MEP-independent silent periods in hand muscles elicited by Transcranial Magnetic Stimulation of the ventral premotor cortex: a non-invasive tool to explore premotor negative motor areas

Abstract

ObjectiveWe investigate the possibility to disrupt motor activity via premotor and parietal cortex stimulation, by inducing cortical silent periods (cSPs) in the voluntarily activated upper limb. MethodsWe analyzed data from 17 subjects with normal brain function, using navigated TMS (nTMS) on individual MR anatomies. We applied single-pulse biphasic stimulation at 120% of resting motor threshold (rMT) in blocks of 30 stimulations on each spot of a 10-16 point grid covering the inferior parietal and frontal lobes in the dominant hemisphere while participants performed voluntary submaximal contraction. Electromyography (EMG) was recorded bilaterally from intrinsic hand muscles. ResultsWe observed cSPs not preceded by a MEP in the contralateral hand in 16/17 participants. The maximum overlap, of individual areas where such MEP-independent cSPs could be evoked, corresponded to the ventral precentral gyrus (MNI coordinates: [x=-57, y=7, z=33]). In a subset of stimulus sites, MEP-independent cSPs were bilateral, with contralateral predominance. Canonical short-latency MEPs were observed in all patients, with maximum overlap over the primary motor cortex. We also observed rare contralateral long-latency (> 23 ms) MEP-like responses from peri-Rolandic TMS. ConclusionsMEP-independent cSPs are systematically elicitable in healthy participants They likely reflect interference with premotor representations of ongoing movements. They offer a novel possibility to investigate higher-order motor functions in the experimental and clinical neurosciences.