Posture-related modulations in motor cortical excitability of the proximal and distal arm muscles.

The effect of postural orientation on the motor corticospinal excitability (MCE) of proximal and distal upper extremity (UE) muscles was investigated. In a crossover design, recruitment curves (RCs), short interval cortical inhibition (SICI) and intracortical facilitation (ICF) of resting anterior deltoid (AD) and first dorsal interosseus (FDI) was assessed in two postures: sitting and standing. Six healthy adults without contraindications to transcranial magnetic stimulation (TMS) participated in the study. TMS was applied over the motor cortical representation of FDI and AD at intensities ranging from 90% to 200% of resting motor threshold (RMT) in increments of 10%. SICI and ICF were assessed for each muscle using a conditioning stimulus (80% RMT) preceding a test stimulus (120% RMT) with an interstimulus interval of 2 ms and 15 ms, respectively. For AD, but not FDI, there was a significant and consistent increase in RC slope during standing compared to sitting. For FDI, there was no difference in ICF and SICI between sitting and standing. However, for AD, while there was no difference in ICF between the two postures, there was a clear trend for SICI to decrease (p=0.06) in standing compared to sitting. These results indicate that postural change from sitting to standing, affects the MCE of proximal but not distal muscles. While this indicates the role of proximal UE muscles in postural control, it also implies that rehabilitation protocols for enhancing proximal arm motor function may be advantaged if administered in a standing posture.