The Effect of Caffeine on Movement-Related Cortical Potential Morphology and Detection.

Movement-related cortical potential (MRCP) is observed in EEG recordings prior to a voluntary movement. It has been used for e.g., quantifying motor learning and for brain-computer interfacing (BCIs). The MRCP amplitude is affected by various factors, but the effect of caffeine is underexplored. The aim of this study was to investigate if a cup of coffee with 85 mg caffeine modulated the MRCP amplitude and the classification of MRCPs versus idle activity, which estimates BCI performance. Twenty-six healthy participants performed 2 × 100 ankle dorsiflexion separated by a 10-min break before a cup of coffee was consumed, followed by another 100 movements. EEG was recorded during the movements and divided into epochs, which were averaged to extract three average MRCPs that were compared. Also, idle activity epochs were extracted. Features were extracted from the epochs and classified using random forest analysis. The MRCP amplitude did not change after consuming caffeine. There was a slight increase of two percentage points in the classification accuracy after consuming caffeine. In conclusion, a cup of coffee with 85 mg caffeine does not affect the MRCP amplitude, and improves MRCP-based BCI performance slightly. The findings suggest that drinking coffee is only a minor confounder in MRCP-related studies.

Obstacle avoidance movement-related motor cortical activity with cognitive task.

Lack of attention to obstacles on the floor or walking path may cause trip and fall accidents. The preparatory activity in the motor cortex to the perturbation associated with obstacle avoidance movements with cognitive task is still unclear. The purpose of this study was to investigate the motor cortical activity involved in the preparation and execution of concurrent obstacle avoidance movement and cognitive task. Twenty young adults were required to step over obstacles that were projected on the floor while performing a cognitive task. The electroencephalogram was recorded, and the movement-related cortical potentials (MRCP) aligned by foot dorsiflexion were evaluated. There was no significant difference in the number of contacts between the toe and the obstacle between the obstacle avoidance task and obstacle avoidance with cognitive task; however, the distance between the toe and the obstacle just before obstacle avoidance movement was significantly extended in the latter task. The amplitude and the onset of MRCP during the dual task were decreased and delayed, respectively, compared with the simple obstacle avoidance movement task. These results suggest that the young participants changed their clearance strategy to stepping over the obstacle during the concurrent motor and cognitive dual task to reduce motor cortical activity.

Distinct cortical networks for hand movement initiation and directional processing: An EEG study.

Movement preparation and initiation have been shown to involve large scale brain networks. Recent findings suggest that movement preparation and initiation are represented in functionally distinct cortical networks. In electroencephalographic (EEG) recordings, movement initiation is reflected as a strong negative potential at medial central channels that is phase-locked to the movement onset - the movement-related cortical potential (MRCP). Movement preparation describes the process of transforming high level movement goals to low level commands. An integral part of this transformation process is directional processing (i.e., where to move). The processing of movement direction during visuomotor and oculomotor tasks is associated with medial parieto-occipital cortex (PO) activity, phase-locked to the presentation of potential movement goals. We surmised that the network generating the MRCP (movement initiation) would encode less information about movement direction than the parieto-occipital network processing movement direction. Here, we studied delta band EEG activity during center-out reaching movements (2D; 4 directions) in visuomotor and oculomotor tasks. In 15 healthy participants, we found a consistent representation of movement direction in PO 300-400 â€‹ms after the direction cue irrespective of the task. Despite generating the MRCP, sensorimotor areas (SM) encoded less information about the movement direction than PO. Moreover, the encoded directional information in SM was less consistent across participants and specific to the visuomotor task. In a classification approach, we could infer the four movement directions from the delta band EEG activity with moderate accuracies up to 55.9%. The accuracies for cue-aligned data were significantly higher than for movement onset-aligned data in either task, which also suggests a stronger representation of movement direction during movement preparation. Therefore, we present direct evidence that EEG delta band amplitude modulations carry information about both arm movement initiation and movement direction, and that they are represented in two distinct cortical networks.

EEG Headset Evaluation for Detection of Single-Trial Movement Intention for Brain-Computer Interfaces.

Brain-computer interfaces (BCIs) can be used in neurorehabilitation; however, the literature about transferring the technology to rehabilitation clinics is limited. A key component of a BCI is the headset, for which several options are available. The aim of this study was to test four commercially available headsets' ability to record and classify movement intentions (movement-related cortical potentials-MRCPs). Twelve healthy participants performed 100 movements, while continuous EEG was recorded from the headsets on two different days to establish the reliability of the measures: classification accuracies of single-trials, number of rejected epochs, and signal-to-noise ratio. MRCPs could be recorded with the headsets covering the motor cortex, and they obtained the best classification accuracies (73%-77%). The reliability was moderate to good for the best headset (a gel-based headset covering the motor cortex). The results demonstrate that, among the evaluated headsets, reliable recordings of MRCPs require channels located close to the motor cortex and potentially a gel-based headset.

Intra- and Inter-Rater Reliability of Manual Feature Extraction Methods in Movement Related Cortical Potential Analysis.

Event related potentials (ERPs) provide insight into the neural activity generated in response to motor, sensory and cognitive processes. Despite the increasing use of ERP data in clinical research little is known about the reliability of human manual ERP labelling methods. Intra-rater and inter-rater reliability were evaluated in five electroencephalography (EEG) experts who labelled the peak negativity of averaged movement related cortical potentials (MRCPs) derived from thirty datasets. Each dataset contained 50 MRCP epochs from healthy people performing cued voluntary or imagined movement, or people with stroke performing cued voluntary movement. Reliability was assessed using the intraclass correlation coefficient and standard error of measurement. Excellent intra- and inter-rater reliability was demonstrated in the voluntary movement conditions in healthy people and people with stroke. In comparison reliability in the imagined condition was low to moderate. Post-hoc secondary epoch analysis revealed that the morphology of the signal contributed to the consistency of epoch inclusion; potentially explaining the differences in reliability seen across conditions. Findings from this study may inform future research focused on developing automated labelling methods for ERP feature extraction and call to the wider community of researchers interested in utilizing ERPs as a measure of neurophysiological change or in the delivery of EEG-driven interventions.

A score to map the lateral nonprimary motor area: Multispectrum intrinsic brain activity versus cortical stimulation.

OBJECTIVE: Multispectrum electrocorticographic components are critical for mapping the nonprimary motor area (NPMA). The objective of this study was to derive and validate a reliable scoring system for electrocorticography-based NPMA mapping (NPMA score) to replace electrical cortical stimulation (ECS) during brain surgery. METHODS: We analyzed 14 consecutive epilepsy patients with subdural electrodes implanted in the frontal lobe at Kyoto University Hospital. The NPMA score was retrospectively derived from multivariate analysis in the derivation group (patients = 7, electrodes = 713, during 2010-2013) and validated in the validation group (patients = 7, electrodes = 772, during 2014-2017). We assessed the accuracy and reliability of the score relative to ECS in determining the NPMA and predicting postoperative functional outcomes. RESULTS: Multivariate analysis in the derivation group led to an 8-point score for predicting ECS-based NPMA (1 point for anatomical localization of the electrode and 1 or 2 points for movement-related electrocorticographic components regardless of somatotopy in very slow cortical potential shifts [<0.5 Hz], 40-80-Hz band power increase, and 8-24-Hz band power decrease), which was validated in the validation group. The area under the receiver operating characteristic curve (AUC) was 0.89 in the derivation group. Good prediction (specificity = 94%, sensitivity = 100%) and discrimination (AUC = 0.87) were reproduced in the validation group. Overall, higher NPMA scores identified 2 patients with postoperative deficits after frontal lobe resection. SIGNIFICANCE: The NPMA score is reliable for NPMA mapping, potentially replacing ECS. It is a potential prognostic marker for postoperative functional deficits.

A rational, multispectral mapping algorithm for primary motor cortex: A primary step before cortical stimulation.

OBJECTIVE: For future artificial intelligence-based brain mapping, development of a rational and safe scoring system for a brain motor mapping algorithm using electrocorticography (ECoG score), which contains various spectral, purely intrinsic brain activities, is necessary for either before or in the absence of electrical cortical stimulation (ECS). METHODS: We evaluated 1114 electrodes of 10 consecutive focal epilepsy patients who underwent subdural electrode implantation before epilepsy surgery at Kyoto University Hospital during 2011-2017. Data from ECoG-based mapping (bandpass filter of 0.016-300/600 Hz) to define the primary motor area (M1) localization were used to create an ECoG score (range = 0-4) by assigning 1 point each for the occurrence of ECoG components: very slow movement-related cortical potentials (<0.5-1.0 Hz), event-related synchronization (76-100 Hz or 100-200 Hz), and event-related desynchronization (8-12 Hz or 12-24 Hz). The ECoG score was assessed by calculating the sensitivity, specificity, and cutoff values of the score for localization concordance with M1 defined using only ECS as a reference. RESULTS: With an area under the receiver operating characteristic curve (AUC) of 0.76, cutoffs of scores of 4 and 1 showed high specificity (94%) and sensitivity (98%) in concordance with ECS-based mapping, respectively. The ECoG score for mapping M1 of the upper limb achieved greater accuracy (AUC = 0.85) compared to that of the face (AUC = 0.64). SIGNIFICANCE: The ECoG score proposed in the present study is rational, simple, and useful to define M1, and it is spatially concordant with ECS. Although ECS is still widely employed for presurgical examination, our proposed application of the ECoG score may be suitable for future brain M1 mapping, and possibly beyond M1 mapping, independently of ECS.

An EEG Experimental Study Evaluating the Performance of Texas Instruments ADS1299.

Texas Instruments ADS1299 is an attractive choice for low cost electroencephalography (EEG) devices owing to its low power consumption and low input referred noise. To date, there have been no rigorous evaluations of its performance. In this EEG experimental study we evaluated the performance of the ADS1299 against a high quality laboratory-based system. Two self-paced lower limb motor tasks were performed by 22 healthy participants. Recorded power across delta, theta, alpha, and beta EEG bands, the power ratio across the motor tasks, pre-movement noise, and signal-to-noise ratio were obtained for evaluation. The amplitude and time of the negative peak in the movement-related cortical potentials (MRCPs) extracted from the EEG data were also obtained. Using linear mixed models, no statistically significant differences (p > 0.05) were found in any of these measures across the two systems. These findings were further supported by evaluation of cosine similarity, waveform differences, and topographic maps. There were statistically significant differences in MRCPs across the motor tasks in both systems. We conclude that the performance of the ADS1299 in combination with wet Ag/AgCl electrodes is analogous to that of a laboratory-based system in a low frequency (<40 Hz) EEG recording.

Paired Associative Stimulation Delivered by Pairing Movement-Related Cortical Potentials With Peripheral Electrical Stimulation: An Investigation of the Duration of Neuromodulatory Effects.

BACKGROUND: Novel paired associative stimulation (novel-PAS), delivered by pairing movement-related cortical potentials (MRCPs) with electrical stimulation of somatosensory afferents, is an innovative neuromodulatory intervention. Novel-PAS results in increased corticomotor excitability and has potential as a rehabilitative adjunct to improve outcomes following stroke. The duration of its excitatory effect has important implications for how this novel PAS intervention might be applied within a traditional therapy session, but previous research has not explored its effects beyond 30 min post-intervention. OBJECTIVE: The objective was to explore changes in corticomotor excitability in healthy participants, over a 60-min period following a single session of novel-PAS. MATERIALS AND METHOD: Ten healthy adults completed a single session of novel-PAS, delivered by pairing 50 MRCPs with peripheral electrical stimulation. TMS was used to elicit motor evoked potentials (MEPs) of the tibialis anterior (TA) muscle, immediately prior to the intervention, and at 0, 30, 45, and 60 min post-intervention. RESULTS: When compared with pre-intervention, there was a statistically significant increase in the mean TA MEP amplitudes at 0 (p = 0.006), 30 (p = 0.006), 45 (p = 0.027), and 60 min post-intervention (p = 0.020). CONCLUSION: Corticomotor excitability is increased for 60 min following this novel-PAS intervention. Future research could investigate the optimal method of combining this neuromodulatory technique with traditional therapy.

EEG neural correlates of goal-directed movement intention.

Using low-frequency time-domain electroencephalographic (EEG) signals we show, for the same type of upper limb movement, that goal-directed movements have different neural correlates than movements without a particular goal. In a reach-and-touch task, we explored the differences in the movement-related cortical potentials (MRCPs) between goal-directed and non-goal-directed movements. We evaluated if the detection of movement intention was influenced by the goal-directedness of the movement. In a single-trial classification procedure we found that classification accuracies are enhanced if there is a goal-directed movement in mind. Furthermore, by using the classifier patterns and estimating the corresponding brain sources, we show the importance of motor areas and the additional involvement of the posterior parietal lobule in the discrimination between goal-directed movements and non-goal-directed movements. We discuss next the potential contribution of our results on goal-directed movements to a more reliable brain-computer interface (BCI) control that facilitates recovery in spinal-cord injured or stroke end-users.

The effect of intervention according to muscle contraction type on the cerebral cortex of the elderly.

[Purpose] Here we investigated the activity of the cerebral cortex after resistance training in the elderly. We evaluated the clinical neuropsychological basis of 2 contractile types, and determined the usefulness of a movement-related cortical potential (MRCP) from an electroencephalography (EEG). [Subjects and Methods] The subjects were 11 females and 11 males aged between 65 and 70 years. The subjects were randomly assigned into a group that performed an eccentric contraction exercise (experimental group I, n=11) and a group that performed a concentric contraction exercise (experimental group II, n=11). We measured activities of the rectus femoris, vastus medialis, and vastus lateralis in the non-dominant lower extremity by using surface electromyography (EMG), and measured brain activity using EEG before conducting an intervention. An intervention was conducted 40 minutes per session, once a day, 3 times a week for 4 weeks. [Results] After the intervention, activity in C4, the Cz area and rectus femoris were significantly different. [Conclusion] Our results demonstrate that MRCP from an EEG has the advantage of being non-invasive and cost-effective. Nonetheless, prospective studies are needed to reveal the specific mechanism underlying eccentric contraction exercise, which can provide baseline data for research related to aging and neural plasticity.

Magnetic stimulation and movement-related cortical activity for acute stroke with hemiparesis.

BACKGROUND AND PURPOSE: This double-blind, randomized, placebo-controlled study investigated the beneficial effects of repetitive transcranial magnetic stimulation (rTMS) to patients with motor paresis in acute subcortical stroke on functional recovery and electrophysiological measures. METHODS: Twenty patients with acute stroke were randomized into real rTMS (n = 10) or sham (n = 10) groups. Patients received five daily sessions of rTMS with 1200 pulses at 1 Hz for 20 min or sham stimulation over the contralesional motor cortex. Movement-related cortical potential MRCP, consisting of the Bereitschaftpotential, negative slope (NS') and motor potential (MP), was recorded during self-paced wrist extension of the affected limb associated with assessment of the Fugl-Meyer assessment (FMA) of the upper extremity, the pegboard test and the grip strength before and after the rTMS session. RESULTS: Real rTMS improved the FMA and pegboard test scores compared to the sham group in the affected hand. This improvement was associated with increases in the MP and NS' over the front-central sites in the ipsilesional hemisphere, whereas the sham group did not show significant changes in MRCP components by rTMS. CONCLUSIONS: Our findings suggest that low-frequency rTMS to the contralesional motor cortex facilitates functional recovery of paretic limbs in acute stroke patients through enhancing the the neuronal activity of ipsilesional motor and pre-motor areas.

Effects of divided attention on movement-related cortical potential in community-dwelling elderly adults: A preliminary study.

Dual-tasking is defined as performing two or more tasks concurrently. This study aimed to investigate the effect of divided attention on movement-related cortical potential (MRCP) during dual-task performance in 11 community-dwelling elderly individuals while the load of the secondary task was altered. MRCP was recorded during a single task (ST), simple dual task (S-DT), and complex dual task (C-DT) as no-, low-, and high-load divided attention tasks, respectively. The ST involved self-paced tapping with an extended right index finger. In the S-DT and C-DT, the subjects simultaneously performed the ST and a visual number counting task with different levels of load. The coefficient of variation of movement frequency was significantly more variable in the C-DT than in the ST. The MRCP amplitude from electroencephalography electrode C3, contralateral to the moving hand, was significantly higher in the C-DT than in the ST. Higher attention diversion led to a significant reduction in MRCP amplitude in the participants. These results suggest that attention division in dual-task situations plays an important role in movement preparation and execution. We propose that MRCP can serve as a marker for screening the ability of older individuals to perform dual-tasks.

Single-trial movement intention detection estimation in patients with Parkinson's disease: a movement-related cortical potential study.

Objectives. Parkinson patients often suffer from motor impairments such as tremor and freezing of movement that can be difficult to treat. To unfreeze movement, it has been suggested to provide sensory stimuli. To avoid constant stimulation, episodes with freezing of movement needs to be detected which is a challenge. This can potentially be obtained using a brain-computer interface (BCI) based on movement-related cortical potentials (MRCPs) that are observed in association with the intention to move. The objective in this study was to detect MRCPs from single-trial EEG.Approach. Nine Parkinson patients executed 100 wrist movements and 100 ankle movements while continuous EEG and EMG were recorded. The experiment was repeated in two sessions on separate days. Using temporal, spectral and template matching features, a random forest (RF), linear discriminant analysis, and k-nearest neighbours (kNN) classifier were constructed in offline analysis to discriminate between epochs containing movement-related or idle brain activity to provide an estimation of the performance of a BCI. Three classification scenarios were tested: 1) within-session (using training and testing data from the same session and participant), between-session (using data from the same participant from session one for training and session two for testing), and across-participant (using data from all participants except one for training and testing on the remaining participant).Main results. The within-session classification scenario was associated with the highest classification accuracies which were in the range of 88%-89% with a similar performance across sessions. The performance dropped to 69%-75% and 70%-75% for the between-session and across-participant classification scenario, respectively. The highest classification accuracies were obtained for the RF and kNN classifiers.Significance. The results indicate that it is possible to detect movement intentions in individuals with Parkinson's disease such that they can operate a BCI which may control the delivery of sensory stimuli to unfreeze movement.

Chrono-EEG dynamics influencing hand gesture decoding: a 10-hour study.

Long-term electroencephalography (EEG) recordings have primarily been used to study resting-state fluctuations. These recordings provide valuable insights into various phenomena such as sleep stages, cognitive processes, and neurological disorders. However, this study explores a new angle, focusing for the first time on the evolving nature of EEG dynamics over time within the context of movement. Twenty-two healthy individuals were measured six times from 2 p.m. to 12 a.m. with intervals of 2 h while performing four right-hand gestures. Analysis of movement-related cortical potentials (MRCPs) revealed a reduction in amplitude for the motor and post-motor potential during later hours of the day. Evaluation in source space displayed an increase in the activity of M1 of the contralateral hemisphere and the SMA of both hemispheres until 8 p.m. followed by a decline until midnight. Furthermore, we investigated how changes over time in MRCP dynamics affect the ability to decode motor information. This was achieved by developing classification schemes to assess performance across different scenarios. The observed variations in classification accuracies over time strongly indicate the need for adaptive decoders. Such adaptive decoders would be instrumental in delivering robust results, essential for the practical application of BCIs during day and nighttime usage.

Movement-related cortical potential and speech-induced suppression during speech production in younger and older adults.

With age, the speech system undergoes important changes that render speech production more laborious, slower and often less intelligible. And yet, the neural mechanisms that underlie these age-related changes remain unclear. In this EEG study, we examined two important mechanisms in speech motor control: pre-speech movement-related cortical potential (MRCP), which reflects speech motor planning, and speaking-induced suppression (SIS), which indexes auditory predictions of speech motor commands, in 20 healthy young and 20 healthy older adults. Participants undertook a vowel production task which was followed by passive listening of their own recorded vowels. Our results revealed extensive differences in MRCP in older compared to younger adults. Further, while longer latencies were observed in older adults on N1 and P2, in contrast, the SIS was preserved. The observed reduced MRCP appears as a potential explanatory mechanism for the known age-related slowing of speech production, while preserved SIS suggests intact motor-to-auditory integration.

EEG Analyses of visual cue effects on executed movements.

BACKGROUND: In electroencephalographic (EEG) or electrocorticographic (ECoG) experiments, visual cues are commonly used for timing synchronization but may inadvertently induce neural activity and cognitive processing, posing challenges when decoding self-initiated tasks. NEW METHOD: To address this concern, we introduced four new visual cues (Fade, Rotation, Reference, and Star) and investigated their impact on brain signals. Our objective was to identify a cue that minimizes its influence on brain activity, facilitating cue-effect free classifier training for asynchronous applications, particularly aiding individuals with severe paralysis. RESULTS: 22 able-bodied, right-handed participants aged 18-30 performed hand movements upon presentation of the visual cues. Analysis of time-variability between movement onset and cue-aligned data, grand average MRCP, and classification outcomes revealed significant differences among cues. Rotation and Reference cue exhibited favorable results in minimizing temporal variability, maintaining MRCP patterns, and achieving comparable accuracy to self-paced signals in classification. COMPARISON WITH EXISTING METHODS: Our study contrasts with traditional cue-based paradigms by introducing novel visual cues designed to mitigate unintended neural activity. We demonstrate the effectiveness of Rotation and Reference cue in eliciting consistent and accurate MRCPs during motor tasks, surpassing previous methods in achieving precise timing and high discriminability for classifier training. CONCLUSIONS: Precision in cue timing is crucial for training classifiers, where both Rotation and Reference cue demonstrate minimal variability and high discriminability, highlighting their potential for accurate classifications in online scenarios. These findings offer promising avenues for refining brain-computer interface systems, particularly for individuals with motor impairments, by enabling more reliable and intuitive control mechanisms.

The effects of kinesio taping on potential in chronic low back pain patients anticipatory postural control and cerebral cortex.

[Purpose] This study aimed to examine the effects of kinesio tape applied to chronic low back pain (CLBP) patients on anticipatory postural control and cerebral cortex potential. [Subjects and Methods] Twenty patients whose low back pain had continued for more than 12 weeks were selected and assigned to a control group (n=10) to which ordinary physical therapy was applied and an experimental group (n=10) to which kinesio tape was applied. Anticipatory postural control was evaluated using electromyography, and movement-related cortical potential (MRCP) was assessed using electroencephalography. Clinical evaluation was performed using a visual analogue scale and the Oswestry disability index. [Results] According to the analysis results for anticipatory postural control, there were significant decreases in the transversus abdominis (TrA) muscle and the external oblique muscle in both groups. Among them, the TrA of the experimental group exhibited the greatest differences. According to the results of a between-group comparison, there was significant difference in the TrA between the two groups. There was also a significant decrease in the MRCP of both groups. In particular, changes in the movement monitoring potential (MMP) of the experimental group were greatest at Fz, C3, Cz, and C4. According to the between-group comparison, there were significant differences in MMP at F3, C3, and Cz. Both groups saw VAS and ODI significantly decrease. Among them, the ODI of the experimental group underwent the greatest change. [Conclusion] Kinesio tape applied to CLBP patients reduced their pain and positively affected their anticipatory postural control and MRCP.

EEG generation mechanism of lower limb active movement intention and its virtual reality induction enhancement: a preliminary study.

Introduction: Active rehabilitation requires active neurological participation when users use rehabilitation equipment. A brain-computer interface (BCI) is a direct communication channel for detecting changes in the nervous system. Individuals with dyskinesia have unclear intentions to initiate movement due to physical or psychological factors, which is not conducive to detection. Virtual reality (VR) technology can be a potential tool to enhance the movement intention from pre-movement neural signals in clinical exercise therapy. However, its effect on electroencephalogram (EEG) signals is not yet known. Therefore, the objective of this paper is to construct a model of the EEG signal generation mechanism of lower limb active movement intention and then investigate whether VR induction could improve movement intention detection based on EEG. Methods: Firstly, a neural dynamic model of lower limb active movement intention generation was established from the perspective of signal transmission and information processing. Secondly, the movement-related EEG signal was calculated based on the model, and the effect of VR induction was simulated. Movement-related cortical potential (MRCP) and event-related desynchronization (ERD) features were extracted to analyze the enhancement of movement intention. Finally, we recorded EEG signals of 12 subjects in normal and VR environments to verify the effectiveness and feasibility of the above model and VR induction enhancement of lower limb active movement intention for individuals with dyskinesia. Results: Simulation and experimental results show that VR induction can effectively enhance the EEG features of subjects and improve the detectability of movement intention. Discussion: The proposed model can simulate the EEG signal of lower limb active movement intention, and VR induction can enhance the early and accurate detectability of lower limb active movement intention. It lays the foundation for further robot control based on the actual needs of users.

Bereitschaftspotential in Multiple System Atrophy.

Objective: Multiple system atrophy (MSA) is a neurodegenerative disorder manifesting as parkinsonism, cerebellar ataxia, and autonomic dysfunction. It is categorized into MSA with predominant parkinsonism (MSA-P) and into MSA with predominant cerebellar ataxia (MSA-C). The pathophysiology of motor control circuitry involvement in MSA subtype is unclear. Bereitschaftspotential (BP) is a feasible clinical tool to measure electroencephalographic activity prior to volitional motions. We recorded BP in patients with MSA-P and MSA-C to investigate their motor cortical preparation and activation for volitional movement. Methods: We included eight patients with MSA-P, eight patients with MSA-C, and eight age-matched healthy controls. BP was recorded during self-paced rapid wrist extension movements. The electroencephalographic epochs were time-locked to the electromyography onset of the voluntary wrist movements. The three groups were compared with respect to the mean amplitudes of early (1,500-500 ms before movement onset) and late (500-0 ms before movement onset) BP. Results: Mean early BP amplitude was non-significantly different between the three groups. Mean late BP amplitude in the two patient groups was significantly reduced in the parietal area contralateral to the movement side compared with that in the healthy control group. In addition, the late BP of the MSA-C group but not the MSA-P group was significantly reduced at the central parietal area compared with that of the healthy control group. Conclusions: Our findings suggest that patients with MSA exhibit motor cortical dysfunction in voluntary movement preparation and activation. The dysfunction can be practicably evaluated using late BP, which represents the cerebello-dentato-thalamo-cortical pathway.