Subthalamic DBS does not restore deficits in corticospinal suppression during movement preparation in Parkinson's disease.

OBJECTIVE: Parkinson's disease (PD) patients exhibit changes in mechanisms underlying movement preparation, particularly the suppression of corticospinal excitability - termed "preparatory suppression" - which is thought to facilitate movement execution in healthy individuals. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) being an attractive treatment for advanced PD, we aimed to study the potential contribution of this nucleus to PD-related changes in such corticospinal dynamics. METHODS: On two consecutive days, we applied single-pulse transcranial magnetic stimulation to the primary motor cortex of 20 advanced PD patients treated with bilateral STN-DBS (ON vs. OFF), as well as 20 healthy control subjects. Motor-evoked potentials (MEPs) were elicited at rest or during movement preparation in an instructed-delay choice reaction time task including left- or right-hand responses. Preparatory suppression was assessed by expressing MEPs during movement preparation relative to rest. RESULTS: PD patients exhibited a deficit in preparatory suppression when it was probed on the responding hand side, particularly when this corresponded to their most-affected hand, regardless of their STN-DBS status. CONCLUSIONS: Advanced PD patients displayed a reduction in preparatory suppression which was not restored by STN-DBS. SIGNIFICANCE: The current findings confirm that PD patients lack preparatory suppression, as previously reported. Yet, the fact that this deficit was not responsive to STN-DBS calls for future studies on the neural source of this regulatory mechanism during movement preparation.

Non-invasive stimulation of the human striatum disrupts reinforcement learning of motor skills.

Reinforcement feedback can improve motor learning, but the underlying brain mechanisms remain underexplored. In particular, the causal contribution of specific patterns of oscillatory activity within the human striatum is unknown. To address this question, we exploited a recently developed non-invasive deep brain stimulation technique called transcranial temporal interference stimulation (tTIS) during reinforcement motor learning with concurrent neuroimaging, in a randomized, sham-controlled, double-blind study. Striatal tTIS applied at 80 Hz, but not at 20 Hz, abolished the benefits of reinforcement on motor learning. This effect was related to a selective modulation of neural activity within the striatum. Moreover, 80 Hz, but not 20 Hz, tTIS increased the neuromodulatory influence of the striatum on frontal areas involved in reinforcement motor learning. These results show that tTIS can non-invasively and selectively modulate a striatal mechanism involved in reinforcement learning, expanding our tools for the study of causal relationships between deep brain structures and human behaviour.

Accelerometry as a tool for measuring the effects of transcranial magnetic stimulation.

OBJECTIVE: We predicted that accelerometry would be a viable alternative to electromyography (EMG) for assessing fundamental Transcranial Magnetic Stimulation (TMS) measurements (e.g. Resting Motor Threshold (RMT), recruitment curves, latencies). NEW METHOD: 21 participants were tested. TMS evoked responses were recorded with EMG on the First Dorsal Interosseus muscle and an accelerometer on the index fingertip. TMS was used to determine the (EMG-defined) RMT, then delivered at a range of intensities allowing determination of both the accelerometry-defined RMT and measurement of recruitment curves. RESULTS: RMT assessed by EMG was significantly lower than for accelerometry (t(19)=-3.84, p<.001, mean±SD EMG = 41.1±5.28% MSO (maximum stimulator output), Jerk = 44.55±5.82% MSO), though RMTs calculated for each technique were highly correlated (r(18)=.72, p<.001). EMG/Accelerometery recruitment curves were strongly correlated (r(14)=.98, p<.001), and Bayesian model comparison indicated they were equivalent (BF01>9). Latencies measured with EMG were lower and more consistent than those identified using accelerometry (χ2(1)=80.38, p<.001, mean±SD EMG=27.01±4.58 ms, Jerk=48.4±15.33 ms). COMPARISON WITH EXISTING METHODS: EMG is used as standard by research groups that study motor control and neurophysiology, but accelerometry has not yet been considered as a potential tool to assess measurements such as the overall magnitude and latency of the evoked response. CONCLUSIONS: While EMG provides more sensitive and reliable measurements of RMT and latency, accelerometry provides a reliable alternative to measure of the overall magnitude of TMS evoked responses.

Relationship between transcranial magnetic stimulation markers of motor control and clinical recovery in obsessive compulsive disorder/Gilles de la Tourette syndrome: a proof of concept case study.

Background: Obsessive compulsive disorder (OCD) and Gilles de la Tourette syndrome (GTS) are neurodevelopmental disorders characterized by difficulties in controlling intrusive thoughts (obsessions) and undesired actions (tics), respectively. Both conditions have been associated with abnormal inhibition but a tangible deficit of inhibitory control abilities is controversial in GTS. Methods: Here, we examined a 25 years-old male patient with severe OCD symptoms and a mild form of GTS, where impairments in motor control were central. Transcranial magnetic stimulation (TMS) was applied over the primary motor cortex (M1) to elicit motor-evoked potentials (MEPs) during four experimental sessions, allowing us to assess the excitability of motor intracortical circuitry at rest as well as the degree of MEP suppression during action preparation, a phenomenon thought to regulate movement initiation. Results: When tested for the first time, the patient presented a decent level of MEP suppression during action preparation, but he exhibited a lack of intracortical inhibition at rest, as evidenced by reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI). Interestingly, the patient's symptomatology drastically improved over the course of the sessions (reduced obsessions and tics), coinciding with feedback given on his good motor control abilities. These changes were reflected in the TMS measurements, with a significant strengthening of intracortical inhibition (SICI and LICI more pronounced than previously) and a more selective tuning of MEPs during action preparation; MEPs became even more suppressed, or selectively facilitated depending on the behavioral condition in which they we probed. Conclusion: This study highlights the importance of better understanding motor inhibitory mechanisms in neurodevelopmental disorders and suggests a biofeedback approach as a potential novel treatment.

Reflecting on what is "skill" in human motor skill learning.

Humans have an exceptional ability to execute a variety of skilled movements. Researchers have been long interested in understanding behavioral and neurophysiological basis of human motor skill learning for advancing both fundamental neuroscientific knowledge and clinical outcomes. However, despite decades of work in this field there is a lack of consensus about what is meant by "skill" in skill learning. With an advent of various task paradigms testing human motor behavior and increasing heterogeneity in motor learning assessments methods, it is very crucial to identify key features of skill in order to avoid any ambiguity that may result in misinterpretation or over-generalization of findings, which could have serious implications for replication and translational research. In this review, we attempt to highlight the features of skill following a historical approach, considering the seminal work that led to the first definitions of skill and including some contemporary concepts emerging from human motor learning research. Overall, based on this literature, we emphasize that skill has some fundamental characteristics, such as- (i) optimal movement selection and execution, (ii) improved movement speed and accuracy, and (iii) reduced movement variability and error. These features of skill can emerge as a consequence of extensive practice/training/learning, thus resulting in an improved performance state beyond baseline levels. Finally we provide some examples of model tasks that can appropriately capture these features of skill, and conclude that any neuroscientific endeavor aimed at understanding the essence of skill in human motor skill learning should focus on these aspects.

Movement characteristics impact decision-making and vice versa.

Previous studies suggest that humans are capable of coregulating the speed of decisions and movements if promoted by task incentives. It is unclear however whether such behavior is inherent to the process of translating decisional information into movements, beyond posing a valid strategy in some task contexts. Therefore, in a behavioral online study we imposed time constraints to either decision- or movement phases of a sensorimotor task, ensuring that coregulating decisions and movements was not promoted by task incentives. We found that participants indeed moved faster when fast decisions were promoted and decided faster when subsequent finger tapping movements had to be executed swiftly. These results were further supported by drift diffusion modelling and inspection of psychophysical kernels: Sensorimotor delays related to initiating the finger tapping sequence were shorter in fast-decision as compared to slow-decision blocks. Likewise, the decisional speed-accuracy tradeoff shifted in favor of faster decisions in fast-tapping as compared to slow-tapping blocks. These findings suggest that decisions not only impact movement characteristics, but that properties of movement impact the time taken to decide. We interpret these behavioral results in the context of embodied decision-making, whereby shared neural mechanisms may modulate decisions and movements in a joint fashion.

Exploring the links between gut microbiota and excitatory and inhibitory brain processes in alcohol use disorder: A TMS study.

While the impact of the gut microbiota on brain and behavior is increasingly recognized, human studies examining this question are still scarce. The primary objective of the current study was to explore the potential relationships between the gut microbiota composition, motor cortical excitability at rest and during inhibitory control, as well as behavioral inhibition, in healthy volunteers and in patients suffering from alcohol use disorder. Motor cortical excitability was examined using a range of transcranial magnetic stimulation (TMS) measures probed at rest, including the recruitment curve, short and long intracortical inhibition, and intracortical facilitation within the primary motor cortex. Moreover, TMS was applied during a choice reaction time task to assess changes in motor excitability associated with inhibitory control. Finally, behavioral inhibition was investigated using a neuropsychological task (anti-saccade). Overall, our results highlight several interesting correlations between microbial composition and brain measures. Hence, higher bacterial diversity, as well as higher relative abundances of UGC-002 and Christensenellaceae R-7 group were correlated with stronger changes in motor excitability associated with inhibitory control. Also, higher abundance of Anaerostipes was associated with higher level of corticospinal excitability. Finally, relative abundances of Bifidobacterium and Faecalibacterium were positively related to performance in the neuropsychological task, suggesting that they might have a positive impact on behavioral inhibition. Although correlation is not causation, the present study suggests that excitatory and inhibitory brain processes might be related to gut microbiota composition. This article is part of the Special Issue on 'Microbiome & the Brain: Mechanisms & Maladies'.

Percepción en las ocupaciones de mujeres con cáncer de mama que ejercen rol de madre trabajadora: una mirada desde el Modelo Persona Ambiente Ocupación / Percepção das ocupações de mulheres com câncer de mama que exercem o papel de mãe trabalhadora: um olhar a partir do Modelo Pessoa Ambiente Ocupação / Perception of the occupational roles of working mothers with breast cancer: a view from the Person-Environment-Occupation Model

Resumen En esta investigación se aborda cómo las mujeres que cumplen el rol de madre trabajadora perciben el impacto en estos roles posterior a la experiencia de tener/haber tenido cáncer de mama, desde el Modelo Persona Ambiente Ocupación, considerando todos sus componentes y como su interacción influye en el desempeño ocupacional. La metodología utilizada se centra en la recopilación de información, por medio de entrevistas realizadas a 10 mujeres acerca de sus experiencias en relación con este diagnóstico, de las cuales 5 están en tratamiento, y las restantes se encuentran recuperadas. De acuerdo con los resultados, las mujeres perciben que su desempeño se vio impactado, debido a las consecuencias físicas, socioemocionales y cognitivas que conlleva el tener/haber tenido cáncer de mama. A su vez se generó un impacto en los roles que desempeñan estas mujeres, por lo cual se evidenció la importancia de contar con redes de apoyo durante todo el proceso. Debido a esto, es necesario llevar a cabo futuras investigaciones que puedan contribuir y fundamentar la importancia de la terapia ocupacional en esta patología para así favorecer un tratamiento integral, considerando sus ocupaciones significativas y los contextos en los cuales se desenvuelven.

Resumo Esta pesquisa aborda, a partir do Modelo Pessoa Ambiente Ocupação, como as mulheres que cumprem o papel de mães trabalhadoras percebem o impacto destes papéis, após a experiência de ter/ter tido câncer de mama, considerando todos os seus componentes e como sua interação influencia o desempenho ocupacional. A metodologia utilizada centra-se na coleta de informação, através de entrevistas a 10 mulheres sobre as suas vivências em relação a este diagnóstico, das quais cinco estão em tratamento e as restantes recuperadas. De acordo com os resultados, as mulheres percebem que seu desempenho foi impactado, devido às consequências físicas, socioemocionais e cognitivas de ter/ter tido câncer de mama. Ao mesmo tempo, gerou-se um impacto nos papéis que essas mulheres desempenham, para o qual ficou evidente a importância de contar com redes de apoio ao longo do processo. Diante disso, faz-se necessária a realização de pesquisas futuras que possam contribuir e fundamentar a importância da terapia ocupacional nessa patologia de forma a favorecer um tratamento integral, considerando suas ocupações significativas e os contextos em que estão inseridas.

Abstract This research addresses the perceptions of women who identify as working mothers regarding the impact on their occupational roles following a breast cancer diagnosis, based on the Person-Environment-Occupation Model. The methodology involved conducting interviews with ten women about their experiences related to their breast cancer diagnosis, of which five were undergoing treatment and five had recovered. The results reveal that these women perceive their performance to be impacted by the physical, socioemotional, and cognitive consequences of having or having had breast cancer. Furthermore, the illness also affected the various roles they inhabited, highlighting the importance of support networks throughout the process. Therefore, future research is essential to underscore the importance of occupational therapy in treating this condition, considering the women's significant occupations and the contexts in which they occur.

Corticospinal Suppression Underlying Intact Movement Preparation Fades in Parkinson's Disease.

BACKGROUND: In Parkinson's disease (PD), neurophysiological abnormalities within the primary motor cortex (M1) have been shown to contribute to bradykinesia, but exact modalities are still uncertain. We propose that such motor slowness could involve alterations in mechanisms underlying movement preparation, especially the suppression of corticospinal excitability-called "preparatory suppression"-which is considered to propel movement execution by increasing motor neural gain in healthy individuals. METHODS: On two consecutive days, 29 PD patients (on and off medication) and 29 matched healthy controls (HCs) underwent transcranial magnetic stimulation over M1, eliciting motor-evoked potentials (MEPs) in targeted hand muscles, while they were either at rest or preparing a left- or right-hand response in an instructed-delay choice reaction time task. Preparatory suppression was assessed by expressing MEP amplitudes during movement preparation relative to rest. RESULTS: Contrary to HCs, PD patients showed a lack of preparatory suppression when the side of the responding hand was analyzed, especially when the latter was the most affected one. This deficit, which did not depend on dopamine medication, increased with disease duration and also tended to correlate with motor impairment, as measured by the Movement Disorder Society Unified Parkinson's Disease Rating Scale, Part III (both total and bradykinesia scores). CONCLUSIONS: Our novel findings indicate that preparatory suppression fades in PD, in parallel with worsening motor symptoms, including bradykinesia. Such results suggest that an alteration in this marker of intact movement preparation could indeed cause motor slowness and support its use in future studies on the relation between M1 alterations and motor impairment in PD. © 2022 International Parkinson and Movement Disorder Society.

Post-error Slowing Reflects the Joint Impact of Adaptive and Maladaptive Processes During Decision Making.

Errors and their consequences are typically studied by investigating changes in decision speed and accuracy in trials that follow an error, commonly referred to as "post-error adjustments". Many studies have reported that subjects slow down following an error, a phenomenon called "post-error slowing" (PES). However, the functional significance of PES is still a matter of debate as it is not always adaptive. That is, it is not always associated with a gain in performance and can even occur with a decline in accuracy. Here, we hypothesized that the nature of PES is influenced by one's speed-accuracy tradeoff policy, which determines the overall level of choice accuracy in the task at hand. To test this hypothesis, we had subjects performing a task in two distinct contexts (separate days), which either promoted speed (hasty context) or cautiousness (cautious context), allowing us to consider post-error adjustments according to whether subjects performed choices with a low or high accuracy level, respectively. Accordingly, our data indicate that post-error adjustments varied according to the context in which subjects performed the task, with PES being solely significant in the hasty context (low accuracy). In addition, we only observed a gain in performance after errors in a specific trial type, suggesting that post-error adjustments depend on a complex combination of processes that affect the speed of ensuing actions as well as the degree to which such PES comes with a gain in performance.

Reward timing matters in motor learning.

Reward timing, that is, the delay after which reward is delivered following an action is known to strongly influence reinforcement learning. Here, we asked if reward timing could also modulate how people learn and consolidate new motor skills. In 60 healthy participants, we found that delaying reward delivery by a few seconds influenced motor learning. Indeed, training with a short reward delay (1 s) induced continuous improvements in performance, whereas a long reward delay (6 s) led to initially high learning rates that were followed by an early plateau in the learning curve and a lower performance at the end of training. Participants who learned the skill with a long reward delay also exhibited reduced overnight memory consolidation. Overall, our data show that reward timing affects the dynamics and consolidation of motor learning, a finding that could be exploited in future rehabilitation programs.

Hasty sensorimotor decisions rely on an overlap of broad and selective changes in motor activity.

Humans and other animals are able to adjust their speed-accuracy trade-off (SAT) at will depending on the urge to act, favoring either cautious or hasty decision policies in different contexts. An emerging view is that SAT regulation relies on influences exerting broad changes on the motor system, tuning its activity up globally when hastiness is at premium. The present study aimed to test this hypothesis. A total of 50 participants performed a task involving choices between left and right index fingers, in which incorrect choices led either to a high or to a low penalty in 2 contexts, inciting them to emphasize either cautious or hasty policies. We applied transcranial magnetic stimulation (TMS) on multiple motor representations, eliciting motor-evoked potentials (MEPs) in 9 finger and leg muscles. MEP amplitudes allowed us to probe activity changes in the corresponding finger and leg representations, while participants were deliberating about which index to choose. Our data indicate that hastiness entails a broad amplification of motor activity, although this amplification was limited to the chosen side. On top of this effect, we identified a local suppression of motor activity, surrounding the chosen index representation. Hence, a decision policy favoring speed over accuracy appears to rely on overlapping processes producing a broad (but not global) amplification and a surround suppression of motor activity. The latter effect may help to increase the signal-to-noise ratio of the chosen representation, as supported by single-trial correlation analyses indicating a stronger differentiation of activity changes in finger representations in the hasty context.

Reward boosts reinforcement-based motor learning.

Besides relying heavily on sensory and reinforcement feedback, motor skill learning may also depend on the level of motivation experienced during training. Yet, how motivation by reward modulates motor learning remains unclear. In 90 healthy subjects, we investigated the net effect of motivation by reward on motor learning while controlling for the sensory and reinforcement feedback received by the participants. Reward improved motor skill learning beyond performance-based reinforcement feedback. Importantly, the beneficial effect of reward involved a specific potentiation of reinforcement-related adjustments in motor commands, which concerned primarily the most relevant motor component for task success and persisted on the following day in the absence of reward. We propose that the long-lasting effects of motivation on motor learning may entail a form of associative learning resulting from the repetitive pairing of the reinforcement feedback and reward during training, a mechanism that may be exploited in future rehabilitation protocols.

Augmented tendency to act and altered impulse control in alcohol use disorders.

Action preparation relies on the operation of control processes that modulate the excitability of the corticospinal tract. On the one hand, excitatory processes prepare the motor system for the forthcoming response; the stronger these influences, the stronger the tendency to act. On the other hand, inhibitory influences allow to suppress inappropriate actions and, more generally, to ensure some sort of impulse control. Because an impairment in these processes could foster inappropriate drinking behavior, the present study aimed at evaluating the motor correlates of such excitatory and inhibitory influences in non-treatment seeking heavy drinkers (HDs) and inpatients suffering from severe alcohol use disorder (SAUDs). Besides, as cue-elicited craving might further alter these processes, we also assessed the impact of an alcohol-related exposure. To do so, 15 healthy controls (HCs), 15 HDs and 15 SAUDs performed a choice reaction time task after having been immersed in a neutral or an alcohol-related environment, using virtual reality videos. Importantly, single-pulse transcranial magnetic stimulation was applied over the left and the right primary motor cortex during the task to elicit motor-evoked potentials in a set of hand muscles allowing us to specifically probe the impact of excitatory and inhibitory processes on motor activity. Our data indicate that excitatory influences are particularly high in both HDs and SAUDs, especially in the dominant hand, an effect that was not observed in HCs. By contrast, inhibitory influences were found to be perfectly normal in HDs, while they were lacking in SAUDs. Furthermore, the alcohol-related exposure enhanced the level of self-reported craving, but this effect only arose in HDs and did not significantly alter the strength of excitatory and inhibitory influences. Overall, although these results have to be taken with caution due to the small sample sizes, this study suggests that enhanced excitatory processes characterize both HDs and SAUDs, while weaker inhibitory influences only concern SAUDs. Hence, an abnormally strong tendency to act could represent a common feature of hazardous drinking, leading individuals to excessive alcohol consumption, whereas deficient impulse control would be a hallmark of more severe forms of AUD, potentially due to the chronic neurotoxic effects of alcohol. Finally, although an alcohol-related exposure does not seem to affect excitatory and inhibitory processes at play during action preparation per se, future works should evaluate changes in corticospinal excitability during the preparation of responses specifically targeting alcohol-related cues.

Trading accuracy for speed over the course of a decision.

Humans and other animals often need to balance the desire to gather sensory information (to make the best choice) with the urgency to act, facing a speed-accuracy tradeoff (SAT). Given the ubiquity of SAT across species, extensive research has been devoted to understanding the computational mechanisms allowing its regulation at different timescales, including from one context to another, and from one decision to another. However, animals must frequently change their SAT on even shorter timescales-that is, over the course of an ongoing decision-and little is known about the mechanisms that allow such rapid adaptations. The present study aimed at addressing this issue. Human subjects performed a decision task with changing evidence. In this task, subjects received rewards for correct answers but incurred penalties for mistakes. An increase or a decrease in penalty occurring halfway through the trial promoted rapid SAT shifts, favoring speeded decisions either in the early or in the late stage of the trial. Importantly, these shifts were associated with stage-specific adjustments in the accuracy criterion exploited for committing to a choice. Those subjects who decreased the most their accuracy criterion at a given decision stage exhibited the highest gain in speed, but also the highest cost in terms of performance accuracy at that time. Altogether, the current findings offer a unique extension of previous work, by suggesting that dynamic cha*nges in accuracy criterion allow the regulation of the SAT within the timescale of a single decision.NEW & NOTEWORTHY Extensive research has been devoted to understanding the mechanisms allowing the regulation of the speed-accuracy tradeoff (SAT) from one context to another and from one decision to another. Here, we show that humans can voluntarily change their SAT on even shorter timescales-that is, over the course of a decision. These rapid SAT shifts are associated with dynamic adjustments in the accuracy criterion exploited for committing to a choice.

Role of the fronto-parietal cortex in prospective action judgments.

Prospective judgments about one's capability to perform an action are assumed to involve mental simulation of the action. Previous studies of motor imagery suggest this simulation is supported by a large fronto-parietal network including the motor system. Experiment 1 used fMRI to assess the contribution of this fronto-parietal network to judgments about one's capacity to grasp objects of different sizes between index and thumb. The neural network underlying prospective graspability judgments overlapped the fronto-parietal network involved in explicit motor imagery of grasping. However, shared areas were located in the right hemisphere, outside the motor cortex, and were also activated during perceptual length judgments, suggesting a contribution to object size estimate rather than motor simulation. Experiment 2 used TMS over the motor cortex to probe transient excitability changes undetected with fMRI. Results show that graspability judgments elicited a selective increase of excitability in the thumb and index muscles, which was maximal before the object display and intermediate during the judgment. Together, these findings suggest that prospective action judgments do not rely on the motor system to simulate the action per se but to refresh the memory of one's maximal grip aperture and facilitate its comparison with object size in right fronto-parietal areas.

Neural bases of inhibitory control: Combining transcranial magnetic stimulation and magnetic resonance imaging in alcohol-use disorder patients.

Inhibitory control underlies the ability to inhibit inappropriate responses and involves processes that suppress motor excitability. Such motor modulatory effect has been largely described during action preparation but very little is known about the neural circuit responsible for its implementation. Here, we addressed this point by studying the degree to which the extent of preparatory suppression relates to brain morphometry. We investigated this relationship in patients suffering from severe alcohol use disorder (AUD) because this population displays an inconsistent level of preparatory suppression and major structural brain damage, making it a suitable sample to measure such link. To do so, 45 detoxified patients underwent a structural magnetic resonance imaging (MRI) and performed a transcranial magnetic stimulation (TMS) experiment, in which the degree of preparatory suppression was quantified. Besides, behavioral inhibition and trait impulsivity were evaluated in all participants. Overall, whole-brain analyses revealed that a weaker preparatory suppression was associated with a decrease in cortical thickness of a medial prefrontal cluster, encompassing parts of the anterior cingulate cortex and superior-frontal gyrus. In addition, a negative association was observed between the thickness of the supplementary area (SMA)/pre-SMA and behavioral inhibition abilities. Finally, we did not find any significant correlation between preparatory suppression, behavioral inhibition and trait impulsivity, indicating that they represent different facets of inhibitory control. Altogether, the current study provides important insight on the neural regions underlying preparatory suppression and allows highlighting that the excitability of the motor system represents a valuable read-out of upstream cognitive processes.

Motor training strengthens corticospinal suppression during movement preparation.

Training can improve motor skills and modify neural activity at rest and during movement execution. Learning-related modulations may also concern motor preparation but the neural correlates and the potential behavioral relevance of such adjustments remain unclear. In humans, preparatory processes have been largely investigated using transcranial magnetic stimulation (TMS) with several studies reporting decreased corticospinal excitability (CSE) relative to a baseline measure at rest; a phenomenon called preparatory suppression. Here, we investigated the effect of motor training on such preparatory suppression, in relation to resting CSE, in humans. We trained participants to initiate quick movements in an instructed-delay reaction time (RT) task and used TMS to investigate changes in CSE over the practice blocks. Training on the task speeded up RTs, with no repercussion on error rates. Training also increased resting CSE. Most interestingly, we found that CSE during action preparation did not mirror the training-related increase observed at rest. Rather, compared with the rising baseline, the degree of preparatory suppression strengthened with practice. This training-related change in preparatory suppression (but not the changes in baseline CSE) predicted RT gains: the subjects showing a greater strengthening of preparatory suppression were also those exhibiting larger gains in RTs. Finally, such a relationship between RTs and preparatory suppression was also evident at the single-trial level, though only in the nonselected effector: RTs were generally faster in trials where preparatory suppression was deeper. These findings suggest that training induces changes in motor preparatory processes that are linked to an enhanced ability to initiate fast movements.NEW & NOTEWORTHY Movement preparation involves a broad suppression in the excitability of the corticospinal pathway, a phenomenon called preparatory suppression. Here, we show that motor training strengthens preparatory suppression and that this strengthening is associated with faster reaction times. Our findings highlight a key role of preparatory suppression in training-driven behavioral improvements.

A TMS study of preparatory suppression in binge drinkers.

Binge drinking consists in a pattern of consumption characterised by the repeated alternation between massive alcohol intakes and abstinence periods. A continuum hypothesis suggests that this drinking endeavour represents an early stage of alcohol dependence rather than a separate phenomenon. Among the variety of alterations in alcohol-dependent individuals (ADIs), one has to do with the motor system, which does not show a normal pattern of activity during action preparation. In healthy controls (HCs), motor-evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) over primary motor cortex (M1) show both facilitation and suppression effects, depending on the time and setting of TMS during action preparation. A recent study focusing on the suppression component revealed that this aspect of preparatory activity is abnormally weak in ADIs and that this defect scales with the risk of relapse. In the present study, we tested whether binge drinkers (BDs) present a similar deficit. To do so, we recorded MEPs in a set of hand muscles applying TMS in 20 BDs and in 20 matched HCs while they were preparing index finger responses in an instructed-delay choice reaction time task. Consistent with past research, the MEP data in HCs revealed a strong MEP suppression in this task. This effect was evident in all hand muscles, regardless of whether they were relevant or irrelevant in the task. BDs also showed some preparatory suppression, yet this effect was less consistent, especially in the prime mover of the responding hand. These findings suggest abnormal preparatory activity in BDs, similar to alcohol-dependent patients, though some of the current results also raise new questions regarding the significance of these observations.