Intra and inter-session reliability of rapid Transcranial Magnetic Stimulation stimulus-response curves of tibialis anterior muscle in healthy older adults

Peri, Elisabetta; Ambrosini, Emilia; Colombo, Vera; Ruit, Mark van de; Grey, Michael J.; Monticone, Marco; Ferriero, Giorgio; Pedrocchi, Alessandra; Ferrigno, Giancarlo; Ferrante, Simona

doi:10.1371/journal.pone.0184828

Cited by 13 publications

(6 citation statements)

References 48 publications

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“…Third, only 24-hour test-retest reliability was investigated in the present study. Therefore, we cannot draw any conclusions about the test-retest reliability within the same session or across larger time spans, which would necessitate another experimental design (Matamala et al, 2018, O’Leary et al, 2015, Pellegrini et al, 2018, Peri et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

Test-retest reliability of intrahemispheric dorsal premotor and primary motor cortex dual-site TMS connectivity measures

Heemels,

Ademi,

Hehl

2024

Preprint

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ObjectiveInvestigating the optimal interstimulus interval (ISI) and the 24-hour test-retest reliability for intrahemispheric dorsal premotor cortex (PMd) – primary motor cortex (M1) connectivity using dual-site transcranial magnetic stimulation (dsTMS).MethodsIn 21 right-handed adults, left intrahemispheric PMd–M1 connectivity has been investigated with a stacked-coil dsTMS setup (conditioning stimulus: 75% of resting motor threshold; test stimulus: eliciting MEPs of 1–1.5 mV) at ISIs of 3, 5–8, and 10 ms. Additionally, M1–M1 short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) were investigated to assess comparability to standard paired-pulse setups.ResultsConditioning PMd led to significant inhibition of M1 output at ISIs of 3 and 5 ms, whereas 10 ms resulted in facilitation (all, p < 0.001), with a fair test-retest reliability for 3 (ICC: 0.47) and 6 ms (ICC: 0.44) ISIs. Replication of SICI (p < 0.001) and ICF (p = 0.017) was successful, with excellent test-retest reliability for SICI (ICC: 0.81).ConclusionThis dsTMS setup can probe the inhibitory and facilitatory PMd–M1 connections, as well as reliably replicate SICI and ICF paradigms.SignificanceThe stacked-coil dsTMS setup for investigating intrahemispheric PMd–M1 connectivity offers promising possibilities to better understand motor control.

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Section: Discussionmentioning

confidence: 99%

Test-retest reliability of intrahemispheric dorsal premotor and primary motor cortex dual-site TMS connectivity measures

Heemels,

Ademi,

Hehl

2024

Preprint

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“…Therefore, for simulated MEPs of higher amplitude, low‐threshold MUs exhibit much lower energy of MUAPs with respect to other MUs in the surface EMG signal (regarded as physiological noise) and thus exhibit lower physiological signal‐to‐noise ratio at higher compared to lower contraction/stimulated levels (Francic & Holobar, 2021 ). The difficulty in identifying low‐threshold MUs in large MEPs notwithstanding, stimulation intensities that elicit MEPs corresponding to the recruitment of the entire motor pool are rare in experimental conditions; for example, even maximal MEP amplitudes do not reach the amplitudes equivalent to the maximal M‐wave (Brouwer & Ashby, 1990 ; Peri et al., 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Decoding firings of a large population of human motor units from high‐density surface electromyogram in response to transcranial magnetic stimulation

Škarabot

Ammann

Balshaw

et al. 2023

The Journal of Physiology

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We describe a novel application of methodology for high‐density surface electromyography (HDsEMG) decomposition to identify motor unit (MU) firings in response to transcranial magnetic stimulation (TMS). The method is based on the MU filter estimation from HDsEMG decomposition with convolution kernel compensation during voluntary isometric contractions and its application to contractions elicited by TMS. First, we simulated synthetic HDsEMG signals during voluntary contractions followed by simulated motor evoked potentials (MEPs) recruiting an increasing proportion of the motor pool. The estimation of MU filters from voluntary contractions and their application to elicited contractions resulted in high (>90%) precision and sensitivity of MU firings during MEPs. Subsequently, we conducted three experiments in humans. From HDsEMG recordings in first dorsal interosseous and tibialis anterior muscles, we demonstrated an increase in the number of identified MUs during MEPs evoked with increasing stimulation intensity, low variability in the MU firing latency and a proportion of MEP energy accounted for by decomposition similar to voluntary contractions. A negative relationship between the MU recruitment threshold and the number of identified MU firings was exhibited during the MEP recruitment curve, suggesting orderly MU recruitment. During isometric dorsiflexion we also showed a negative association between voluntary MU firing rate and the number of firings of the identified MUs during MEPs, suggesting a decrease in the probability of MU firing during MEPs with increased background MU firing rate. We demonstrate accurate identification of a large population of MU firings in a broad recruitment range in response to TMS via non‐invasive HDsEMG recordings. Key points Transcranial magnetic stimulation (TMS) of the scalp produces multiple descending volleys, exciting motor pools in a diffuse manner. The characteristics of a motor pool response to TMS have been previously investigated with intramuscular electromyography (EMG), but this is limited in its capacity to detect many motor units (MUs) that constitute a motor evoked potential (MEP) in response to TMS. By simulating synthetic signals with known MU firing patterns, and recording high‐density EMG signals from two human muscles, we show the feasibility of identifying firings of many MUs that comprise a MEP. We demonstrate the identification of firings of a large population of MUs in the broad recruitment range, up to maximal MEP amplitude, with fewer required stimuli compared to intramuscular EMG recordings. The methodology demonstrates an emerging possibility to study responses to TMS on a level of individual MUs in a non‐invasive manner.

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“…Although SR curves have been regarded as a relatively stable characteristic of the corticospinal projections and a reliable measure of corticospinal excitability, they have only been extensively characterized for the distal muscles of the limbs. Some studies that examined the reliability of the SR curves in the proximal muscles of the upper extremity suggest they are less reliable ( 46 , 64 ) compared to measures obtained in intrinsic hand muscles ( 41 , 44 ) and tibialis anterior ( 65 ). Perhaps, there could be inherent differences in the input-output properties of corticospinal projections between muscles designed for a greater level of dexterity compared to those used for postural stability.…”

Section: Discussionmentioning

confidence: 99%

Effects of motor stimulation of the tibial nerve on corticospinal excitability of abductor hallucis and pelvic floor muscles

Eginyan

Zhou

Williams

et al. 2023

Front. Rehabil. Sci.

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IntroductionPeripheral nerve stimulation can modulate the excitability of corticospinal pathways of muscles in the upper and lower limbs. Further, the pattern of peripheral nerve stimulation (continuous vs. intermittent) may be an important factor determining the modulation of this corticospinal excitability. The pelvic floor muscles (PFM) are crucial for maintaining urinary continence in humans, and share spinal segmental innervation with the tibial nerve. We explored the idea of whether the neuromodulatory effects of tibial nerve stimulation (TibNS) could induce effects on somatic pathways to the PFM. We evaluated the effects of two patterns of stimulation (intermittent vs. continuous) on corticospinal excitability of the PFM compared to its effect on the abductor hallucis (AH) muscle (which is directly innervated by the tibial nerve). We hypothesized that intermittent TibNS would increase, while continuous stimulation would decrease, the excitability of both AH and PFM.MethodsTwenty able-bodied adults (20-33 years of age) enrolled in this study. TibNS was delivered either intermittently (1 ms pulses delivered at 30Hz with an on:off duty cycle of 600:400 ms, for 60 min), or continuously (1 ms pulses delivered at 30Hz for 36 min) just above the motor threshold of the AH. We randomized the order of the stimulation pattern and tested them on separate days. We used surface electromyography (EMG) to record motor-evoked responses (MEP) in the PFM and AH following transcranial magnetic stimulation (TMS). We generated stimulus-response (SR) curves to quantify the changes in peak-to-peak MEP amplitude relative to TMS intensity to assess changes in corticospinal excitability pre- and post-stimulation.Results and ConclusionWe found that TibNS increased corticospinal excitability only to AH, with no effects in PFM. There was no difference in responses to continuous vs. intermittent stimulation. Our results indicate a lack of effect of TibNS on descending somatic pathways to the PFM, but further investigation is required to explore other stimulation parameters and whether neuromodulatory effects may be spinal in origin.

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Intra and inter-session reliability of rapid Transcranial Magnetic Stimulation stimulus-response curves of tibialis anterior muscle in healthy older adults

Cited by 13 publications

References 48 publications

Test-retest reliability of intrahemispheric dorsal premotor and primary motor cortex dual-site TMS connectivity measures

Test-retest reliability of intrahemispheric dorsal premotor and primary motor cortex dual-site TMS connectivity measures

Decoding firings of a large population of human motor units from high‐density surface electromyogram in response to transcranial magnetic stimulation

Effects of motor stimulation of the tibial nerve on corticospinal excitability of abductor hallucis and pelvic floor muscles

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