Age-related decline in GABAergic intracortical inhibition can be counteracted by long-term learning of balance skills.

Ageing induces a decline in GABAergic intracortical inhibition, which seems to be associated not only with decremental changes in well-being, sleep quality, cognition and pain management but also with impaired motor control. So far, little is known regarding whether targeted interventions can prevent the decline of intracortical inhibition in the primary motor cortex in the elderly. Therefore, the present study investigated whether age-related cortical dis-inhibition could be reversed after 6 months of balance learning and whether improvements in postural control correlated with the extent of reversed dis-inhibition. The results demonstrated that intracortical inhibition can be upregulated in elderly subjects after long-term balance learning and revealed a correlation between changes in balance performance and intracortical inhibition. This is the first study to show physical activity-related upregulation of GABAergic inhibition in a population with chronic dis-inhibition and may therefore be seminal for many pathologies in which the equilibrium between inhibitory and excitatory neurotransmitters is disturbed. KEY POINTS: Ageing induces a decline in GABAergic intracortical inhibition. So far, little is known regarding whether targeted interventions can prevent the decline of intracortical inhibition in the primary motor cortex in the elderly. After 6 months of balance learning, intracortical inhibition can be upregulated in elderly subjects. The results of this study also revealed a correlation between changes in balance performance and intracortical inhibition. This is the first study to show physical activity-related upregulation of GABAergic inhibition in a population with chronic dis-inhibition.

Brain Activation During Active Balancing and Its Behavioral Relevance in Younger and Older Adults: A Functional Near-Infrared Spectroscopy (fNIRS) Study.

Age-related deterioration of balance control is widely regarded as an important phenomenon influencing quality of life and longevity, such that a more comprehensive understanding of the neural mechanisms underlying this process is warranted. Specifically, previous studies have reported that older adults typically show higher neural activity during balancing as compared to younger counterparts, but the implications of this finding on balance performance remain largely unclear. Using functional near-infrared spectroscopy (fNIRS), differences in the cortical control of balance between healthy younger (n = 27) and older (n = 35) adults were explored. More specifically, the association between cortical functional activity and balance performance across and within age groups was investigated. To this end, we measured hemodynamic responses (i.e., changes in oxygenated and deoxygenated hemoglobin) while participants balanced on an unstable device. As criterion variables for brain-behavior-correlations, we also assessed postural sway while standing on a free-swinging platform and while balancing on wobble boards with different levels of difficulty. We found that older compared to younger participants had higher activity in prefrontal and lower activity in postcentral regions. Subsequent robust regression analyses revealed that lower prefrontal brain activity was related to improved balance performance across age groups, indicating that higher activity of the prefrontal cortex during balancing reflects neural inefficiency. We also present evidence supporting that age serves as a moderator in the relationship between brain activity and balance, i.e., cortical hemodynamics generally appears to be a more important predictor of balance performance in the older than in the younger. Strikingly, we found that age differences in balance performance are mediated by balancing-induced activation of the superior frontal gyrus, thus suggesting that differential activation of this region reflects a mechanism involved in the aging process of the neural control of balance. Our study suggests that differences in functional brain activity between age groups are not a mere by-product of aging, but instead of direct behavioral relevance for balance performance. Potential implications of these findings in terms of early detection of fall-prone individuals and intervention strategies targeting balance and healthy aging are discussed.

Effects of an external compared to an internal focus of attention on the excitability of fast and slow(er) motor pathways.

The neurophysiological mechanisms underlying the behavioural improvements usually associated with an external (EF) compared with an internal focus of attention (IF) remain poorly investigated. Surround inhibition in the primary cortex has been shown to be more pronounced with an EF, indicating a more spatial restriction of the motor command. However, the influence of different foci on the temporal aspect of the motor command, such as the modulation of fast versus slow(er) motor pathways, remains unknown and was therefore investigated in this study. Fourteen participants were asked to press on a pedal with the right foot to match its position with a target line displayed on a screen. The deviation of the pedal from the target line was used as a behavioural parameter and compared between both foci (EF vs IF). Additionally, conditioned H-reflexes were evoked during the motor task to assess the excitability of fast (direct) and slower (more indirect) motor pathways when adopting an EF or IF. With an EF compared to an IF, the motor performance was enhanced (P = .001; + 24%) and the activation of slow(er) motor pathways was reduced (P < 0.001, - 11.73%). These findings demonstrate for the first time that using different attentional strategies (EF and IF) has an influence on the excitability of slow(er) motor pathways. Together with the increased intracortical inhibition and surround inhibition known from previous studies, the diminished activation in the slow(er) motor pathways further explains why using an EF is a more economic strategy.

How to Serve Faster in Tennis: The Influence of an Altered Focus of Attention and Augmented Feedback on Service Speed in Elite Players.

ABSTRACT: Keller, M, Kuhn, YA, Lüthy, F, and Taube, W. How to serve faster in tennis: the influence of an altered focus of attention and augmented feedback on service speed in elite players. J Strength Cond Res 35(4): 1119-1126, 2021-Different approaches, such as providing augmented feedback (AF) or adopting an external focus of attention (EF), have been shown to directly enhance performance in recreational athletes. Furthermore, research has shown that combining AF with EF (AF + EF) results in superior performance compared to AF and EF alone. Here, we tested the influence of AF, EF, AF + EF, and an internal focus of attention (IF) on service speed in elite tennis players. High-level national tennis players (19.2 ± 3.7 years) were asked to serve flat serves to a target zone with maximum speed. With respect to service speed, a significant main effect of condition was found (p ≤ 0.001). Post hoc comparisons revealed faster serves for AF compared to control serves without instruction/feedback (p < 0.01) and compared to EF (p < 0.05), whereas no significant difference was found between EF and IF (p = 0.81). The fastest service speeds were found in the AF condition, whereas the combination of AF + EF did not further promote performance. The number of serves landed in the target zone did not differ between conditions (p = 0.17). Thus, no speed-accuracy trade-off was found, indicating that enhanced service speeds did not result in less serves landed in the target zone. Augmented feedback seems most beneficial to instantly enhance tennis serve performance. In contrast to previous studies with recreational sportsmen, EF did not differ from IF, providing further evidence that expertise level and task-relevant instructions mediate the influence of attentional focus on motor performance.

Surround inhibition can instantly be modulated by changing the attentional focus.

To further investigate the mechanism of surround inhibition (SI) and to determine whether adopting different attentional strategies might have an impact on the modulation of SI, the effects of adopting an external (EF) or internal focus of attention (IF) on SI and motor performance were investigated. While performing an index flexion with either an EF or IF, transcranial magnetic stimulation was applied at various time points in 14 healthy subjects. When adopting an EF compared to an IF, the results show an improved motor performance (+14.7% in MVC) and a reduced bEMG in the adjacent APB (-22.3%) during maximal index flexion. This was accompanied by an increased SI in the APB with an EF (+26.4%). Additionally, the decrease in bEMG correlated with the magnitude of SI in APB. The current results demonstrate an efficient way to modulate SI by changing the attentional focus in healthy subjects and might, at least in part, explain the better motor performance being associated with an EF. The present findings help to better understand the positive mechanisms of an EF on SI in the healthy motor system and may also points towards a treatment strategy in pathologies with disturbed SI such as focal hand dystonia.

Intracortical Inhibition Within the Primary Motor Cortex Can Be Modulated by Changing the Focus of Attention.

It is well recognized that an external focus (EF) compared with an internal focus (IF) of attention improves motor learning and performance. Studies have indicated benefits in accuracy, balance, force production, jumping performance, movement speed, oxygen consumption, and fatiguing task. Although behavioral outcomes of using an EF strategy are well explored, the underlying neural mechanisms remain unknown. A recent TMS study compared the activity of the primary motor cortex (M1) between an EF and an IF. More precisely, this study showed that, when adopting an EF, the activity of intracortical inhibitory circuits is enhanced. On the behavioral level, the present protocol tests the influence of attentional foci on the time to task failure (TTF) when performing submaximal contractions of the first dorsal interosseous (FDI). Additionally, the current paper describes two TMS protocols to assess the influence of attentional conditions on the activity of cortical inhibitory circuits within the M1. Thus, the present article describes how to use single-pulse TMS at intensities below the motor threshold (subTMS) and paired-pulse TMS, inducing short-interval intracortical inhibition (SICI) when applied to the M1. As these methods are assumed to reflect the responsiveness of GABAergic inhibitory neurons, without being affected by spinal reflex circuitries, they are well suited to measuring the activity of intracortical inhibitory circuits within the M1. The results show that directing attention externally improves motor performance, as participants were able to prolong the time to task failure. Moreover, the results were accompanied by a larger subTMS-induced electromyography suppression and SICI when adopting an EF compared to an IF. As the level of cortical inhibition within the M1 was previously demonstrated to influence motor performance, the enhanced inhibition with an EF might contribute to the better movement efficiency observed in the behavioral task, indicated by a prolonged TTF with an EF.