Paired associative stimulation (PAS) induces changes in the excitability of human sensorimotor cortex that outlast the procedure. PAS typically involves repeatedly pairing stimulation of a peripheral nerve that innervates an intrinsic hand muscle, with transcranial magnetic stimulation (TMS) over the representation of that muscle in the primary motor cortex. Depending on the timing of the stimuli, PAS leads to either an increase (PAS25) or decrease (PAS10) in excitability. Both protocols, however, have been associated with an increase in excitability of nearby muscle representations not specifically targeted by PAS. Based on these spill-over effects, we hypothesized that an additive, excitability-enhancing effect on PAS25 applied to one muscle representation may be produced by simultaneously applying PAS(25 or 10) to a nearby representation. In different experiments prototypical PAS25 targeting the left thumb representation (abductor pollicis brevis; APB) was combined with either PAS25 or PAS10 applied to the left little finger representation (abductor digiti minimi; ADM) or, in a control experiment, with PAS10 also targeting the APB. In an additional control experiment PAS10 targeted both representations. The plasticity effects were quantified by measuring the amplitude of motor evoked potentials (MEPs) recorded before and after PAS. As expected, prototypical PAS25 was associated with an increase in MEP amplitude in the APB muscle. This effect was enhanced when PAS also targeted the ADM representation, but only when a different inter-stimulus timing (PAS10) was used. These results suggest that PAS-induced plasticity is modified by concurrently targeting separate motor cortical representations with excitatory and inhibitory protocols.
- paired associative stimulation
- transcranial magnetic stimulation
- motor cortex
- motor evoked potential
- Copyright © 2015, Journal of Neurophysiology