Bäumer T, Schippling S, Kroeger J, Zittel S, Koch G, Thomalla G, Rothwell J C, Siebner H R, Orth M, Münchau A
Department of Neurology, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
Clin Neurophysiol. 2009 Sep;120(9):1724-31. doi: 10.1016/j.clinph.2009.07.035. Epub 2009 Aug 15.
In macaques, intracortical electrical stimulation of ventral premotor cortex (PMv) can modulate ipsilateral primary motor cortex (M1) excitability at short interstimulus intervals (ISIs).
Adopting the same conditioning-test approach, we used bifocal transcranial magnetic stimulation (TMS) to examine intrahemispheric connectivity between left PMv and M1 in humans. A conditioning stimulus (CS) was applied to PMv at intensities of 80% and 90% of active motor threshold (AMT) and 90% and 110% of resting motor threshold (RMT). A supra-threshold test stimulus (TS) was given 2, 4, 6, 8 and 10 ms after the CS and the amplitude of the motor evoked potential (MEP) was measured to probe corticospinal excitability.
The CS facilitated corticospinal excitability in ipsilateral M1 when PMv was stimulated with 80% AMT 4 or 6 ms before the TS. At the same ISIs, the CS suppressed corticospinal excitability when the stimulus intensity was increased to 90% RMT. Conditioning effects were site-specific because conditioning the dorsal premotor cortex (PMd) at three different sites produced different effects. Using neuronavigated TMS the PMv site where applied CS produced changes in ipsilateral M1 excitability was located at the border between ventral Brodmann area (BA) 6 and BA 44, the human homologue of monkey's PMv (area F5).
We infer that the corticospinal motor output from M1 to contralateral hand muscles can be facilitated or inhibited by a CS over ipsilateral PMv.
The fact that conditioning effects following PMd stimulation differ from those after PMv stimulation supports the concept that inputs from premotor cortices to M1 are functionally segregated.
在猕猴中,腹侧运动前皮层(PMv)的皮质内电刺激可在短刺激间隔(ISI)下调节同侧初级运动皮层(M1)的兴奋性。
采用相同的条件刺激-测试方法,我们使用双焦点经颅磁刺激(TMS)来检测人类左侧PMv和M1之间的半球内连接。条件刺激(CS)以主动运动阈值(AMT)的80%和90%以及静息运动阈值(RMT)的90%和110%的强度施加于PMv。在CS后2、4、6、8和10毫秒给予阈上测试刺激(TS),并测量运动诱发电位(MEP)的幅度以探测皮质脊髓兴奋性。
当在TS前4或6毫秒用80%AMT刺激PMv时,CS促进了同侧M1的皮质脊髓兴奋性。在相同的ISI下,当刺激强度增加到90%RMT时,CS抑制了皮质脊髓兴奋性。条件作用效应具有位点特异性,因为在三个不同位点对背侧运动前皮层(PMd)进行条件刺激产生了不同的效应。使用神经导航TMS,施加CS后同侧M1兴奋性发生变化的PMv位点位于腹侧布罗德曼区(BA)6和BA 44之间的边界,即猴子PMv(F5区)的人类同源区域。
我们推断,同侧PMv上的CS可促进或抑制从M1到对侧手部肌肉的皮质脊髓运动输出。
PMd刺激后的条件作用效应与PMv刺激后的不同,这一事实支持了运动前皮层向M1的输入在功能上是分离的这一概念。