RESEARCH ARTICLE Transcranial Direct Current Stimulation Improves Ipsilateral Selective Muscle Activation in a Frequency Dependent Manner

Failure to suppress antagonist muscles can lead to movement dysfunction, such as the ab-normal muscle synergies often seen in the upper limb after stroke. A neurophysiological sur-rogate of upper limb synergies, the selectivity ratio (SR), can be determined from the ratio of biceps brachii (BB) motor evoked potentials to transcranial magnetic stimulation prior to forearm pronation versus elbow flexion. Surprisingly, cathodal transcranial direct current stimulation (c-TDCS) over ipsilateral primary motor cortex (M1) reduces (i.e. improves) the SR in healthy adults, and chronic stroke patients. The ability to suppress antagonist mus-cles may be exacerbated at high movement rates. The aim of the present study was to in-vestigate whether the selective muscle activation of the biceps brachii (BB) is dependent on altering frequency demands, and whether the c-tDCS improvement of SR is dependent on task frequency. Seventeen healthy participants performed repetitive isometric elbow flexion and forearm pronation at three rates, before and after c-tDCS or sham delivered to ipsilater-al left M1. Ipsilateral c-tDCS improved the SR in a frequency dependent manner by selec-tively suppressing BB antagonist excitability. Our findings confirm that c-tDCS is an effective tool for improving selective muscle activation, and provide novel evidence for its ef-ficacy at rates of movement where it is most likely to benefit task performance