Cortical Mechanisms of Central Fatigue and Sense of Effort.

The purpose of this study was to investigate cortical mechanisms upstream to the corticospinal motor neuron that may be associated with central fatigue and sense of effort during and after a fatigue task. We used two different isometric finger abduction protocols to examine the effects of muscle activation and fatigue the right first dorsal interosseous (FDI) of 12 participants. One protocol was intended to assess the effects of muscle activation with minimal fatigue (control) and the other was intended to elicit central fatigue (fatigue). We hypothesized that high frequency repetitive transcranial magnetic stimulation (rTMS) of the supplementary motor area (SMA) would hasten recovery from central fatigue and offset a fatigue-induced increase in sense of effort by facilitating the primary motor cortex (M1). Constant force-sensation contractions were used to assess sense of effort associated with muscle contraction. Paired-pulse TMS was used to assess intracortical inhibition (ICI) and facilitation (ICF) in the active M1 and interhemispheric inhibitory (IHI) was assessed to determine if compensation occurs via the resting M1. These measures were made during and after the muscle contraction protocols. Corticospinal excitability progressively declined with fatigue in the active hemisphere. ICF increased at task failure and ICI was also reduced at task failure with no changes in IHI found. Although fatigue is associated with progressive reductions in corticospinal excitability, compensatory changes in inhibition and facilitation may act within, but not between hemispheres of the M1. rTMS of the SMA following fatigue enhanced recovery of maximal voluntary force and higher levels of ICF were associated with lower sense of effort following stimulation. rTMS of the SMA may have reduced the amount of upstream drive required to maintain motor output, thus contributing to a lower sense of effort and increased rate of recovery of maximal force.

An evaluation of paired motor unit estimates of persistent inward current in human motoneurons.

Persistent inward current (PIC) plays an important role in setting the input-output gain of motoneurons. In humans, these currents are estimated by calculating the difference between synaptic input at motor unit recruitment and derecruitment (ΔF) derived from paired motor unit recordings. The primary objective of this study was to use the relationship between reciprocal inhibition (RI) and PIC to estimate the contribution of PIC relative to other motoneuron properties that result in nonlinear motor unit firing behavior. This study also assessed the contribution of other intrinsic properties (spike threshold accommodation and spike frequency adaptation) to ΔF estimates of PIC in human motor units by using ramps with varying rates of rise and duration. It was hypothesized that slower rates of ramp rise and longer ramp durations would inflate ΔF estimates of PIC, and RI and PIC values would only be correlated during the ramp with the fastest rate of rise and shortest duration when spike threshold accommodation and spike frequency adaptation is minimized. Fourteen university-aged participants took part in this study. Paired motor unit recordings were made from the right soleus muscle during ramp contractions of plantar flexors with three different rates of rise and durations. ΔF estimates of PIC increased with decreased rates of ramp rise (P < 0.01) and increased ramp durations (P < 0.01), most likely due to spike frequency adaptation. A correlation (r = 0.41; P < 0.03) between ΔF and RI provides evidence that PIC is the primary contributor to ΔF in shorter ramps with faster rates of rise.