Reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kinetics

Abstract Transcranial magnetic stimulation (TMS) of the motor cortex can be used during a voluntary contraction to inhibit corticospinal drive to the muscle and consequently induce involuntary muscle relaxation. Our aim was to evaluate the reproducibility and the effect of varying experimental condi...

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Main Authors: Joery P. Molenaar, Elianne vanZandvoort, Baziel G. vanEngelen, Nicol C. Voermans, Jonne Doorduin
Format: Article
Language:English
Published: Wiley 2022-10-01
Series:Physiological Reports
Subjects:
Online Access:https://doi.org/10.14814/phy2.15491
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author Joery P. Molenaar
Elianne vanZandvoort
Baziel G. vanEngelen
Nicol C. Voermans
Jonne Doorduin
author_facet Joery P. Molenaar
Elianne vanZandvoort
Baziel G. vanEngelen
Nicol C. Voermans
Jonne Doorduin
author_sort Joery P. Molenaar
collection DOAJ
description Abstract Transcranial magnetic stimulation (TMS) of the motor cortex can be used during a voluntary contraction to inhibit corticospinal drive to the muscle and consequently induce involuntary muscle relaxation. Our aim was to evaluate the reproducibility and the effect of varying experimental conditions (robustness) of TMS‐induced muscle relaxation. Relaxation of deep finger flexors was assessed in 10 healthy subjects (5 M, 5 F) using handgrip dynamometry with normalized peak relaxation rate as main outcome measure, that is, peak relaxation rate divided by (voluntary plus TMS‐evoked)force prior to relaxation. Both interday and interrater reliability of relaxation rate were high with intraclass correlation coefficient of 0.88 and 0.92 and coefficient of variation of 3.8 and 3.7%, respectively. Target forces of 37.5% of maximal voluntary force or higher resulted in similar relaxation rate. From 50% of maximal stimulator output and higher relaxation rate remained the same. Only the most lateral position (>2 cm from the vertex) rendered lower relaxation rate (mean ± SD: 11.1 ± 3.0 s−1, 95% CI: 9.0–13.3 s−1) compared to stimulation at the vertex (12.8 ± 1.89 s−1, 95% CI: 11.6–14.1 s−1). Within the range of baseline skin temperatures, an average change of 0.5 ± 0.2 s−1 in normalized peak relaxation rate was measured per 1°C change in skin temperature. In conclusion, interday and interrater reproducibility and reliability of TMS‐induced muscle relaxation of the finger flexors were high. Furthermore, this technique is robust with limited effect of target force, stimulation intensity, and coil position. Muscle relaxation is strongly affected by skin temperature; however, this effect is marginal within the normal skin temperature range. We deem this technique well suited for clinical and scientific assessment of muscle relaxation.
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spelling doaj.art-7fd4a5eb08fb45acb43c7e522f2a900b2023-12-11T10:47:16ZengWileyPhysiological Reports2051-817X2022-10-011020n/an/a10.14814/phy2.15491Reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kineticsJoery P. Molenaar0Elianne vanZandvoort1Baziel G. vanEngelen2Nicol C. Voermans3Jonne Doorduin4Department of Neurology, Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Center Nijmegen The NetherlandsDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Center Nijmegen The NetherlandsDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Center Nijmegen The NetherlandsDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Center Nijmegen The NetherlandsDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour Radboud University Medical Center Nijmegen The NetherlandsAbstract Transcranial magnetic stimulation (TMS) of the motor cortex can be used during a voluntary contraction to inhibit corticospinal drive to the muscle and consequently induce involuntary muscle relaxation. Our aim was to evaluate the reproducibility and the effect of varying experimental conditions (robustness) of TMS‐induced muscle relaxation. Relaxation of deep finger flexors was assessed in 10 healthy subjects (5 M, 5 F) using handgrip dynamometry with normalized peak relaxation rate as main outcome measure, that is, peak relaxation rate divided by (voluntary plus TMS‐evoked)force prior to relaxation. Both interday and interrater reliability of relaxation rate were high with intraclass correlation coefficient of 0.88 and 0.92 and coefficient of variation of 3.8 and 3.7%, respectively. Target forces of 37.5% of maximal voluntary force or higher resulted in similar relaxation rate. From 50% of maximal stimulator output and higher relaxation rate remained the same. Only the most lateral position (>2 cm from the vertex) rendered lower relaxation rate (mean ± SD: 11.1 ± 3.0 s−1, 95% CI: 9.0–13.3 s−1) compared to stimulation at the vertex (12.8 ± 1.89 s−1, 95% CI: 11.6–14.1 s−1). Within the range of baseline skin temperatures, an average change of 0.5 ± 0.2 s−1 in normalized peak relaxation rate was measured per 1°C change in skin temperature. In conclusion, interday and interrater reproducibility and reliability of TMS‐induced muscle relaxation of the finger flexors were high. Furthermore, this technique is robust with limited effect of target force, stimulation intensity, and coil position. Muscle relaxation is strongly affected by skin temperature; however, this effect is marginal within the normal skin temperature range. We deem this technique well suited for clinical and scientific assessment of muscle relaxation.https://doi.org/10.14814/phy2.15491muscle relaxationreproducibilityrobustnessskin temperaturetranscranial magnetic stimulation
spellingShingle Joery P. Molenaar
Elianne vanZandvoort
Baziel G. vanEngelen
Nicol C. Voermans
Jonne Doorduin
Reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kinetics
Physiological Reports
muscle relaxation
reproducibility
robustness
skin temperature
transcranial magnetic stimulation
title Reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kinetics
title_full Reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kinetics
title_fullStr Reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kinetics
title_full_unstemmed Reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kinetics
title_short Reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kinetics
title_sort reproducibility and robustness of motor cortical stimulation to assess muscle relaxation kinetics
topic muscle relaxation
reproducibility
robustness
skin temperature
transcranial magnetic stimulation
url https://doi.org/10.14814/phy2.15491
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AT bazielgvanengelen reproducibilityandrobustnessofmotorcorticalstimulationtoassessmusclerelaxationkinetics
AT nicolcvoermans reproducibilityandrobustnessofmotorcorticalstimulationtoassessmusclerelaxationkinetics
AT jonnedoorduin reproducibilityandrobustnessofmotorcorticalstimulationtoassessmusclerelaxationkinetics