Effects of postexercise blood flow occlusion on quadriceps responses to transcranial magnetic stimulation

For a fatigued hand muscle, group III/IV afferent firing maintains intracortical facilitation (ICF) without influencing corticospinal excitability. Exercise of larger muscles produces greater afferent firing. Thus, this study investigated if fatigue-related firing of group III/IV afferents from a large muscle group (quadriceps) modulates intracortical and corticospinal networks. In two sessions, participants (n = 18) completed a 2-min maximal voluntary isometric contraction (MVIC) of knee extensors with (OCC) or without (CON) postexercise blood flow occlusion to maintain afferent firing. Pre- and postexercise, single- and paired-pulse transcranial magnetic stimulation (TMS) elicited motor evoked potentials (MEPs) from vastus lateralis (VL), vastus medialis, and rectus femoris. Test pulse intensities evoked VL MEPs of ∼0.5 mV and were adjusted postexercise. The conditioning stimulus for ICF and short-interval intracortical inhibition (SICI) was constant and set to evoke ∼50% of maximum ICF. Muscle pain was also assessed (0-10 scale). Postexercise, muscle pain was greater for OCC than CON (Median = 8.6 vs. 2.3; P < 0.001). MEPs were depressed for CON (all muscles: Δ -24.3 to -34.1%; P ≤ 0.018) despite increased stimulus intensity (∼10%, P < 0.001), but both MEPs and intensity remained unchanged for OCC. ICF was depressed postexercise in OCC (VL and RF: Δ -59.8% and -28.8%, respectively P = 0.016-0.018) but not in CON (all muscles: Δ -3.8 to -44.3%, P = 0.726-1.0), but was not different between conditions (interactions: P = 0.143-0.252). No interactions were observed for SICI (all muscles: P ≥ 0.266). Group III/IV afferent firing counteracts the postcontraction depression of MEPs in quadriceps. However, intracortical inhibitory and facilitatory networks are not implicated in this response.NEW & NOTEWORTHY Maintained exercise-induced firing of group III/IV quadriceps muscle afferents counteracts known reductions in corticospinal excitability that occur with fatigue. However, the results suggest that this increased excitability is not underpinned by changes in intracortical facilitatory or inhibitory networks. These findings are not consistent with previous findings for hand muscle, which reported preserved intracortical facilitation with fatigue-related sustained group III/IV muscle afferent firing.