Lackmy-Vallée A, Klomjai W, Bussel B, Katz R, Roche N. Anodal transcranial direct current stimulation of the motor cortex induces opposite modulation of reciprocal inhibition in wrist extensor and flexor. J Neurophysiol 112: 1505-1515, 2014. First published June 11, 2014 doi:10.1152/jn.00249.2013.-Transcranial direct current stimulation (tDCS) is used as a noninvasive tool to modulate brain excitability in humans. Recently, several studies have demonstrated that tDCS applied over the motor cortex also modulates spinal neural network excitability and therefore can be used to explore the corticospinal control acting on spinal neurons. Previously, we showed that reciprocal inhibition directed to wrist flexor motoneurons is enhanced during contralateral anodal tDCS, but it is likely that the corticospinal control acting on spinal networks controlling wrist flexors and extensors is not similar. The primary aim of the study was to explore the effects of anodal tDCS on reciprocal inhibition directed to wrist extensor motoneurons. To further examine the supraspinal control acting on the reciprocal inhibition between wrist flexors and extensors, we also explored the effects of the tDCS applied to the ipsilateral hand motor area. In healthy volunteers, we tested the effects induced by sham and anodal tDCS on reciprocal inhibition pathways innervating wrist muscles. Reciprocal inhibition directed from flexor to extensor muscles and the reverse situation, i.e., reciprocal inhibition, directed from extensors to flexors were studied in parallel with the H reflex technique. Our main finding was that contralateral anodal tDCS induces opposing effects on reciprocal inhibition: it decreases reciprocal inhibition directed from flexors to extensors, but it increases reciprocal inhibition directed from extensors to flexors. The functional result of these opposite effects on reciprocal inhibition seems to favor wrist extension excitability, suggesting an asymmetric descending control onto the interneurons that mediate reciprocal inhibition. motor cortex; human; spinal cord THE CONTROL OF NEURAL TRANSMISSION in pathways mediating reciprocal inhibition in antagonist muscles has continued to raise questions ever since Sherrington (1906), who first introduced the concept of reciprocal innervation. Intracellular recordings in cat spinal cord reveal a striking similarity in the descending and segmental convergence on agonist ␣-motoneurons and Ia inhibitory interneurons of the antagonist ␣-motoneurons (Hultborn 1976;Lundberg 1970). Lundberg (1970) proposed that these connections from the brain to corresponding ␣-motoneurons and Ia interneurons were also used in parallel during voluntary movement in order to achieve a coordinated contraction and relaxation of the antagonist muscles. Consistent with animal data, it has been shown in humans that pathways mediating reciprocal inhibition in flexor and extensor motoneurons are disynaptic, and that motoneurons and inhibitory interneurons have received similar segmental and descending control (Cav...