title: Reversal of Practice-related Effects on Corticospinal Excitability has no Immediate Effect on Behavioral Outcome.
abstract: BACKGROUND
  Motor training usually increases the excitability of corticospinal outputs to the trained muscles. However, it is uncertain to what extent the change in excitability is a critical component of behavioral learning or whether it is a non-specific side effect.
  
  
  OBJECTIVE
  We used a depotentiation protocol to abolish the training-induced increase of corticospinal excitability and tested whether this had any immediate effect on the improved motor performance.
  
  
  METHODS
  We used an index finger abduction task in which behavioral improvement is known to be associated with M1 excitability changes as monitored by the amplitude of motor-evoked potentials produced by single-pulse transcranial magnetic stimulation (TMS). These effects could be reversed by a depotentiation protocol using a short form of continuous theta-burst stimulation (cTBS150). Participants underwent three experimental interventions: 'motor training', 'motor training plus cTBS150' and 'cTBS150'. M1 excitability and TMS-evoked finger movements were assessed before the experimental interventions and 5 min, 15 min, and 30 min thereafter. Motor retention was tested 45 min after the experimental interventions.
  
  
  RESULTS
  During training, acceleration of the practiced movement improved. At the end of training, M1 excitability and the acceleration of TMS-evoked index finger movements in the direction of training had increased and the enhanced performance was retained when tested 45 min later. The depotentiation protocol, delivered immediately after the end of training, reversed the excitability changes in M1 but did not affect the acceleration of the TMS-evoked finger movement nor the retention of performance. The depotentiation protocol alone did not modify M1 excitability.
  
  
  CONCLUSIONS
  The present study indicates that in the short term, increases in corticospinal excitability are not related to immediate changes in behavioral motor outcome.
authors.affiliation: Neuromed Institute (IRCCS), Pozzilli, Isernia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Bologna
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rocchi
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Paparella
authors.affiliation: Neuromed Institute (IRCCS), Pozzilli, Isernia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Nardella
authors.affiliation: Neuromed Institute (IRCCS), Pozzilli, Isernia, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Li Voti
authors.affiliation: Neuromed Institute (IRCCS), Pozzilli, Isernia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Conte
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK; Department of Neurology, University of Ljubljana, Slovenia.
authors.forename: Maja
authors.initials: M
authors.lastname: Kojovic
authors.affiliation: Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK.
authors.forename: John C
authors.initials: JC
authors.lastname: Rothwell
authors.affiliation: Neuromed Institute (IRCCS), Pozzilli, Isernia, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Italy. Electronic address: alfredo.berardelli@uniroma1.it.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Berardelli
mesh_terms: D000328:Adult; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005260:Female; D005385:Fingers / Q000502:physiology*; D006801:Humans; D007858:Learning / Q000502:physiology*; D036881:Long-Term Synaptic Depression / Q000502:physiology; D008297:Male; D009044:Motor Cortex / Q000502:physiology*; D009048:Motor Skills / Q000502:physiology*; D009068:Movement / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology; D011712:Pyramidal Tracts / Q000502:physiology*; D013826:Theta Rhythm; D013997:Time Factors; D050781:Transcranial Magnetic Stimulation; D055815:Young Adult
keywords: Depotentiation; Primary motor cortex; Transcranial magnetic stimulation