interval, Movement Velocity, and Joint Angle

Somatosensory inputs affect primary motor cortex (M1) excitability; however, the effect of movement-induced somatosensory inputs on M1 excitability is unknown. This study examined whether M1 excitability is modulated by somatosensory inputs with passive movement in 29 healthy subjects. Motor-evoked potentials (MEPs), elicited by transcranial magnetic stimulation (TMS) were recorded from the first dorsal interosseous (FDI) muscle (Experiment 1). M- and F-waves were measured from the FDI muscle (Experiment 2). Passive movements of the index finger were performed in the adduction direction. TMS pulses were preceded by starting passive movements with interstimulus intervals (ISIs) of 30, 60, 90, 120, 150, 180, and 210 ms. TMS or electrical stimulation was performed in the midrange of the metacarpophalangeal joint during passive movements. MEPs were significantly facilitated at 90, 120, and 150 ms (p < 0.05). No M- or F-wave changes were observed for any ISI. In addition, we investigated whether MEP changes were dependent on passive movement velocity and joint angle. Passive movement was performed at two movement velocities (Experiment 3) or joint angles (Experiment 4). MEP facilitation was observed depending on the movement velocities or joint angles. These experiments demonstrated that somatosensory inputs induced by passive movements facilitated M1 excitability depending on the ISIs, passive movement velocity, and joint angle.

Modulation of Corticospinal Excitability Depends on the Pattern of Mechanical Tactile Stimulation

We investigated the effects of different patterns of mechanical tactile stimulation (MS) on corticospinal excitability by measuring the motor-evoked potential (MEP). This was a single-blind study that included nineteen healthy subjects. MS was applied for 20 min to the right index finger. MS intervention was defined as simple, lateral, rubbing, vertical, or random. Simple intervention stimulated the entire finger pad at the same time. Lateral intervention stimulated with moving between left and right on the finger pad. Rubbing intervention stimulated with moving the stimulus probe, fixed by protrusion pins. Vertical intervention stimulated with moving in the forward and backward directions on the finger pad. Random intervention stimulated to finger pad with either row protrudes. MEPs were measured in the first dorsal interosseous muscle to transcranial magnetic stimulation of the left motor cortex before, immediately after, and 5–20 min after intervention. Following simple intervention, MEP amplitudes were significantly smaller than preintervention, indicating depression of corticospinal excitability. Following lateral, rubbing, and vertical intervention, MEP amplitudes were significantly larger than preintervention, indicating facilitation of corticospinal excitability. The modulation of corticospinal excitability depends on MS patterns. These results contribute to knowledge regarding the use of MS as a neurorehabilitation tool to neurological disorder.

Effects of cathodal transcranial direct current stimulation to primary somatosensory cortex on short-latency afferent inhibition

The aim of this study was to investigate the effects of cathodal transcranial direct current stimulation (tDCS) applied over the primary somatosensory cortex (S1) on short-interval afferent inhibition (SAI). Thirteen healthy individuals participated in this study. Cathodal tDCS was applied for 15 min at 1 mA over the left S1. Motor-evoked potentials (MEPs) were measured from the right first dorsal interosseous muscle in response to transcranial magnetic stimulation (TMS) of the left motor cortex before tDCS (pre), immediately after tDCS (immediately), and 15 min after tDCS (post-15 min). SAI was evaluated by measuring MEPs in response to TMS pulses applied 40 ms after peripheral electrical stimulation of the index finger. For each measurement period (pre, immediately, and post-15 min), MEP amplitude was significantly smaller when TMS followed index finger stimulation (SAI condition) than when TMS was delivered alone (single TMS) (P<0.01), indicating expression of SAI. The MEP ratio (MEP of SAI/MEP of single TMS) at post-15 min was significantly larger than that of pre (P<0.05), indicating suppression of SAI. However, no significant difference was observed between pre and immediately, and immediately and post-15 min. These results suggest that cathodal tDCS applied over the S1 causes a decrease in S1 excitability following peripheral electrical stimulation and cathodal tDCS applied over the S1 decreased the inhibitory effects of SAI.