Facilitation of muscle responses to magnetic brain stimulation by mechanical stimuli in man

Abstract
Transcranial magnetic brain stimuli were applied to 9 normal subjects and compound muscle action potentials were recorded from the right abductor digiti minimi with surface electrodes. Vibration of 120 Hz, 0.6 mm peak to peak amplitude, applied to the muscle tendon enhanced its responses to magnetic brain stimuli. This facilitation corresponds to the tonic vibration reflex. Inhibition of muscle responses was not seen with vibration. Thus it is likely that the known inhibition of stretch reflexes by vibration is purely presynaptic. Small rectangular mechanical stimuli (rise time 200 mm/s, amplitude 1 mm) applied to ADM elicited short and long loop reflex responses. When brain stimuli were given 7–16 ms after the muscle tap, muscle responses were enhanced. It is argued that this is a result of the summation of the effects of Ia afferent impulses and descending pyramidal volleys at the alpha motoneurones. A separate late facilitation corresponding with the arrival of muscle afferent inputs to the sensori-motor cortex was not seen.