Effects of transcranial magnetic stimulation (TMS) current direction and pulse waveform on cortico-cortical connectivity: A registered report TMS-EEG study.

Transcranial magnetic stimulation (TMS)-evoked potentials (TEPs) are a promising proxy for measuring effective connectivity, that is, the directed transmission of physiological signals along cortico-cortical tracts, and for developing connectivity-based biomarkers. A crucial point is how stimulation parameters may affect TEPs, as they may contribute to the general variability of findings across studies. Here, we manipulated two TMS parameters (i.e. current direction and pulse waveform) while measuring (a) an early TEP component reflecting contralateral inhibition of motor areas, namely, M1-P15, as an operative model of interhemispheric cortico-cortical connectivity, and (b) motor-evoked potentials (MEP) for the corticospinal pathway. Our results showed that these two TMS parameters are crucial to evoke the M1-P15, influencing its amplitude, latency, and replicability. Specifically, (a) M1-P15 amplitude was strongly affected by current direction in monophasic stimulation; (b) M1-P15 latency was significantly modulated by current direction for monophasic and biphasic pulses. The replicability of M1-P15 was substantial for the same stimulation condition. At the same time, it was poor when stimulation parameters were changed, suggesting that these factors must be controlled to obtain stable single-subject measures. Finally, MEP latency was modulated by current direction, whereas non-statistically significant changes were evident for amplitude. Overall, our study highlights the importance of TMS parameters for early TEP responses recording and suggests controlling their impact in developing connectivity biomarkers from TEPs. Moreover, these results point out that the excitability of the corticospinal tract, which is commonly used as a reference to set TMS intensity, may not correspond to the excitability of cortico-cortical pathways.

M1-P15 as a cortical marker for transcallosal inhibition: A preregistered TMS-EEG study.

In a recently published study combining transcranial magnetic stimulation and electroencephalography (TMS-EEG), an early component of TMS-evoked potentials (TEPs), i.e., M1-P15, was proposed as a measure of transcallosal inhibition between motor cortices. Given that early TEPs are known to be highly variable, further evidence is needed before M1-P15 can be considered a reliable index of effective connectivity. Here, we conceived a new preregistered TMS-EEG study with two aims. The first aim was validating the M1-P15 as a cortical index of transcallosal inhibition by replicating previous findings on its relationship with the ipsilateral silent period (iSP) and with performance in bimanual coordination. The second aim was inducing a task-dependent modulation of transcallosal inhibition. A new sample of 32 healthy right-handed participants underwent behavioral motor tasks and TMS-EEG recording, in which left and right M1 were stimulated both during bimanual tasks and during an iSP paradigm. Hypotheses and methods were preregistered before data collection. Results show a replication of our previous findings on the positive relationship between M1-P15 amplitude and the iSP normalized area. Differently, the relationship between M1-P15 latency and bimanual coordination was not confirmed. Finally, M1-P15 amplitude was modulated by the characteristics of the bimanual task the participants were performing, and not by the contralateral hand activity during the iSP paradigm. In sum, the present results corroborate our previous findings in validating the M1-P15 as a cortical marker of transcallosal inhibition and provide novel evidence of its task-dependent modulation. Importantly, we demonstrate the feasibility of preregistration in the TMS-EEG field to increase methodological rigor and transparency.

Sharing motor plans while acting jointly: A TMS study.

When acting together, we may represent not only our own individual goals but also a collective goal. Although behavioural evidence suggests that agents' motor plans might be related to collective goals, direct neurophysiological evidence of whether collective goals are motorically represented is still scarce. The aim of the present transcranial magnetic stimulation (TMS) study is to begin to fill this gap. A participant and a confederate were asked to sequentially perform a two-choice reaction time task by acting on pressure sensors. In their own turn, they saw a cue indicating whether to lift their fingers from (or to press them on) a pressure sensor to shoot a ball across the screen as fast as possible. The confederate responded with the right hand, the participant with the left hand. While the confederate acted on the sensor, the participant's motor evoked potentials (MEPs) were collected from the right Extensor Carpi Ulnaris. If participants represent their own and the confederate's actions as being directed to a collective goal, MEPs amplitude should be modulated according to the action the confederate should perform. To test this conjecture, we contrasted three conditions: a Joint condition, in which both players worked together with their collective goal being to shoot the ball to get it to a common target, a Parallel condition, in which the players performed exactly the same task but received independent outcomes for their performance, and a Competitive condition, in which the outcome of the game still depended on the other player performance, but without the collective goal feature. Results showed no MEPs modulation according to the confederate's action in the Joint condition. Post-hoc exploratory analyses both provide some hints about this negative finding and also suggest possible improvements (i.e., adopting a different dependent variable, avoiding task-switching between conditions) for testing our hypothesis that collective goal can be represented motorically.

Head magnetomyography (hMMG): A novel approach to monitor face and whole head muscular activity.

Muscular activity recording is of high basic science and clinical relevance and is typically achieved using electromyography (EMG). While providing detailed information about the state of a specific muscle, this technique has limitations such as the need for a priori assumptions about electrode placement and difficulty with recording muscular activity patterns from extended body areas at once. For head and face muscle activity, the present work aimed to overcome these restrictions by exploiting magnetoencephalography (MEG) as a whole head myographic recorder (head magnetomyography, hMMG). This is in contrast to common MEG studies, which treat muscular activity as artifact in electromagnetic brain activity. In a first proof-of-concept step, participants imitated emotional facial expressions performed by a model. Exploiting source projection algorithms, we were able to reconstruct muscular activity, showing spatial activation patterns in accord with the hypothesized muscular contractions. Going one step further, participants passively observed affective pictures with negative, neutral, or positive valence. Applying multivariate pattern analysis to the reconstructed hMMG signal, we were able to decode above chance the valence category of the presented pictures. Underlining the potential of hMMG, a searchlight analysis revealed that generally neglected neck muscles exhibit information on stimulus valence. Results confirm the utility of hMMG as a whole head electromyographic recorder to quantify muscular activation patterns including muscular regions that are typically not recorded with EMG. This key advantage beyond conventional EMG has substantial scientific and clinical potential.

The role of medial prefrontal cortex in processing emotional self-referential information: a combined TMS/fMRI study.

In this study we investigate the neural basis of emotional content in self-referential processing by using a combination of off-line repetitive Transcranial Magnetic Stimulation (rTMS) applied to the medial prefrontal cortex (mPFC) and whole-brain functional Magnetic Resonance Imaging (fMRI).We applied effective or ineffective (sham) 1-Hz rTMS to the mPFC of 14 healthy participants who immediately thereafter underwent fMRI while performing a personality attribution task to self or to others. rTMS produced an increase in the participants' reaction time (≈ 60 msec) when processing negative attributes. The neuroimaging findings indicated the involvement of a network of cortical nodes distant from those at the stimulation site; these distant nodes showed task-specific changes in blood oxygen level-dependent (BOLD) activity after effective TMS. The posterior cingulate cortex seemingly encoded the negative dimension of stimuli, but it did not differentiate between self or other. On the contrary the left angular gyrus and the left anterior temporal cortex showed changes indicating encoding of negative self-directed categorization. The mPFC region did not show effects of rTMS along the self-other dimension, but only along the affective dimension. The results indicate that the mPFC is a pivotal node in a cortical network that supports affective referential reasoning. Therefore, a key function of mPFC seems to be related to the processing of negative attributes. In the other nodes of the network the two dimensions of self-other attribution and affective attribution are partially independent, but largely overlapping with different degrees of local specialization.

Spatial and Temporal Characteristics of Set-Related Inhibitory and Excitatory Inputs from the Dorsal Premotor Cortex to the Ipsilateral Motor Cortex Assessed by Dual-Coil Transcranial Magnetic Stimulation.

The capacity to produce movements only at appropriate times is fundamental in successful behavior and requires a fine interplay between motor inhibition and facilitation. Evidence in humans indicates that the dorsal premotor cortex (PMCd) is involved in such preparatory and inhibitory processes, but how PMCd modulates motor output in humans is still unclear. We investigated this issue in healthy human volunteers, using a variant of the dual-coil transcranial magnetic stimulation (TMS) technique that allows testing the short-latency effects of conditioning TMS to the left PMCd on test TMS applied to the ipsilateral orofacial primary motor cortex (M1). Participants performed a delayed cued simple reaction time task. They were asked to produce a lip movement cued by an imperative GO-signal presented after a predictable SET-period, during which TMS was applied at different intervals. Results showed that the area of motor evoked potentials (MEPs) to test TMS was modulated by conditioning TMS. A transient inhibition cortico-bulbar excitability by PMCd stimulation was observed around the middle of the SET-period. Conversely, a ramping excitatory effect of PMCd stimulation appeared towards the end of the SET-period, as the time of the predicted GO-signal approached. The time-course of PMCd-M1 activity scaled to the varying SET-period duration. Our data indicate that inhibition and excitation of motor output during a delayed reaction time task are two distinct neural phenomena. They both originate in PMCd and are conveyed via cortico-cortical connections to the ipsilateral M1, where they are integrated to produce harmonic fluctuations of motor output.

Online repetitive transcranial magnetic stimulation (TMS) to the parietal operculum disrupts haptic memory for grasping.

The parietal operculum (OP) contains haptic memory on the geometry of objects that is readily transferrable to the motor cortex but a causal role of OP in memory-guided grasping is only speculative. We explored this issue by using online high-frequency repetitive transcranial magnetic stimulation (rTMS). The experimental task was performed by blindfolded participants acting on objects of variable size. Trials consisted in three phases: haptic exploration of an object, delay, and reach-grasp movement onto the explored object. Motor performance was evaluated by the kinematics of finger aperture. Online rTMS was applied to the left OP region separately in each of the three phases of the task. The results showed that rTMS altered grip aperture only when applied in the delay phase to the OP. In a second experiment a haptic discriminative (match-to-sample) task was carried out on objects similar to those used in the first experiment. Online rTMS was applied to the left OP. No psychophysical effects were induced by rTMS on the detection of explicit haptic object size. We conclude that neural activity in the OP region is necessary for proficient memory-guided haptic grasping. The function of OP seems to be critical while maintaining the haptic memory trace and less so while encoding it or retrieving it.

The dorsal premotor cortex exerts a powerful and specific inhibitory effect on the ipsilateral corticofacial system: a dual-coil transcranial magnetic stimulation study.

A rich pattern of connectivity is present in non-human primates between the dorsal premotor cortex (PMCd) and the motor cortex (M1). By analogy, similar connections are hypothesized in humans between the PMCd and the ipsilateral hand-related M1. However, the technical difficulty of applying transcranial magnetic stimulation (TMS) with a dual-coil paradigm to two cortical regions in such close spatial proximity renders their in vivo demonstration difficult. The present work aims at assessing in humans the existence of short-latency influences of the left PMCd on the ipsilateral corticofacial system by means of TMS. A dual-coil TMS paradigm was used with 16 participants. Test TMS pulses were applied to the left orofacial M1, and conditioning TMS pulses were applied to three distinct points of the ipsilateral PMCd along the caudal part of the superior frontal sulcus. The inter-stimulus interval (ISI) between condTMS and testTMS varied in 2-ms steps between 2 and 8 ms. Motor evoked potentials (MEPs) in the active orbicularis oris muscle were recorded. CondTMS exerted a robust effect on the corticofacial system only when applied to one specific portion of the PMCd and only at one specific ISI (6 ms). The effect consisted in a systematic suppression of facial MEPs compared to those obtained by testTMS alone. No other effect was found. We provide evidence for a specific short-latency inhibitory effect of the PMCd on the ipsilateral M1, likely witnessing direct corticocortical connectivity in humans. We also describe a novel paradigm to test ipsilateral PMCd-M1 in humans.

Motor resonance meets motor performance.

The aim of the present work is to explore which of two different models better explains facilitation/interference effects when participants have to conditionally react to an observed action with a movement. The Dimensional Overlap model assumes two parallel routes, an automatic route and a rule-based one, that interact only when the stimulus-set and the response-set share some dimensions. In the alternative model, a motor resonance for rule-based reaction, the automatic visuo-motor transformation is always an obligatory step that provides the correct categorization of the observed action as the input for the rule-based route, thus linking the two routes in a serial fashion. We explicitly tested which of the hypotheses fits better the data by asking participants to perform one of two different actions in a two-choice reaction paradigm. In one condition participants were required to perform the opposite action compared to the one they saw (COUNTER task: see A→do B, see B→do A), while in the other they were required to perform two actions that did not share any dimension with the stimulus-set (NEUTRAL task: see A→do C, see B→do D). We predicted an advantage for the NEUTRAL task if the Dimensional Overlap model was correct, while a similar performance was foreseen if the motor resonance-based model was correct. Since the interpretation of these results was not straightforward, we conducted a distributional analysis of participants' response accuracies in order to understand whether a serial or a general parallel model explained better the data. We found clear evidence that participants responded above chance before the motor representation of the action observed was activated. We conclude that two separate systems in the human brain can transform observed actions in own motor representations. One is stimulus-driven, while the second is rule-driven. Likely, their activity is mutually independent along parallel pathways.

Haptic working memory for grasping: the role of the parietal operculum.

We investigated how haptic information on object geometry is encoded in the parietal operculum (OP) and is used for guiding object-directed motor acts in humans. We tested the effects of conditioning single-pulse transcranial magnetic stimulation (spTMS) applied to the left OP on corticospinal excitability assessed by a test spTMS applied to the ipsilateral motor cortex (M1) 5 ms after conditioning spTMS. Participants explored the size of a graspable object visually or haptically and waited for a go-signal to grasp it in the dark. They received TMS during the delay phase. In a separate group of participants performing the same task, conditioning spTMS was applied to the ventral premotor cortex (vPM) 7 ms before test spTMS. Results showed that conditioning TMS over OP modulated M1 output according to the information on object size that had been acquired haptically but not visually. Vice versa, conditioning TMS over vPM modulated M1 output according to information on object size acquired by vision but not haptically. Moreover spTMS over OP produced a significant modulation of the upcoming reaching behavior only when the object had been explored haptically. We show that OP contains a haptic memory of objects' macrogeometry and the appropriate motor plan for grasping them.

Bottom-up and top-down visuomotor responses to action observation.

Action observation produces automatic "mirror" responses in the observers' motor system. However, in daily life, nonimitative actions are often required to be produced in response to others' acts, generating a conflict between automatic and voluntary responses. First, we used single-pulse transcranial magnetic stimulation (TMS) to assess the temporal dynamics of motor output in healthy volunteers preparing rule-based counter-imitative motor responses cued by different observed hand movements. Second, we applied the same paradigm after 1-Hz repetitive TMS (rTMS) of the left posterior parietal cortex (PPC) and of the left dorsolateral prefrontal cortex (dlPFC). The results showed an early (150 ms from onset of visual stimuli) stimulus-driven mirror response that was followed by a later (300 ms) rule-based nonmirror response. rTMS applied to the PPC modulated only the early mirror response. Conversely, rTMS to the dlPFC modulated specifically the late rule-based motor response. The data indicate that a fast bottom-up process mediated by the dorsal visual stream produces automatic imitative responses. Arbitrary rule-based visuomotor associations are on the contrary mediated by a slower system, relying on the prefrontal cortex. The 2 systems are mutually independent and compete for motor output in socially relevant situations only at a distal level.

Spatiotemporal dynamics in understanding hand-object interactions.

It is generally accepted that visual perception results from the activation of a feed-forward hierarchy of areas, leading to increasingly complex representations. Here we present evidence for a fundamental role of backward projections to the occipito-temporal region for understanding conceptual object properties. The evidence is based on two studies. In the first study, using high-density EEG, we showed that during the observation of how objects are used there is an early activation of occipital and temporal areas, subsequently reaching the pole of the temporal lobe, and a late reactivation of the visual areas. In the second study, using transcranial magnetic stimulation over the occipital lobe, we showed a clear impairment in the accuracy of recognition of how objects are used during both early activation and, most importantly, late occipital reactivation. These findings represent strong neurophysiological evidence that a top-down mechanism is fundamental for understanding conceptual object properties, and suggest that a similar mechanism might be also present for other higher-order cognitive functions.

The motor system resonates to the distal goal of observed actions: testing the inverse pliers paradigm in an ecological setting.

Does motor mirroring in humans reflect the observed movements or the goal of the observed motor acts? Tools that dissociate the agent/object dynamics from the movements of the body parts used to operate them provide a model for testing resonance to both movements and goals. Here, we describe the temporal relationship of the observer's motor excitability, assessed with transcranial magnetic stimulation (TMS), with the observed goal-directed tool actions, in an ecological setting. Motor-evoked potentials (MEPs) to TMS were recorded from the opponens pollicis (OP, thumb flexor) and the extensor indicis proprius (EIP, index extensor) muscles of participants while they observed a person moving several small objects with a pair of normal pliers (closed by finger flexion) or reverse pliers (opened by finger flexion). The MEPs were a significant predictor of the pliers' kinematics that occurred in a variable time interval between -400 and +300 ms from TMS. Whatever pliers' type was being observed, OP MEPs correlated positively and EIP MEPs correlated negatively with the velocity of pliers' tips closure. This datum was confirmed both at individual and at a group level. Motor simulation can be demonstrated in single observers in a "real-life" ecological setting. The relation of motor resonance to the tool type shows that the observer's motor system codes the distal goal of the observed acts (i.e., grasping and releasing objects) in terms of its own motor vocabulary, irrespective of the actual finger movements that were performed by the observed actor.

Whole-brain haemodynamic after-effects of 1-Hz magnetic stimulation of the posterior superior temporal cortex during action observation.

The posterior superior temporal sulcus (pSTS) is active when observing biological motion. We investigated the functional connections of the pSTS node within the action observation network by measuring the after-effect of focal repetitive transcranial magnetic stimulation (rTMS) with whole-brain functional magnetic resonance imaging (fMRI). Participants received 1-Hz rTMS over the pSTS region for 10 min and underwent fMRI immediately after. While scanned, they were shown short video clips of a hand grasping an object (grasp clips) or moving next to it (control clips). rTMS-fMRI was repeated for four consecutive blocks. In two blocks we stimulated the left pSTS region and in the other two the right pSTS region. For each side TMS was applied with an effective intensity (95 % of motor threshold) or with ineffective intensity (50 % of motor threshold). Brain regions showing interactive effects of (clip type) × (TMS intensity) were identified in the lateral temporo-occipital cortex, in the anterior intraparietal region and in the ventral premotor cortex. Remote effects of rTMS were mostly limited to the stimulated hemisphere and consisted in an increase of blood oxygen level-dependent responses to grasp clips compared to control clips. We show that the pSTS occupies a pivotal relay position during observation of goal-directed actions.

Early and late motor responses to action observation.

Is a short visuomotor associative training sufficient to reverse the visuomotor tuning of mirror neurons in adult humans? We tested the effects of associative training on corticospinal modulation during action observation in the 100-320 ms interval after action onset. In two separate experiments, the acceleration of transcranial magnetic stimulation (TMS)-induced movements was recorded before and after training participants to respond to observed acts with an opposite or similar behavior. Before training, TMS-induced accelerations mirrored the observed action at 250 and 320 ms. After training, responses at 250 ms were unchanged and still mirrored the stimuli, without any effect of training direction. Only at 320 ms, we observed training-dependent changes in evoked responses. A control experiment with non-biological rotational movements as visual stimuli indicated that spatial stimulus-response compatibility is not sufficient to account for the results of the two main experiments. We show that the effects of a short visuomotor associative training are not pervasive on the automatic mirror responses. 'Early' (250 ms) responses were not influenced by training. Conversely only 'late' (320 ms) responses changed according to the training direction. This biphasic time course indicates that two distinct mechanisms produce the automatic mirror responses and the newly learned visuomotor associations.

The frames of reference of the motor-visual aftereffect.

Repeatedly performing similar motor acts produces short-term adaptive changes in the agent's motor system. One striking use-dependent effect is the motor-to-visual aftereffect (MVA), a short-lasting negative bias in the conceptual categorization of visually-presented training-related motor behavior. The MVA is considered the behavioral counterpart of the adaptation of visuomotor neurons that code for congruent executed and observed motor acts. Here we characterize which features of the motor training generate the MVA, along 3 main dimensions: a) the relative role of motor acts vs. the semantics of the task-set; b) the role of muscular-specific vs. goal-specific training and c) the spatial frame of reference with respect to the whole body. Participants were asked to repeatedly push or pull some small objects in a bowl as we varied different components of adapting actions across three experiments. The results show that a) the semantic value of the instructions given to the participant have no role in generating the MVA, which depends only on the motor meaning of the training act; b) both intrinsic body movements and extrinsic action goals contribute simultaneously to the genesis of the MVA and c) changes in the relative position of the acting hand compared to the observed hand, when they do not involve changes to the movement performed or to the action meaning, do not have an effect on the MVA. In these series of experiments we confirm that recent motor experiences produce measurable changes in how humans see each others' actions. The MVA is an exquisite motor effect generated by two distinct motor sub-systems, one operating in an intrinsic, muscular specific, frame of reference and the other operating in an extrinsic motor space.

Your actions in my cerebellum: subclinical deficits in action observation in patients with unilateral chronic cerebellar stroke.

Empirical evidence indicates that cognitive consequences of cerebellar lesions tend to be mild and less important than the symptoms due to lesions to cerebral areas. By contrast, imaging studies consistently report strong cerebellar activity during tasks of action observation and action understanding. This has been interpreted as part of the automatic motor simulation process that takes place in the context of action observation. The function of the cerebellum as a sequencer during executed movements makes it a good candidate, within the framework of embodied cognition, for a pivotal role in understanding the timing of action sequences. Here, we investigated a cohort of eight patients with chronic, first-ever, isolated, ischemic lesions of the cerebellum. The experimental task consisted in identifying a plausible sequence of pictures from a randomly ordered group of still frames extracted from (a) a complex action performed by a human actor ("biological action" test) or (b) a complex physical event occurring to an inanimate object ("folk physics" test). A group of 16 healthy participants was used as control. The main result showed that cerebellar patients performed significantly worse than controls in both sequencing tasks, but performed much worse in the "biological action" test than in the "folk physics" test. The dissociation described here suggests that observed sequences of simple motor acts seem to be represented differentially from other sequences in the cerebellum.

Transcranial Magnetic Mapping of the Short-Latency Modulations of Corticospinal Activity from the Ipsilateral Hemisphere during Rest.

Skilled hand function relies heavily on the integrity of the primary motor cortex (M1) and on a web of cortico-cortical connections projecting onto it. We used a novel explorative paradigm to map the origin of cortico-M1 pathways assessed by dual transcranial magnetic stimulation (TMS) in three healthy participants. Subthreshold conditioning TMS (cTMS) was delivered over a grid of ≈100 spots. Covering the left hemisphere, and was followed by suprathreshold test (tTMS) delivered over the ipsilateral M1. Grid points were tested eight times, with inter-stimulus intervals between cTMS and tTMS of 4 and 7 ms. Participants were asked to stay relaxed with no particular task. Motor evoked potentials (MEPs) from cTMS + tTMS were normalized to MEPs from tTMS alone and were compared to the value expected from tTMS alone using t-statistics. The t-values from each grid point were then used to plot statistical maps. Several foci of significant cortico-M1 interactions were found in the dorsal-medial frontal cortex, in the ventral frontal cortex, in the superior and inferior parietal lobules and in the parietal operculum. The majority of active foci had inhibitory effects on corticospinal excitability. The spatial location of the network of different subjects overlapped but with some anatomical variation of single foci. TMS statistical mapping during the resting state revealed a complex inhibitory cortical network. The explorative approach to TMS as a brain mapping tool produced results that are self-standing in single subjects overcoming inter-individual variability of cortical active sites.

One's motor performance predictably modulates the understanding of others' actions through adaptation of premotor visuo-motor neurons.

Neurons firing both during self and other's motor behavior (mirror neurons) have been described in the brain of vertebrates including humans. The activation of somatic motor programs driven by perceived behavior has been taken as evidence for mirror neurons' contribution to cognition. The inverse relation, that is the influence of motor behavior on perception, is needed for demonstrating the long-hypothesized causal role of mirror neurons in action understanding. We provide here conclusive behavioral and neurophysiological evidence for that causal role by means of cross-modal adaptation coupled with a novel transcranial magnetic stimulation (TMS)-adaptation paradigm. Blindfolded repeated motor performance of an object-directed action (push or pull) induced in healthy participants a strong visual after-effect when categorizing others' actions, as a result of motor-to-visual adaptation of visuo-motor neurons. TMS over the ventral premotor cortex, but not over the primary motor cortex, suppressed the after-effect, thus localizing the population of adapted visuo-motor neurons in the premotor cortex. These data are exquisitely consistent in humans with the existence of premotor mirror neurons that have access to the action meaning. We also show that controlled manipulation of the firing properties of this neural population produces strong predictable changes in the way we categorize others' actions.