Abstract
The cortico-motoneuronal system (CMS), i.e. the monosynaptic projection from primary motor cortex to motoneurons in lamina IX of the spinal cord is, among all mammals, best developed in humans. Increasing evidence suggests that the CMS is crucially important for skilled individuated finger movements. Little is known about to what extent the strength of the CMS differs between hand muscles. Here we measured CMS excitation to the first dorsal interosseus (FDI), abductor pollicis brevis (APB) and abductor digiti minimi (ADM) muscles in healthy subjects by using a novel penta-stimulation technique (PST) and single motor unit (SMU) recordings. The PST is an extension of the triple-stimulation technique. It applies two additional supramaximal electrical stimuli at the wrist to the 'peripheral nerve of no interest' (in the case of the FDI and ADM the median nerve, in the case of the APB the ulnar nerve) to collide with the descending volleys in that nerve elicited by transcranial magnetic stimulation of motor cortex and electrical stimulation of Erb's point. This eliminates volume conduction from neighbouring muscles innervated by the nerve of no interest and, therefore, allows accurate determination of the PST response. The PST respo...Continue Reading
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