Szubski, Christoph, Martin Burtscher, and Wolfgang N. Lö scher. The effects of short-term hypoxia on motor cortex excitability and neuromuscular activation. J Appl Physiol 101: 1673-1677, 2006. First published August 17, 2006 doi:10.1152/japplphysiol.00617.2006.-The effects of acute hypoxia on motor cortex excitability, force production, and voluntary activation were studied using single-and double-pulse transcranial magnetic stimulation techniques in 14 healthy male subjects. Electrical supramaximal stimulations of the right ulnar nerve were performed, and transcranial magnetic stimulations were delivered to the first dorsal interosseus motor cortex area during short-term hypoxic (HX) and normoxic (NX) condition. M waves, voluntary activation, F waves, resting motor threshold (rMT), recruitment curves (100 -140% of rMT), and short-interval intracortical inhibition and intracortical facilitation were measured. Moreover, motor-evoked potentials (MEPs) and cortical silent periods were determined during brief isometric maximum right index finger abductions. Hypoxia was induced by breathing a fraction of inspired oxygen of 12% via a face mask. M waves, voluntary activation, and F waves did not differ between NX and HX. The rMT was significantly lower in HX (55.79 Ϯ 9.40%) than in NX (57.50 Ϯ 10.48%) (P Ͻ 0.01), whereas MEP recruitment curve, short-interval intracortical inhibition, intracortical facilitation, maximum right index finger abduction, and MEPs were unaffected by HX. In contrast, the cortical silent periods in HX (158.21 Ϯ 33.96 ms) was significantly shortened compared with NX (169.42 Ϯ 39.69 ms) (P Ͻ 0.05). These data demonstrate that acute hypoxia results in increased cortical excitability and suggest that acute hypoxia alters motor cortical ion-channel function and GABAergic transmission. transcranial magnetic stimulation; voluntary activation; cortical silent period STUDIES OF HYPOXIA-INDUCED CHANGES in central nervous system function have primarily focused on behavioral parameters and revealed impairments in psychomotor skills (25, 43) and cognitive performances (24,29,32). In addition to these deteriorations in performance, evidence of slowed visual and auditory reaction time has been demonstrated in experimental conditions corresponding to an altitude of ϳ6,100 m (15, 16).Numerous in vitro studies on central neurons strongly suggested that reduced arterial oxygen saturation impairs central nervous system function (34). In particular, the cerebral neuron excitability critically depends on sufficient O 2 supply, but hypoxia may not only compromise ion channels but also signaling pathways and neurotransmitter function (22,35). So far, most of our knowledge about the processes underlying hypoxia-induced alterations of neuronal excitability and synaptic neurotransmission has been gained from in vitro patchclamped studies.As yet, in vivo studies addressing the functional consequences of reduced O 2 supply to the neuromuscular system have primarily focused on effects on muscle force generation (13), endu...