Conditioning effect of transcranial magnetic stimulation evoking motor-evoked potential on V-wave response

The aim of this study was to examine the collision responsible for the volitional V-wave evoked by supramaximal electrical stimulation of the motor nerve during voluntary contraction. V-wave was conditioned by transcranial magnetic stimulation (TMS) over the motor cortex at several inter-stimuli intervals (ISI) during weak voluntary plantar flexions (n = 10) and at rest for flexor carpi radialis muscle (FCR; n = 6). Conditioning stimulations were induced by TMS with intensity eliciting maximal motor-evoked potential (MEPmax). ISIs used were ranging from -20 to +20 msec depending on muscles tested. The results showed that, for triceps surae muscles, conditioning TMS increased the V-wave amplitude (similar to +250%) and the associated mechanical response (similar to +30%) during weak voluntary plantar flexion (10% of the maximal voluntary contraction -MVC) for ISIs ranging from +6 to +18 msec. Similar effect was observed at rest for the FCR with ISI ranging from +6 to +12 msec. When the level of force was increased from 10 to 50% MVC or the conditioning TMS intensity was reduced to elicit responses of 50% of MEPmax, a significant decrease in the conditioned V-wave amplitude was observed for the triceps surae muscles, linearly correlated to the changes in MEP amplitude. The slope of this correlation, as well as the electro-mechanical efficiency, was closed to the identity line, indicating that V-wave impact at muscle level seems to be similar to the impact of cortical stimulation. All these results suggest that change in V-wave amplitude is a great index to reflect changes in cortical neural drive addressed to spinal motoneurons.