ORIGINAL ARTICLES Does the Recruitment of Excitation and Inhibition in the Motor Cortex Differ?

Summary: The level of excitability within the motor cortex can be described as a balance between excitation and inhibition, but it is unknown how well both processes correlate. To address this ques-tion, the authors measured motor cortical excitability and inhibition in healthy human subjects, comparing the recruitment of motor evoked potentials (MEPs) and the duration of the cortical silent period (CSP) after transcranial magnetic stimulation (TMS). Single-pulse “focal ” TMS was applied at intensities varying between 90% and 200 % of motor thresholds to the right motor cortex of 15 healthy volunteers. The peak-to peak size of MEP responses and the dura-tion of the CSP were measured in small hand muscles. Stimulus-response (S-R) curves were constructed by plotting the MEP size and CSP duration against stimulus intensities. The absolute duration of CSP and the size MEPs correlated significantly and to a similar extent with stimulus intensity (r! 0.60 and 0.53, respectively). The slope of the MEP-S-R was steeper compared with CSP-S-R, partic-ularly at low stimulation intensities. CSP duration saturated earlier and CSP-S-Rs were shifted upwards at a given stimulus intensity compared with MEP-S-Rs. The findings suggest that recruitment of inhibition and excitation within the sensorimotor cortex correlate. However, inhibitory effects are recruited at lower intensities and saturate earlier than excitation