Changes in motoneuron excitability during voluntary muscle activity in humans with spinal cord injury

The excitability of resting motoneurons increases following spinal cord injury (SCI). The extent to which motoneuron excitability changes during voluntary muscle activity in humans with SCI, however, remains poorly understood. To address this question, we measured F waves by using supramaximal electrical stimulation of the ulnar nerve at the wrist and cervicomedullary motor-evoked potentials (CMEPs) by using high-current electrical stimulation over the cervicomedullary junction in the first dorsal interosseous muscle at rest and during 5 and 30% of maximal voluntary contraction into index finger abduction in individuals with chronic cervical incomplete SCI and aged-matched control participants. We found higher persistence (number of F waves present in each set) and amplitude of F waves at rest in SCI compared with control participants. With increasing levels of voluntary contraction, the amplitude, but not the persistence, of F waves increased in both groups but to a lesser extent in SCI compared with control participants. Similarly, the CMEP amplitude increased in both groups but to a lesser extent in SCI compared with controls. These results were also found at matched absolutely levels of electromyographic activity, suggesting that these changes were not related to decreases in voluntary motor output after SCI. F-wave and CMEP amplitudes were positively correlated across conditions in both groups. These results support the hypothesis that the responsiveness of the motoneuron pool during voluntary activity decreases following SCI, which could alter the generation and strength of voluntary muscle contractions.NEW & NOTEWORTHY How the excitability of motoneurons changes during voluntary muscle activity in humans with spinal cord injury (SCI) remains poorly understood. We found that F-wave and cervicomedullary motor-evoked potential amplitude, outcomes reflecting motoneuronal excitability, increased during voluntary activity compared with rest in SCI participants but to a lesser extent that in controls. These results suggest that the responsiveness of motoneurons during voluntary activity decreases following SCI, which might affect functionally relevant plasticity after the injury.