Skip to main content
Log in

Distinct changes in cortical and spinal excitability following high-frequency repetitive TMS to the human motor cortex

  • Research Article
  • Published:
Experimental Brain Research Aims and scope Submit manuscript

Abstract

It has been shown that high-frequency repetitive transcranial magnetic stimulation (rTMS) to the human primary motor hand area (M1-HAND) can induce a lasting increase in corticospinal excitability. Here we recorded motor evoked potentials (MEPs) from the right first dorsal interosseus muscle to investigate how sub-threshold high-frequency rTMS to the M1-HAND modulates cortical and spinal excitability. In a first experiment, we gave 1500 stimuli of 5 Hz rTMS. At an intensity of 90% of active motor threshold, rTMS produced no effect on MEP amplitude at rest. Increasing the intensity to 90% of resting motor threshold (RMT), rTMS produced an increase in MEP amplitude. This facilitatory effect gradually built up during the course of rTMS, reaching significance after the administration of 900 stimuli. In a second experiment, MEPs were elicited during tonic contraction using weak anodal electrical or magnetic test stimuli. 1500 (but not 600) conditioning stimuli at 90% of RMT induced a facilitation of MEPs in the contracting FDI muscle. In a third experiment, 600 conditioning stimuli were given at 90% of RMT to the M1-HAND. Using two well-established conditioning-test paradigms, we found a decrease in short-latency intracortical inhibition (SICI), and a facilitation of the first peak of facilitatory I-waves interaction (SICF). There was no correlation between the relative changes in SICI and SICF. These results demonstrate that subthreshold 5 Hz rTMS can induce lasting changes in specific neuronal subpopulations in the human corticospinal motor system, depending on the intensity and duration of rTMS. Short 5 Hz rTMS (600 stimuli) at 90% of RMT can selectively shape the excitability of distinct intracortical circuits, whereas prolonged 5 Hz rTMS (≥900 stimuli) provokes an overall increase in excitability of the corticospinal output system, including spinal motoneurones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1A–C
Fig. 2A, B
Fig. 3
Fig. 4A, B
Fig. 5A–C

Similar content being viewed by others

References

  • Chen R, Classen J, Gerloff G, Celnik P, Wassermann EM, Hallett M, Cohen LG (1997) Depression of motor cortex excitability by low frequency transcranial magnetic stimulation. Neurology 48:1398–1403

    CAS  PubMed  Google Scholar 

  • Day BL, Dressler D, Maertens de Noordhout A, Marsden CD, Nakashima K, Rothwell JC, Thompson PD (1989) Electric and magnetic stimulation of human motor cortex: surface EMG and single motor unit responses. J Physiol 412:449–473

    CAS  PubMed  Google Scholar 

  • Di Lazzaro V, Oliviero A, Profice P, Saturno E, Pilato F, Insola A, Mazzone P, Tonali P, Rothwell JC (1998) Comparison of descending volleys evoked by transcranial magnetic and electric stimulation in conscious humans. Electroen Clin Neuro 109:397–401

    Article  Google Scholar 

  • Di Lazzaro V, Oliviero A, Profice P, Insola A, Mazzone P, Tonali P, Rothwell JC (1999) Direct recordings of descending volleys after transcranial magnetic and electric motor cortex stimulation in conscious humans. Electroen Clin Neuro Suppl 51:120–126

    Google Scholar 

  • Di Lazzaro V, Oliviero A, Mazzone P, Pilato F, Saturno E, Dileone M, Insola A, Tonali PA, Rothwell JC (2002) Short-term reduction of intracortical inhibition in the human motor cortex induced by repetitive transcranial magnetic stimulation. Exp Brain Res 147:108–113

    Article  PubMed  Google Scholar 

  • Fitzgerald PB, Brown TL, Daskalakis ZJ, Chen R, Kulkarni J (2002) Intensity-dependent effects of 1 Hz rTMS on human corticospinal excitability. Clin Neurophysiol 113:1136–1141

    Article  PubMed  Google Scholar 

  • Gangitano M, Valero-Cabre A, Tormos JM, Mottaghy FM, Romero JR, Pascual-Leone A (2002) Modulation of input-output curves by low and high frequency repetitive transcranial magnetic stimulation of the motor cortex. Clin Neurophysiol 113:1249–1257

    Article  PubMed  Google Scholar 

  • Gerschlager W, Siebner HR, Rothwell JC (2001) Decreased corticospinal excitability after subthreshold 1 Hz rTMS over lateral premotor cortex. Neurology 57:379–380

    PubMed  Google Scholar 

  • Hallett M (2000) Transcranial magnetic stimulation and the human brain. Nature 6792:147–150

    Article  Google Scholar 

  • Kujirai T, Caramia MD, Rothwell JC, Day BL, Thompson PD, Ferbert A, Wroe S, Asselman P, Marsden CD (1993) Corticocortical inhibition in human motor cortex. J Physiol 471:501–519

    CAS  PubMed  Google Scholar 

  • Maeda F, Keenan JP, Tormos JM, Topka H, Pascual-Leone A (2000a) Modulation of corticospinal excitability by repetitive transcranial magnetic stimulation. Clin Neurophysiol 111:800–805

    Article  CAS  PubMed  Google Scholar 

  • Maeda F, Keenan JP, Tormos JM, Topka H, Pascual-Leone A (2000b) Interindividual variability of the modulatory effects of repetitive transcranial magnetic stimulation on cortical excitability. Exp Brain Res 133:425–430

    Article  CAS  PubMed  Google Scholar 

  • Modugno N, Nakamura Y, MacKinnon CD, Filipovic SR, Bestmann S, Berardelli A, Rothwell JC (2001) Motor cortex excitability following short trains of repetitive magnetic stimuli. Exp Brain Res 140:453–459

    Article  CAS  PubMed  Google Scholar 

  • Muellbacher W, Ziemann U, Boroojerdi B, Hallett M (2000) Effects of low-frequency transcranial magnetic stimulation on motor excitability and basic motor behavior. Clin Neurophysiol 111:1002–1007

    Article  CAS  PubMed  Google Scholar 

  • Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9:97–113

    Article  CAS  PubMed  Google Scholar 

  • Pascual-Leone A, Valls-Sole J, Wassermann EM, Hallett M (1994) Responses to rapid-rate transcranial magnetic stimulation of the human motor cortex. Brain 117:847–858

    PubMed  Google Scholar 

  • Pascual-Leone A, Tormos JM, Keenan J, Tarazona F, Canete C, Catala MD (1998) Study and modulation of human cortical excitability with transcranial magnetic stimulation. J Clin Neurophysiol 15:333–343

    Article  CAS  PubMed  Google Scholar 

  • Peinemann A, Lehner C, Mentschel C, Munchau A, Conrad B, Siebner HR (2000) Subthreshold 5-Hz repetitive transcranial magnetic stimulation of the human primary motor cortex reduces intracortical paired-pulse inhibition. Neurosci Lett 296:21–24

    Article  CAS  PubMed  Google Scholar 

  • Peinemann A, Reimer B, Löer C, Quartarone A, Münchau A, Conrad B, Siebner HR (2004) Long-lasting increase in corticospinal excitability after 1800 pulses of subthreshold 5 Hz repetitive TMS to the motor cortex. Clin Neurophysiol 115(7):1519–26

    Article  PubMed  Google Scholar 

  • Rizzo V, Siebner H, Modugno N, Pesenti A, Munchau A, Gerschlager W, Webb RM, Rothwell JC (2004) Shaping the excitability of human motor cortex with premotor rTMS. J Physiol 554:483–495

    Article  CAS  PubMed  Google Scholar 

  • Romero JR, Anschel D, Sparing R, Gangitano M, Pascual-Leone A (2002) Subthreshold low frequency repetitive transcranial magnetic stimulation selectively decreases facilitation in the motor cortex. Clin Neurophysiol 113:101–107

    Article  PubMed  Google Scholar 

  • Rossini PM, Barker AT, Berardelli A, Caramia MD, Caruso G, Cracco RQ, Dimitrijevic MR, Hallett M, Katayama Y, Lucking CH (1994) Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application. Report of an IFCN committee. Electroen Clin Neuro 91:79–92

    Article  CAS  Google Scholar 

  • Rothwell JC (1997) Techniques and mechanisms of action of transcranial stimulation of the human motor cortex. J Neurosci Meth 74:113–122

    Article  CAS  PubMed  Google Scholar 

  • Rothwell JC (1999) Paired-pulse investigations of short-latency intracortical facilitation using TMS in humans. Electroen Clin Neuro Suppl 51:113–119

    CAS  Google Scholar 

  • Rounis E, Siebner HR, et al (2003) The effect of 5 Hz repetitive transcranial magnetic stimulation over the left primary motor hand area on regional blood flow and motor cortex excitability. NeuroImage 19:17822 (available on CD-Rom in Issue 2, Suppl 1)

    Google Scholar 

  • Siebner HR, Rothwell J (2003) Transcranial magnetic stimulation: new insights into representational cortical plasticity. Exp Brain Res 148:1–16

    Google Scholar 

  • Siebner HR, Peller M, Willoch F, Minoshima S, Boecker H, Auer C, Drzezga A, Conrad B, Bartenstein P (2000) Lasting cortical activation after repetitive TMS of the motor cortex: a glucose metabolic study. Neurology 54:956–963

    CAS  PubMed  Google Scholar 

  • Siebner HR, Takano B, Peinemann A, Schwaiger M, Conrad B, Drzezga A (2001) Continuous transcranial magnetic stimulation during positron emission tomography: a suitable tool for imaging regional excitability of the human cortex. NeuroImage 14:883–890

    Article  CAS  PubMed  Google Scholar 

  • Sommer M, Wu T, Tergau F, Paulus W (2002) Intra- and interindividual variability of motor responses to repetitive transcranial magnetic stimulation. Clin Neurophysiol 113:265–269

    Article  CAS  PubMed  Google Scholar 

  • Tokimura H, Ridding MC, Tokimura Y, Amassian VE, Rothwell JC (1996) Short latency facilitation between pairs of threshold magnetic stimuli applied to human motor cortex. Electroen Clin Neuro 101:263–272

    Article  CAS  Google Scholar 

  • Touge T, Gerschlager W, Brown P, Rothwell JC (2001) Are the after effects of low-frequency rTMS on motor cortex excitability due to changes in the efficacy of cortical synapses? Clin Neurophysiol 112:2138–2145

    Article  CAS  PubMed  Google Scholar 

  • Ugawa Y, Rothwell JC, Day BL, Thompson PD, Marsden CD (1991) Percutaneous electrical stimulation of corticospinal pathways at the level of the pyramidal decussation in humans. Ann Neurol 29:418–27

    CAS  PubMed  Google Scholar 

  • Valero-Cabre A, Oliveri M, Gangitano M, Pascual-Leone A (2001) Modulation of spinal cord excitability by subthreshold repetitive transcranial magnetic stimulation of the primary motor cortex in humans. Neuroreport 12:3845–3848

    Article  CAS  PubMed  Google Scholar 

  • Wassermann EM (1998) Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5–7, 1996. Electroen Clin Neuro 108:1–16

    Google Scholar 

  • Wu T, Sommer M, Tergau F, Paulus W (2000) Lasting influence of repetitive transcranial magnetic stimulation on intracortical excitability in human subjects. Neurosci Lett 287:37–40

    Article  CAS  PubMed  Google Scholar 

  • Ziemann U (1999) Intracortical inhibition and facilitation in the conventional paired TMS paradigm. Electroen Clin Neuro Suppl 51:127–136

    CAS  Google Scholar 

  • Ziemann U, Lonnecker S, Steinhoff BJ, Paulus W (1996) Effects of antiepileptic drugs on motor cortex excitability in humans: a transcranial magnetic stimulation study. Ann Neurol 40:367–378

    CAS  PubMed  Google Scholar 

  • Ziemann U, Tergau F, Wassermann EM, Wischer S, Hildebrandt J, Paulus W (1998a) Demonstration of facilitatory I waves interaction in the human motor cortex by paired transcranial magnetic stimulation. J Physiol 511:181–190

    Article  CAS  PubMed  Google Scholar 

  • Ziemann U, Tergau F, Wischer S, Hildebrandt J, Paulus W (1998b) Pharmacological control of facilitatory I-wave interaction in the human motor cortex. A paired transcranial magnetic stimulation study. Electroen Clin Neuro 109:321–330

    Article  CAS  Google Scholar 

Download references

Acknowledgements

H.R. Siebner was supported by the Bundesministerium für Bildung und Forschung (grant 01GO0206) and the Volkswagen Foundation (grant I/79 932).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Angelo Quartarone.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Quartarone, A., Bagnato, S., Rizzo, V. et al. Distinct changes in cortical and spinal excitability following high-frequency repetitive TMS to the human motor cortex. Exp Brain Res 161, 114–124 (2005). https://doi.org/10.1007/s00221-004-2052-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00221-004-2052-5

Keywords

Navigation