We examined whether the recruitment properties of the corticospinal pathway to intrinsic hand muscles are influenced by variations of the shoulder joint angle. Abductor digiti minimi (ADM) motor evoked potentials (MEPs) in response to transcranial magnetic stimulation were examined during different static positions of the shoulder joint in the horizontal plane from 30 degrees adduction to 30 degrees abduction with respect to the neutral position at 0 degrees, while elbow and wrist joints were constrained statically at 90 degrees and 180 degrees respectively. We found that 30 degrees abduction of the shoulder significantly depressed MEP size and prolonged MEP latency in comparison with 30 degrees shoulder adduction. The neutral shoulder angle position (at 0 degrees ) significantly reduced MEP size but had no effect on MEP latency in comparison with 30 degrees shoulder abduction. The input-output relationship between MEP size and stimulus intensity was sigmoidal. The plateau value and maximum slope were significantly lower at 30 degrees abduction than at 30 degrees adduction of the shoulder. However, the threshold value did not differ significantly between the two positions. To differentiate excitability changes at cortical versus subcortical sites, intracortical inhibition (ICI) and intracortical facilitation (ICF) were assessed using a paired-magnetic pulse paradigm. A significant decrease in ICF was observed after changing shoulder position from 30 degrees adduction to 30 degrees abduction. In contrast, no variation in the amount of ICI occurred in relation to the same changes in shoulder position. ADM F-waves elicited by electrical stimulation of the ulnar nerve at the wrist were significantly decreased at 30 degrees shoulder abduction in comparison with 30 degrees adduction. A similar pattern was observed in one subject in whom the H-reflex could be exceptionally elicited in ADM. We conclude that shoulder position influences the recruitment efficiency (gain) of the corticospinal volleys to motoneurons of intrinsic hand muscles. It is proposed that activity of peripheral receptors signalling static shoulder position influences corticomotor excitability of hand muscles both at the cortical and at the spinal level. This modulation may be functionally relevant when reaching to grasp objects.
The systemic injection of L-Acetylcarnitine (L-Ac) induces a reversible increase in recurrent inhibition. In addition, L-Ac potentiation of recurrent inhibition has been found to increase the synchronous activity of single motor units, as detected by traditional linear analysis in the time domain. This result has been recently confirmed using a nonlinear method based on the analysis of embedded determinism (%DET) extracted from the surface EMG. The present study aimed at testing the general applicability of RQA methodology, as a viable tool for assessing motor unit synchronization, by extending the analysis of surface EMG, as revealed by changes in %DET induced by L-Ac, to many upper and lower limb muscles and to muscles that are not easily studied by needle electrodes, such as the orbicularis oculi. Subjects performed brief periods of tonic contractions, alternated to periods of rests to avoid muscle fatigue. Pharmacological enhancement of recurrent inhibition was obtained by a short-lasting intravenous injection of L-Ac. Control experiments were performed replacing L-Ac injection with saline injection. The average %DET showed a significant increase during L-Ac injection in the deltoid, biceps brachii, extensor carpi radialis, while no effect was observed in the opponens pollicis and abductor digiti minimi for the upper limb muscles. Similarly, the average %DET showed a significant increase during L-Ac injection in the quadriceps, soleus, and tibialis anterior, while no effect was observed in the abductor hallucis for the lower limb muscles. RQA of orbicularis oculi muscle activity showed no increase in %DET during L-Ac injection in analogy to what found in the intrinsic muscles of the hand and foot, known to be devoid of recurrent inhibition. The presence or absence of drug-induced increase in motor unit synchronization agrees with the known distribution of recurrent inhibition in the various motor nuclei. The overall significance of these findings is the potential application of RQA methodology as a reliable and independent tool for generally assessing motor unit synchronization from surface EMG under strictly controlled experimental condition.
We examined whether the recruitment properties of the corticospinal pathway to forearm muscles are influenced by variations of the shoulder joint angle. Flexor carpi radialis (FCR) and extensor carpi radialis (ECR) muscles motor evoked potentials (MEPs) in response to transcranial magnetic stimulation were examined during different static positions of shoulder joint in the horizontal plane: from 30 degrees abduction to 30 degrees adduction. We found that at 30 degrees shoulder adduction, maximum slope and plateau phase of the ECR and FCR input-output relationship (i.e., relation between MEP size and stimulus intensity) were significantly higher and lower than at 30 degrees abduction of the shoulder joint, respectively. Intracortical inhibition (ICI) and intracortical facilitation (ICF) of the FCR were assessed using a paired-magnetic pulse paradigm. A significant decrease in ICF was observed after changing shoulder position from 30 degrees abduction to 30 degrees adduction. On the contrary, no variation in the amount of ICI occurred in relation to the same changes in shoulder position. FCR H-reflex to electrical stimulation of median nerve at elbow did not differ significantly between the two shoulder positions. We conclude that shoulder position influences the recruitment efficiency (gain) of the corticospinal volleys to motoneurones of forearm muscles. It is proposed that activity of peripheral receptors signaling static shoulder position influences corticomotor excitability of forearm muscles mainly at cortical level, although C3-C4 propriospinal system could be also involved. It is proposed that the above changes in corticomotoneuronal excitability to forearm muscles as function of shoulder joint position are part of a global proximal-distal synergy operating throughout reaching movements.
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