title: Intracortical inhibition and facilitation in human facial motor area: difference between upper and lower facial area.
abstract: OBJECTIVE
  To investigate the intracortical inhibitory and excitatory systems in the motor cortical representation of upper and lower facial muscles.
  
  
  METHODS
  Paired-pulse transcranial magnetic stimulation (TMS) was applied to 7 healthy volunteers, with the interstimulus interval (ISI) between the conditioning stimulus (CS) and test stimulus, varied from 1 to 20 ms. CS was set at 90% of motor threshold. Muscle evoked potentials (MEPs) were recorded from first dorsal interosseus (FDI), orbicularis oculi (o. oculi) and mentalis muscles.
  
  
  RESULTS
  TMS evoked MEPs in o. oculi on both ipsi- and contralateral sides in all subjects. In the paired-pulse study, MEP amplitude in the mentalis decreased at short ISIs of 1-3 ms, followed by increases at 12-20 ms. These effects were similar to those in the FDI. O. oculi did not show a distinct inhibitory period at short ISIs and facilitation at long ISIs was detected but was significantly less than in FDI and mentalis. In o. oculi, there was no significant difference between the effects of ipsilateral and contralateral CS on the MEPs.
  
  
  CONCLUSIONS
  The bi-hemispheric control of volitional movement and the modulation from brainstem projections appear to markedly influence intracortical inhibitory and excitatory systems in the motor cortical representation of o. oculi.
authors.affiliation: Laboratory for Magnetic Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue KS452, Boston, MA 02215, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.forename: H
authors.initials: H
authors.lastname: Théoret
authors.forename: F M
authors.initials: FM
authors.lastname: Mottaghy
authors.forename: M
authors.initials: M
authors.lastname: Gangitano
authors.forename: A
authors.initials: A
authors.lastname: Pascual-Leone
mesh_terms: D000328:Adult; D004558:Electric Stimulation / Q000379:methods; D019054:Evoked Potentials, Motor / Q000502:physiology; D005152:Facial Muscles / Q000502:physiology*; D006801:Humans; D008280:Magnetics; D008297:Male; D009044:Motor Cortex / Q000502:physiology*; D009433:Neural Inhibition / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology; D012016:Reference Values