Repeated pairing of electrical stimulation of a peripheral nerve with transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) representation for a target muscle can induce neuroplastic adaptations in the human brain related to motor learning. The extent to which the motor state during this form of paired associative stimulation (PAS) influences the degree and mechanisms of neuroplasticity or motor learning is unclear. Here, we investigated the effect of volitional muscle contraction during PAS on: (1) measures of general corticomotor excitability and intracortical circuit excitability; and (2) motor performance and learning. We assessed measures of corticomotor excitability using TMS and motor skill performance during a serial reaction time task (SRTT) at baseline and at 0, 30, 60 min post-PAS. Participants completed a SRTT retention test 1 week following the first two PAS sessions. Following the PAS intervention where the hand muscle maintained an active muscle contraction (PASACTIVE), there was lower short interval intracortical inhibition compared to PAS during a resting motor state (PASREST) and a sham PAS condition (PASCONTROL). SRTT performance improved within the session regardless of PAS condition. SRTT retention was greater following both PASACTIVE and PASREST after 1 week compared to PASCONTROL. These findings suggest that PAS may enhance motor learning retention and that motor state may be used to target different neural mechanisms of intracortical excitation and inhibition during PAS. This observation may be important to consider for the use of therapeutic noninvasive brain stimulation in neurologic patient populations.
This state-of-the-an book on the economics of power system reliability is a timely contribution to the understanding of the tradeoff between the rising unit cost of supplying electricity and the cost imposed on consumers by reduced reliability and power shortages. The simulation methodology used to elucidate the tradeoff starts from the premise that society benefits most from a power system supply that minimizes both the outage cost to consumers and the cost of the system itself. This novel approach goes well beyond the traditional engineering appruach to power system planning, which has considered minimizing the cost of the system alone. The stimulating and controversial aspect of the approach for energy economists is the identification and measmment of consumer outage costs. The author discusses some relevant theory for residential, industrial, and other users in Pan I. and in Pan I1 presents a case study for C w a v e l , Brazil, in which outage costs are estimated through survey methods As with the most empirical applications of any theory, there are a few shortfalls that should be noted. The case study is concerned with evaluating the distribution nehvork only.
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