, 1999). Because the analysis was limited to the first 1.5 ms of the peak, corresponding to the periodicity between each TMS-induced corticospinal volley (Hallett, 2007; Reis et al., 2008), the peak size probably reflects the EPSP evoked

by a single corticospinal volley at motoneuron level. Increasing the TMS intensity leads to larger corticospinal volleys and to additional volleys (Burke et al., 1993; Di Lazzaro et al., 1998a); earlier or later volleys would have induced earlier or later peaks in the PSTH. When test TMS intensity was increased, the latency of the earliest peak evoked in the PSTH did not change in all the motor units investigated; check details in 16 of the 45 motor units, a second peak could be evoked but

the analysis was limited to the first peak. As observed in a previous study (Devanne et al., 1997), the peak size increased linearly with TMS intensity. This suggests a linear increase in the underlying corticospinal EPSP. This EPSP depends on the membrane properties of the spinal motoneuron innervating the motor unit investigated (Hultborn, 2002), and on the corticospinal input induced buy Pexidartinib by TMS. This input depends on the summation of the effects evoked by TMS at the cortical level: the stimulating electric fields activate neural network in the primary motor cortex, including inhibitory and excitatory interneurons, and pyramidal cells (Fig. 5). The resulting corticospinal volley depends on the balance between TMS-induced inhibitory and excitatory inputs to pyramidal cells. When TMS was suprathreshold for a peak in the PSTH, and when its intensity was increased, the excitation counterbalanced the inhibition at the cortical level, which made the pyramidal cells discharge: the greater the cortical excitation, Low-density-lipoprotein receptor kinase the stronger the cortical outflow (more pyramidal

cells discharge) and this leads to larger peaks in the PSTH (spatial summation of corticospinal EPSPs at motoneuron level; Fig. 5). The linear relationship between TMS intensity and peak size thus reflects the input/output properties of the cortico-motoneuronal network (cortical network and spinal motoneuron). Note that this conclusion is limited to the cortical networks with the lowest thresholds, activated with very low TMS intensities that we could investigate with PSTHs. At higher intensities, MEPs are evoked in EMG activity, and the sigmoid recruitment curve could then be due to non-linear summation at both cortical and spinal levels (several motoneurons discharge, not just one; Devanne et al., 1997; Lackmy & Marchand-Pauvert, 2010). In the paired pulse paradigm, the conditioning pulse was subthreshold for a peak in the PSTH but suprathreshold for SICI, the threshold intensity for inhibitory interneurons being lower than for excitatory ones (Fig. 5; Ziemann et al., 1996).