title: Transcranial magnetic stimulation and human muscle fatigue.
abstract: During exercise, changes occur at many sites in the motor pathway, including the muscle fiber, motoneuron, motor cortex, and "upstream" of the motor cortex. Some of the changes result in fatigue, which can be defined as a decrease in ability to produce maximal muscle force voluntarily. Transcranial magnetic stimulation (TMS) over the human motor cortex reveals changes in both motor evoked potentials (MEPs) and the silent period during and after fatiguing voluntary contractions in normal subjects. The relationship of these changes to loss of force or fatigue is unclear. However, during a sustained maximal contraction TMS evokes extra force from the muscle and thus demonstrates the development of suboptimal output from the motor cortex, that is, fatigue at a supraspinal level. In some patients with symptoms of fatigue, the response to TMS after exercise is altered, but the changed MEP behavior is not yet linked to particular symptoms or pathology.
authors.affiliation: Prince of Wales Medical Research Institute and University of New South Wales, Barker Street, Randwick, Sydney, NSW 2031, Australia. jl.taylor@unsw.edu.au
authors.forename: J L
authors.initials: JL
authors.lastname: Taylor
authors.forename: S C
authors.initials: SC
authors.lastname: Gandevia
mesh_terms: D004558:Electric Stimulation / Q000295:instrumentation*; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D015444:Exercise / Q000502:physiology; D006801:Humans; D009044:Motor Cortex / Q000502:physiology; D009046:Motor Neurons / Q000166:cytology / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D018763:Muscle Fatigue / Q000502:physiology*; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology; D009468:Neuromuscular Diseases / Q000503:physiopathology; D050781:Transcranial Magnetic Stimulation