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Updated: Dec 14, 2025

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Interlimb neural interactions in corticospinal and spinal reflex circuits during preparation and execution of
Atsushi Sasaki1,2, Naotsugu Kaneko1,2, Yohei Masugi1,3
1Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Meguro, Tokyo, Japan.
Abstract:
Although coordinated and simultaneous movement of upper and lower limb muscles is required for activities of daily living, interlimb neural interaction mechanisms and their nature are yet to be fully elucidated. The purpose of this study was to investigate effects of motor preparation and execution of ipsilateral, contralateral, and bilateral upper limb muscle contractions on the excitability of corticospinal and spinal reflex circuits of the lower limb muscles. Fourteen able-bodied individuals were recruited in each study. Experiments were conducted to investigate 1) corticospinal excitability with transcranial magnetic stimulation applied on the primary motor cortex to evoke motor evoked potentials (MEPs) and 2) spinal reflex excitability with transcutaneous spinal cord stimulation applied at the lumbothoracic level to evoke spinal reflexes. Measurements were recorded from multiple right lower limb muscles simultaneously during 1) ipsilateral (right), 2) contralateral (left), and 3) bilateral (right and left) elbow flexion. The results indicate that MEPs in lower limb muscles were facilitated during both preparation and execution of elbow flexion, whereas spinal reflexes were facilitated only during motor execution. Moreover, the extent of facilitation did not differ between right, left, and bilateral contractions. In conclusion, motor preparation for upper limb muscle contractions did not affect spinal circuits but seemed to affect the supraspinal networks controlling lower limb muscles. However, actual contraction (motor execution) of upper limb muscles is required to facilitate spinal reflex circuits controlling the lower limb muscles. Moreover, interlimb remote facilitation in corticospinal and spinal reflex circuits did not depend on whether contralateral or ipsilateral hands were contracted or if they were contracted bilaterally.NEW & NOTEWORTHY We found that upper limb muscle contractions facilitated corticospinal circuits controlling lower limb muscles even during motor preparation, whereas motor execution of the task was required to facilitate spinal circuits. We also found that facilitation did not depend on whether contralateral or ipsilateral hands were contracted or if they were contracted bilaterally. Overall, these findings suggest that training of unaffected upper limbs may be useful to enhance facilitation of affected lower limbs in paraplegic individuals.
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