Motor point stimulation induces more robust F‐waves than peripheral nerve stimulation

Abstract

The F‐wave is a motor response induced by electrical stimulation of peripheral nerves via the antidromic firing of motor nerves, which reflects the motoneuron excitability. To induce F‐waves, transcutaneous peripheral nerve stimulation (PNS) is used, which activates nerve branches via transcutaneous electrodes over the nerve branches. An alternative method to activate peripheral nerves, that is, motor point stimulation (MPS), which delivers electrical stimulation over the muscle belly, has not been used to induce F‐waves. In our previous studies, we observed that MPS induced F‐wave‐like responses, that is, motor responses at the latency of F‐waves at a supramaximal stimulation. Here, we further investigated the F‐wave‐like responses induced by MPS in comparison with PNS in the soleus muscle. Thirteen individuals participated in this study. We applied MPS and PNS on the participant's left soleus muscle. Using a monopolar double‐pulse stimulation, the amplitude of the second H‐reflex induced by PNS decreased, whereas the amplitude of the motor response at the F‐wave latency induced by MPS did not decrease. These results suggest that the motor response at the F‐wave latency induced by MPS was not an H‐reflex but an F‐wave. We also found that the F‐wave induced by MPS had a greater amplitude and higher persistence and caused less pain when compared with the F‐waves induced using PNS. We conclude that MPS evokes antidromic firing inducing F‐waves more consistently compared with PNS.

Neuromuscular recruitment pattern in motor point stimulation

“…Also, the H‐reflex was not observed using MPS regardless of stimulus intensity, while F‐waves were recorded at relatively weaker stimulus intensity (Figure 3A,B), which were also confirmed by previous studies 6,7,23 . In addition to a lack of H‐reflexes in the present study, our group recently showed that MPS does not induce reciprocal inhibition 6 .…”