The human motor system consists of several divisions in the frontal lobes. The physiological function of projections from the dorsolateral prefrontal cortex (DLPFC) to the primary motor cortex (M1) remains elusive. Here, we introduce theta burst stimulation (TBS)-based protocols to target inhibitory and facilitatory connections in the DLPFC-M1 network.

Surface EMG responses (MEPs) were recorded from the relaxed first dorsal interosseous (FDI) of 16 normal subjects following transcranial magnetic stimulation (TMS) over the hand area of the primary motor cortex. These test responses were conditioned by a subthreshold stimulus applied 2-15 ms beforehand over a range of anterior or medial sites. Stimuli applied 3-5 cm anterior to the hand motor area (site A) or 6 cm anterior to the vertex on the nasion-inion line (site B) inhibited the test responses at short latency. The largest effect was seen when the interstimulus interval was 6 ms and the intensity of the conditioning stimulus was equal to 0.9x active motor threshold (AMT) at the hand area. Increasing the intensity to 1.2x AMT produced facilitation. Suppression of surface EMG responses was mirrored in the behavior of single motor units. Conditioning stimuli had no effect on responses evoked in the active FDI muscle by transcranial electric stimulation of motor cortex nor on forearm flexor H reflexes even though MEPs in the same muscle were suppressed at appropriate interstimulus intervals. We conclude that low-intensity TMS over presumed premotor areas of frontal cortex can engage corticocortical connections to the primary motor hand area.

The ability to sequence information is fundamental to human performance. When subjects are asked to respond to one of several possible spatial locations of a stimulus, reaction times and error rates decrease when the target follows a sequence. In this article, we review the numerous theoretical and methodological perspectives that have been used to study sequence learning. The opportunity now exists to integrate evidence from different domains of cognitive science to begin to provide a comprehensive account of sequence learning. We suggest that subjects can learn sequences based on different information in a hierarchical representation, including either sequences of stimuli or sequences of responses. This learning can occur both with and without explicit awareness of the sequence. Multiple modes of learning exist and are subserved by different neural circuits.

What are the brain mechanisms that mediate conscious object recognition? To investigate this question, it is essential to distinguish between brain processes that cause conscious recognition of a stimulus from other correlates of its sensory processing. Previous fMRI studies have identified large-scale brain activity ranging from striate to high-level sensory and prefrontal regions associated with conscious visual perception or recognition. However, the possible role of changes in connectivity during conscious perception between these regions has only rarely been studied. Here, we used fMRI and connectivity analyses, together with 120 custom-generated, two-tone, Mooney images to directly assess whether conscious recognition of an object is accompanied by a dynamical change in the functional coupling between extrastriate cortex and prefrontal areas. We compared recognizing an object versus not recognizing it in 19 naïve subjects using two different response modalities. We find that connectivity between the extrastriate cortex and the dorsolateral prefrontal cortex (DLPFC) increases when objects are consciously recognized. This interaction was independent of the response modality used to report conscious recognition. Furthermore, computing the difference in Granger causality between recognized and not recognized conditions reveals stronger feedforward connectivity than feedback connectivity when subjects recognized the objects. We suggest that frontal and visual brain regions are part of a functional network that supports conscious object recognition by changes in functional connectivity.

Over the past 20 years, neuroimaging has become a predominant technique in systems neuroscience. One might envisage that over the next 20 years the neuroimaging of distributed processing and connectivity will play a major role in disclosing the brain's functional architecture and operational principles. The inception of this journal has been foreshadowed by an ever-increasing number of publications on functional connectivity, causal modeling, connectomics, and multivariate analyses of distributed patterns of brain responses. I accepted the invitation to write this review with great pleasure and hope to celebrate and critique the achievements to date, while addressing the challenges ahead.

Nerve cells in the monkey's prefrontal cortex and nucleus medialis dorsalis of the thalamus show changes of firing frequency associated with the performance of a delayed response test. Most cells increase firing during the cue presentation period or at the beginning of the ensuing delay; spike discharge highler than that in intertrial periods is present in some cells throughout the delay. These changes are interpreted as suggestive evidence of a role of frontothalamic circuits in the attentive process involved in short-term memory

Four of five patients with marked global amnesia, and others with new learning impairments, showed normal processing facilitation for novel stimuli (nonwords) and/or for familiar stimuli (words) on a word/nonword (lexical) decision task. The data are interpreted as a reflection of the learning capabilities of in-line neural processing stages with multiple, distinct, informational codes. These in-line learning processes are separate from the recognition/recall memory impaired by amygdalohippocampal/dosomedial thalamic damage, but probably supplement such memory in some tasks in normal individuals. Preserved learning of novel information seems incompatible with explanations of spared learning in amnesia that are based on the episodic/semantic or memory/habit distinctions, but is consistent with the procedural/declarative hypothesis.

We examined implicit memory using priming and procedural learning tasks in patients with probable Dementia-Alzheimer's Type (DAT) to examine whether priming and procedural processes could be dissociated and whether task specificity was a factor in DAT patient performance. Priming was tested using a word recognition paradigm (perceptual priming) and by repeated administrations of a fragmented objects test (long term priming). Procedural learning was tested using repeated and random sequences on a choice serial reaction time task and by repeated administration of a puzzle map of the United States. DAT patients were compared to hospitalized depressed patients, patients suffering from Progressive Supranuclear Palsy (PSP), and normal controls. We found that DAT patients demonstrated marginal but significant implicit learning on both procedural learning and perceptual priming tasks. DAT patients performed relatively better on the procedural learning task than a perceptual priming task compared to PSP patients, suggesting that priming of meaningful stimuli is subserved by cortical structures whereas procedural motor responses to simple serial visual stimulus patterns can be maintained by subcortical systems. Furthermore, our findings suggest that priming and procedural processes can be dissociated and that task specificity is a factor in interpreting the results of implicit learning paradigms in DAT patients. The implications of these results for models of knowledge representation and memory processes as well as the way they can serve as models for testing nootropic drug effects are discussed.

Changes of local synaptic activity during acquisition of a visuomotor skill were examined with positron emission tomography (PET) imaging of regional cerebral blood flow (rCBF). Eight subject learned the pursuit rotor task, a predictable tracking task, during three sequential PET scans (day 1). Subjects returned 2 days later and repeated the three pursuit trials and PET scans (day 2) after completing an extensive practice session. Control scans without movement bracketed the pursuit trials on both days to rule out time effects unrelated to motor skill learning. PET images were transformed to a common stereotaxic space using matched magnetic resonance imaging (MRI) scans. Group learning effects were determined by a repeated measures multivariate analysis of variance (ANOVA). During motor skill acquisition (day 1), increases of synaptic activity were identified in cortical motor areas and cerebellum, supporting the hypothesis that procedural motor learning occurs in motor execution areas. During long-term practice (day 2), changes were limited to the bilateral putamen, bilateral parietal cortex, and left premotor cortex. To characterize differences in the rate of learning between subjects, each subject's performance data from day 1 was fit with a power function. The exponents were correlated with rCBF data on a pixel-by-pixel basis. Rapid skill acquisition was associated with increasing rCBF in premotor, prefrontal, and cingulate areas, and decreasing rCBF in visual processing areas located in the temporal and occipital cortex. This pattern in fast learners may reflect a more rapid shift from a visually guided strategy (accessing perceptual areas) to an internally generated model (accessing premotor and prefrontal areas). © 1994 Wiley-Liss, Inc.

Transcranial magnetic stimulation (TMS) is rapidly developing as a powerful, non-invasive tool for studying the human brain. A pulsed magnetic field creates current flow in the brain and can temporarily excite or inhibit specific areas. TMS of motor cortex can produce a muscle twitch or block movement; TMS of occipital cortex can produce visual phosphenes or scotomas. TMS can also alter the functioning of the brain beyond the time of stimulation, offering potential for therapy.

1. We investigated interhemispheric interactions between the human hand motor areas using transcranial cortical magnetic and electrical stimulation. 2. A magnetic test stimulus was applied over the motor cortex contralateral to the recorded muscle (test motor cortex), and an electrical or magnetic conditioning stimulus was applied over the ipsilateral hemisphere (conditioning motor cortex). We investigated the effects of the conditioning stimulus on responses to the test stimulus. 3. Two effects were elicited at different interstimulus intervals (ISIs): early facilitation (ISI = 4-5 ms) and late inhibition (ISI > or = 11 ms). 4. The early facilitation was evoked by a magnetic or anodal electrical conditioning stimulus over the motor point in the conditioning hemisphere, which suggests that the conditioning stimulus for early facilitation directly activates corticospinal neurones. 5. The ISIs for early facilitation taken together with the time required for activation of corticospinal neurones by I3-waves in the test hemisphere are compatible with the interhemispheric conduction time through the corpus callosum. Early facilitation was observed in responses to I3-waves, but not in responses to D-waves nor to I1-waves. Based on these results, we conclude that early facilitation is mediated through the corpus callosum. 6. If the magnetic conditioning stimulus induced posteriorly directed currents, or if an anodal electrical conditioning stimulus was applied over a point 2 cm anterior to the motor point, then we observed late inhibition with no early facilitation. 7. Late inhibition was evoked in responses to both I1- and I3-waves, but was not evoked in responses to D-waves. The stronger the conditioning stimulus was, the greater was the amount of inhibition. These results are compatible with surround inhibition at the motor cortex.

The pFC has a crucial role in cognitive control, executive function, and sensory processing. Functional imaging, neurophysiological, and animal studies provide evidence for a functional connectivity between the dorsolateral pFC (DLPFC) and the primary motor cortex (M1) during free choice but not instructed choice selection tasks. In this study, twin coil, neuronavigated TMS was used to examine the precise timing of the functional interaction between human left DLPFC and ipsilateral M1 during the execution of a free/specified choice selection task involving the digits of the right hand. In a thumb muscle that was not involved in the task, a conditioning pulse to the left DLPFC enhanced the excitability of the ipsilateral M1 during free selection more than specified selection 100 msec after presentation of the cue; the opposite effect was seen at 75 msec. However, the difference between free and externally specified conditions disappeared when a task-specific muscle was investigated. In this case, the influence from DLPFC was dominated by task involvement rather than mode of selection, suggesting that other processes related to movement execution were also operating. Finally, we show that the effects were spatially specific because they were absent when an adjacent area of DLPFC was stimulated. These results reveal temporally and spatially selective interactions between BA 46 and M1 that are both task and muscle specific.

Recent studies have shown that frontoparietal cortices and interconnecting regions in the basal ganglia and the cerebellum are related to motor skill learning. We propose that motor skill learning occurs independently and in different coordinates in two sets of loop circuits: cortex-basal ganglia and cortex-cerebellum. This architecture accounts for the seemingly diverse features of motor learning.

Functional connections between dorsal premotor cortex (PMd) and primary motor cortex (M1) have been revealed by paired-pulse transcranial magnetic stimulation (TMS). We tested if such connections would be modulated during a cognitive process (response selection) known to rely on those circuits. PMd-M1 TMS applied 75 ms after a cue to select a manual response facilitated motor-evoked potentials (MEPs). MEPs were facilitated at 50 ms in a control task of response execution, suggesting that PMd-M1 interactions at 75 ms are functionally specific to the process of response selection. At 100 ms, PMd-M1 TMS delayed choice reaction time (RT). Importantly, the MEP (at 75 ms) and the RT (at 100 ms) effects were correlated in a way that was hand-specific. When the response was made with the M1-contralateral hand, MEPs correlated with slower RTs. When the response was made with the M1-ipsilateral hand, MEPs correlated with faster RTs. Paired-pulse TMS confined to M1 did not produce these effects, confirming the causal influence of PMd inputs. This study shows that a response selection signal evolves in PMd early during the reaction period (75-100 ms), impacts on M1 and affects behaviour. Such interactions are temporally, anatomically and functionally specific, and have a causal role in choosing which movement to make.

We have used positron emission tomography to study the functional anatomy of motor sequence learning. Subjects learned sequences of keypresses by trial and error using auditory feedback. They were scanned with eyes closed under three conditions: at rest, while performing a sequence that was practiced before scanning until overlearned, and while learning new sequences at the same rate of performance. Compared with rest, both sequence tasks activated the contralateral sensorimotor cortex to the same extent. Comparing new learning with performance of the prelearned sequence, differences in activation were identified in other areas. (1) Prefrontal cortex was only activated during new sequence learning. (2) Lateral premotor cortex was significantly more activated during new learning, whereas the supplementary motor area was more activated during performance of the prelearned sequence. (3) Activation of parietal association cortex was present during both motor tasks, but was significantly greater during new learning. (4) The putamen was equally activated by both conditions. (5) The cerebellum was activated by both conditions, but the activation was more extensive and greater in degree during new learning. There was an extensive decrease in the activity of prestriate cortex, inferotemporal cortex, and the hippocampus in both active conditions, when compared with rest. These decreases were significantly greater during new learning. We draw three main conclusions. (1) The cerebellum is involved in the process by which motor tasks become automatic, whereas the putamen is equally activated by sequence learning and retrieval, and may play a similar role in both. (2) When subjects learn new sequences of motor actions, prefrontal cortex is activated. This may reflect the need to generate new responses. (3) Reduced activity of areas concerned with visual processing, particularly during new learning, suggests that selective attention may involve depressing the activity of cells in modalities that are not engaged by the task.

We used positron emission tomography to study new learning and automatic performance in normal volunteers. Subjects learned sequences of eight finger movements by trial and error. In a previous experiment we showed that the prefrontal cortex was activated during new learning but not during during automatic performance. The aim of the present experiment was to see what areas could be reactivated if the subjects performed the prelearned sequence but were required to pay attention to what they were doing. Scans were carried out under four conditions. In the first the subjects performed a prelearned sequence of eight key presses; this sequence was learned before scanning and was practiced until it had become overlearned, so that the subjects were able to perform it automatically. In the second condition the subjects learned a new sequence during scanning. In a third condition the subjects performed the prelearned sequence, but they were required to attend to what they were doing; they were instructed to think about the next movement. The fourth condition was a baseline condition. As in the earlier study, the dorsal prefrontal cortex and anterior cingulate area 32 were activated during new learning, but not during automatic performance. The left dorsal prefrontal cortex and the right anterior cingulate cortex were reactivated when subjects paid attention to the performance of the prelearned sequence compared with automatic performance of the same task. It is suggested that the critical feature was that the subjects were required to attend to the preparation of their responses. However, the dorsal prefrontal cortex and the anterior cingulate cortex were activated more when the subjects learned a new sequence than they were when subjects simply paid attention to a prelearned sequence. New learning differs from the attention condition in that the subjects generated moves, monitored the outcomes, and remembered the responses that had been successful. All these are nonroutine operations to which the subjects must attend. Further analysis is needed to specify which are the nonroutine operations that require the involvement of the dorsal prefrontal and anterior cingulate cortex.

Events like the World Championships in athletics and the Olympic Games raise the public profile of competitive sports. They may also leave us wondering what sets the competitors in these events apart from those of us who simply watch. Here we attempt to link neural and cognitive processes that have been found to be important for elite performance with computational and physiological theories inspired by much simpler laboratory tasks. In this way we hope to inspire neuroscientists to consider how their basic research might help to explain sporting skill at the highest levels of performance.

Paired-pulse transcranial magnetic stimulation (TMS) has been applied as a probe to test functional connectivity within distinct cortical areas of the human motor system. Here, we tested the interaction between the posterior parietal cortex (PPC) and ipsilateral motor cortex (M1). A conditioning TMS pulse over the right PPC potentiates motor evoked-potentials evoked by a test TMS pulse over the ipsilateral motor cortex, with a time course characterized by two phases: an early peak at 4 ms interstimulus interval (ISI) and a late peak at 15 ms ISI. Activation of this facilitatory pathway depends on the intensity of stimulation, because the effects are induced with a conditioning stimulus of 90% resting motor threshold but not at lower or higher intensities. Similar results were obtained testing the ipsilateral interaction in the left hemisphere with a slightly different time course. In control experiments, we found that activation of this facilitatory pathway depends on the direction of induced current in the brain and is specific for stimulation of the caudal part of the inferior parietal sulcus (cIPS) site, because it is not observed for stimulation of adjacent scalp sites. Finally, we found that by using poststimulus time histogram analysis of single motor unit firing, the PPC conditioning increases the excitability of ipsilateral M1, enhancing the relative amount of late I wave input recruited by the test stimulus over M1, suggesting that such interaction is mediated by specific interneurons in the motor cortex. The described facilitatory connections between cIPS and M1 may be important in a variety of motor tasks and neuropsychiatric disorders.

Transcranial magnetic stimulation (TMS) can be used in two different ways to investigate the contribution of cortical areas involved in grasp/reach movements in humans. It can produce "virtual lesions" that interfere with activity in particular cortical areas at specific times during a task, or it can be used in a twin coil design to test the excitability of cortical projections to M1 at different times during a task. The former method has described how cortical structures such as the ventral premotor cortex (PMv), dorsal premotor cortex (PMd) and the anterior intraparietal sulcus (aIPS) are important for specific aspects of reaching, grasping and lifting objects. In the latter method, a conditioning stimulus (CS) is first used to activate putative pathways to the motor cortex from, for example, posterior parietal cortex (PPC) or PMd, while a second, test stimulus (TS), delivered over the primary motor cortex a few ms later probes any changes in excitability that are produced by the input. Thus changes in the effectiveness of the conditioning pulse give an indication of how the excitability of the connection changes over time and during a specific task. Here we review studies describing the time course of operation of parallel intracortical circuits and cortico-cortical connections between the PMd, PMv, PPC and M1, thus demonstrating that functional interplay between these areas and the primary motor cortices is not fixed, but can change in a highly task-, condition- and time-dependent manner.

We have been investigating motor control and learning in parkinsonian subjects. In the current study, we sought to explore the existence of deficits in procedural motor learning, which is a form of implicit motor learning where skill improves over repetitive blocks of trials. We sought to determine, in particular, whether any such deficit is accentuated during specific types or phases of learning. We would expect that those specific learning tasks would require the greatest participation of the basal ganglia. Numerous studies have found that Parkinson's disease (PD) patients may show deficits in learning. Combined with information about basal ganglia neuronal connections and activity, this led some investigators to suggest that one of the key functions of the basal ganglia is to facilitate learning. To investigate these learning deficits, we used a robotic device to generate conservative force fields that disturbed the subjects' arm movements, thereby generating a "virtual mechanical environment" that subjects learned to manipulate. Movements were successively grouped into blocks comprising five different conditions: motor performance, early learning, late learning, negative transfer, and aftereffect motor performance. Our results with eight right-handed PD subjects and nine age-matched controls showed a relative decrease in the rate of learning for the PD patients in all blocks, but greater differences emerged between groups during novelty phases of learning. In particular, the difference in performance during the negative transfer condition reached statistical significance, suggesting that the basal ganglia might be a key center for "switching" motor patterns. Our results support the hypothesis that deficiencies in procedural motor learning are characteristic of PD. They add to existing evidence which has suggested a key role for the basal ganglia when new sensorimotor mappings are required by novel task environments. Better understanding of these deficits should facilitate the rehabilitation of PD patients.

Understanding how different brain regions interact with one another is at the heart of current endeavors in cognitive and basic neuroscience. Unlike most neuroimaging techniques, transcranial magnetic stimulation (TMS) allows the establishment of causal relationships in the study of the functional architecture of the human brain. While this tool is increasingly used to probe the functional and causal nature of the associations between brain regions, a comprehensive guide documenting the various existing stimulation protocols is currently lacking, limiting its use.

Electromyographic (EMG) responses evoked in hand muscles by a magnetic test stimulus over the motor cortex can be suppressed if a conditioning stimulus is applied to the opposite hemisphere 6-30 ms earlier. In order to define the mechanism and the site of action of this inhibitory phenomenon, we recorded descending volleys produced by the test stimulus through high cervical, epidural electrodes implanted for pain relief in three conscious subjects. These could be compared with simultaneously recorded EMG responses in hand muscles. When the test stimulus was given on its own it evoked three waves of activity (I-waves) in the spinal cord, and a small EMG response in the hand. A prior conditioning stimulus to the other hemisphere suppressed the size of both the descending spinal cord volleys and the EMG responses evoked by the test stimulus when the interstimulus interval was greater than 6 ms. In the spinal recordings, the effect was most marked for the last I-wave (I3), whereas the second I2-wave was only slightly inhibited, and the first I-wave (I1) was not inhibited at all. We conclude that transcranial stimulation over the lateral part of the motor cortex of one hemisphere can suppress the excitability of the contralateral motor cortex.

Theta burst transcranial magnetic stimulation (TBS) is considered to produce plastic changes in human motor cortex. Here, we examined the inhibitory and excitatory effects of TBS on implicit sequence learning using a probabilistic serial reaction time paradigm. We investigated the involvement of several cortical regions associated with implicit sequence learning by examining probabilistic sequence learning in five age- and IQ-matched groups of healthy participants following continuous inhibitory TBS over primary motor cortex (M1); or the supplementary motor area (SMA) or dorsolateral prefrontal cortex (DLPFC) or following intermittent excitatory TBS of M1; or after sham TBS. Relative to sham TBS, probabilistic sequence learning was abolished by inhibitory TBS over M1, demonstrating that this region is critical for implicit motor sequence learning. Sequence learning was not significantly affected by inhibitory TBS over the SMA, DLPFC or excitatory TBS over M1. These results demonstrate that the M1 mediates implicit sequence learning.

Transcranial magnetic stimulation (TMS) has become a mainstay of cognitive neuroscience, thus facing new challenges due to its widespread application on behaviorally silent areas. In this review we will summarize the main technical and methodological considerations that are necessary when using TMS in cognitive neuroscience, based on a corpus of studies and technical improvements that has become available in most recent years. Although TMS has been applied only relatively recently on a large scale to the study of higher functions, a range of protocols that elucidate how this technique can be used to investigate a variety of issues is already available, such as single pulse, paired pulse, dual-site, repetitive and theta burst TMS. Finally, we will touch on recent promising approaches that provide powerful new insights about causal interactions among brain regions (i.e., TMS with other neuroimaging techniques) and will enable researchers to enhance the functional resolution of TMS (i.e., state-dependent TMS). We will end by briefly summarizing and discussing the implications of the newest safety guidelines.

In this study, we investigated motor and cognitive procedural learning in typically developing children aged 8-12 years with a serial reaction time (SRT) task and a probabilistic classification learning (PCL) task. The aims were to replicate and extend the results of previous SRT studies, to investigate PCL in school-aged children, to explore the contribution of declarative knowledge to SRT and PCL performance, to explore the strategies used by children in the PCL task via a mathematical model, and to see whether performances obtained in motor and cognitive tasks correlated. The results showed similar learning effects in the three age groups in the SRT and in the first half of the PCL tasks. Participants did not develop explicit knowledge in the SRT task whereas declarative knowledge of the cue-outcome associations correlated with the performances in the second half of the PCL task, suggesting a participation of explicit knowledge after some time of exposure in PCL. An increasing proportion of the optimal strategy use with increasing age was observed in the PCL task. Finally, no correlation appeared between cognitive and motor performance. In conclusion, we extended the hypothesis of age invariance from motor to cognitive procedural learning, which had not been done previously. The ability to adopt more efficient learning strategies with age may rely on the maturation of the fronto-striatal loops. The lack of correlation between performance in the SRT task and the first part of the PCL task suggests dissociable developmental trajectories within the procedural memory system.

One of the enduring mysteries of brain function concerns the process of cognitive control. How does complex and seemingly willful behaviour emerge from interactions between millions of neurons? This has long been suspected to depend on the prefrontal cortex--the neocortex at the anterior end of the brain--but now we are beginning to uncover its neural basis. Nearly all intended behaviour is learned and so depends on a cognitive system that can acquire and implement the 'rules of the game' needed to achieve a given goal in a given situation. Studies indicate that the prefrontal cortex is central in this process. It provides an infrastructure for synthesizing a diverse range of information that lays the foundation for the complex forms of behaviour observed in primates.

Transcranial magnetic stimulation (TMS) is a widely used brain stimulation technique that allows noninvasive examination of different excitatory and inhibitory circuits at the systems level in the intact human brain. In recent years, considerable knowledge has been accumulated about the physiology of several of these facilitatory and inhibitory processes individually. However, activity in the corresponding neural circuits is not independent of each other. This paper reviews the experiments using triple-pulse TMS that are specifically designed to study interactions between intracortical circuits. These studies have provided evidence for a complex network of interconnected neural circuits within and across cerebral hemispheres. The current knowledge about the functional organization of this network, its pharmacology and functional implications for human motor control are discussed in detail. These findings have clinical relevance because specific interactions between neural circuits may be impaired in neurologic and psychiatric disorders. We conclude that triple-pulse TMS studies will help to integrate and better understand the physiologic processes involved in human motor behavior.

Inductions of long-term potentiation (LTP) and depression (LTD) are modulated if they are preceded by a priming protocol, in a manner consistent with metaplasticity. Depotentiation refers to reversal of LTP by a subsequent protocol that has no effect by itself. Paired associative stimulation (PAS) at interstimulus interval of 25 ms (PAS25) and 10 ms (PAS10) produces spike timing-dependent LTP-like and LTD-like effects in human primary motor cortex. Continuous theta burst stimulation (cTBS) with 600 pulses produces an LTD-like effect, whereas cTBS with 150 pulses (cTBS150) has no effect by itself. We investigated whether cortical plasticity induced by PAS can be modulated by heterosynaptic inputs of cTBS150. PAS25 and PAS10 primed and followed by cTBS150 were compared withPAS25 and PAS10 alone. Motor evoked potential (MEP) amplitude, recruitment curve, and intracortical circuits including short-interval intracortical inhibition (SICI), long-interval intracortical inhibition (LICI), intracortical facilitation, and short-latency afferent inhibition were measured before and after the interventions. After PAS25 alone, MEP amplitude increased while intracortical circuits did not change. A priming cTBS150 enhanced the effects of PAS25 with further increase in MEP amplitude and led to reduction in SICI and LICI. PAS25 followed by cTBS150 led to reduced MEP amplitude and increased LICI and SICI. Both priming and following cTBS150 reversed the LTD-like effect produced by PAS10 with little change in intracortical circuits. We conclude that cortical plasticity induced by PAS and cTBS interacts in a heterosynaptic and bidirectional manner. The order of the interventions determines whether the underlying mechanisms are related to metaplasticity or depotentiation.

Interhemispheric inhibition (IHI) refers to the neurophysiological mechanism in which one hemisphere of the brain inhibits the opposite hemisphere. IHI can be studied by transcranial magnetic stimulation using a conditioning-test paradigm. We investigated IHI from 5 motor related cortical areas in the right hemisphere to the left primary motor cortex (M1). These areas are hand and face representations of M1, dorsal premotor cortex, somatosensory cortex, and dorsolateral prefrontal cortex. Test stimulus was delivered to the left M1 and conditioning stimulus (CS) was delivered to one of 5 motor related cortical areas in the right hemisphere. The time course of IHI, effects of different CS intensities and current directions on IHI were tested. Maximum IHI was found at interstimulus intervals of approximately 10 ms (short latency IHI, SIHI) and approximately 50 ms (long latency IHI, LIHI) for the motor related areas tested. LIHI could be elicited over a wide range of CS intensities, whereas SIHI required higher CS intensities. We conclude that there are 2 distinct phases of IHI from motor related cortical areas to the opposite M1 through the corpus callosum, and they are mediated by different neuronal populations.

This study examined the effect of bilateral transfer and performance variation on 10 trials of a pursuit-rotor task. 95 right-handed healthy men (M age = 21.0 yr., SD = 3.6) were randomly divided into Right-Left (R-L: n = 50) and Left-Right (L-R: n = 45) groups. The former performed the task with the right hand first and the latter group used the left hand first. Target contact times on the pursuit-rotor task improved at about the same rate. Contact times by the left hand after using the right hand were longer than those when the left hand was used first. Although variation of contact times converged with repeated trials, when the left hand was used first, the performance variation remained large for right-handed participants.

We studied the role of the dorsolateral prefrontal cortex in procedural learning. Normal subjects completed several blocks of a serial reaction time task using only one hand without or with concurrent non-invasive repetitive transcranial magnetic stimulation. To disrupt their function transiently, stimulation was applied at low intensity over the supplementary motor area or over the dorsolateral prefrontal cortex contralateral or ipsilateral to the hand used for the test. Stimulation to the contralateral dorsolateral prefrontal cortex markedly impaired procedural implicit learning, as documented by the lack of significant change in response times during the task. Stimulation over the other areas did not interfere with learning. These results support the notion of a critical role of contralateral dorsolateral prefrontal structures in learning of motor sequences.

Acquisition of a new skill is generally associated with a decrease in the need for effortful control over performance, leading to the development of automaticity. Automaticity by definition has been achieved when performance of a primary task is minimally affected by other ongoing tasks. The neural basis of automaticity was examined by testing subjects in a serial reaction time (SRT) task under both single-task and dual-task conditions. The diminishing cost of dual-task performance was used as an index for automaticity. Subjects performed the SRT task during two functional magnetic imaging sessions separated by 3 h of behavioral training over multiple days. Behavioral data showed that, by the end of testing, subjects had automated performance of the SRT task. Before behavioral training, performance of the SRT task concurrently with the secondary task elicited activation in a wide network of frontal and striatal regions, as well as parietal lobe. After extensive behavioral training, dual-task performance showed comparatively less activity in bilateral ventral premotor regions, right middle frontal gyrus, and right caudate body; activity in other prefrontal and striatal regions decreased equally for single-task and dual-task conditions. These data suggest that lateral and dorsolateral prefrontal regions, and their corresponding striatal targets, subserve the executive processes involved in novice dual-task performance. The results also showed that supplementary motor area and putamen/globus pallidus regions showed training-related decreases for sequence conditions but not for random conditions, confirming the role of these regions in the representation of learned motor sequences.

Repetitive transcranial magnetic stimulation (rTMS) has in recent years been used to explore therapeutic opportunities in a bewildering variety of conditions. Although there is good evidence that this technique can modify cortical activity, the rationale for its use in many of the conditions investigated so far is not clear. Here we discuss the effects of rTMS in healthy subjects and how it has been used in a number of neurological conditions. We argue that a better understanding of both the effects of rTMS and the pathological processes underlying the conditions for which it is used will reveal whether rTMS really does offer therapeutic potential and, if so, for which conditions.

Many studies have implicated the dorsolateral prefrontal cortex in the acquisition of skill, including procedural sequence learning. However, the specific role it performs in sequence learning has remained uncertain. This type of skill has been intensively studied using the serial reaction time task. We used three versions of this task: a standard task where the position of the stimulus cued the response; a non-standard task where the color of the stimulus was related to the correct response; and a combined task where both the color and position simultaneously cued the response. We refer to each of these tasks based upon the cues available for guiding learning as position, color and combined tasks. The combined task usually shows an enhancement of skill acquisition, a result of being driven by two simultaneous and congruent cues. Prior to the performance of each of these tasks the function of the dorsolateral prefrontal cortex was disrupted using repetitive transcranial magnetic stimulation. This completely prevented learning within the position task, while sequence learning occurred to a similar extent in both the color and combined tasks. So, following prefrontal stimulation the expected learning enhancement in the combined task was lost, consistent with only a color cue being available to guide sequence learning in the combined task. Neither of these effects was observed following stimulation at the parietal cortex. Hence the critical role played by the dorsolateral prefrontal cortex in sequence learning is related exclusively to spatial cues. We suggest that the dorsolateral prefrontal cortex operates over the short term to retain and manipulate spatial information to allow cortical and subcortical structures to learn a predictable sequence of actions. Such functions may emerge from the broader role the dorsolateral prefrontal cortex has in spatial working memory. These results argue against the dorsolateral prefrontal cortex constituting part of the neuronal substrate responsible for general aspects of implicit or explicit sequence learning.

Transcranial magnetic stimulation is increasingly used as a tool to explore cortical motor function in healthy subjects and in patients with neurological disease or injury. This review describes a "twin coil" TMS approach that allows investigation of time related changes in functional connectivity between primary motor cortex and other areas in preparation for a forthcoming movement. Investigations into premotor-motor interactions show that these are specific to the type of task that is performed as well as the muscles used to control the movement, allowing us to monitor information flow within motor networks with millisecond time resolution.

The role of the prefrontal cortex remains controversial. Neuroimaging studies support modality-specific and process-specific functions related to working memory and attention. Its role may also be defined by changes in its influence over other brain regions including sensory and motor cortex. We used functional magnetic imaging (fMRI) to study the free selection of actions and colours. Control conditions used externally specified actions and colours. The prefrontal cortex was activated during free selection, regardless of modality, in contrast to modality-specific activations outside prefrontal cortex. Structural equation modelling (SEM) of fMRI data was used to test the hypothesis that although the same regions of prefrontal cortex may be active in tasks within different domains, there is task-dependent effective connectivity between prefrontal cortex and non-prefrontal cortex. The SEM included high-order interactions between modality, selection and regional activity. There was greater coupling between prefrontal cortex and motor cortex during free selection and action tasks, and between prefrontal cortex and visual cortex during free selection of colours. The results suggest that the functions of the prefrontal cortex may be defined not only by selection-specific rather than modality-specific processes, but also by changing patterns of effective connectivity from prefrontal cortex to motor and sensory cortices.

We studied the neural correlates of visuomotor sequence learning using functional magnetic resonance imaging (fMRI). In the test condition, subjects learned, by trial and error, the correct order of pressing two buttons consecutively for 10 pairs of buttons (2 x 10 task); in the control condition, they pressed buttons in any order. Comparison between the test condition and the control condition revealed four brain areas specifically related to learning: the dorsolateral prefrontal cortex (DLPFC), the presupplementary motor area (pre-SMA), the precuneus, and the intraparietal sulcus (IPS). We found that the time course of activation during learning was different between these areas. To normalize the individual differences in the speed of learning, we classified the performance of each subject into three learning stages: early, intermediate, and advanced stages. Both the relative increase of signal intensity and the number of activated pixels within the four areas showed significant changes across the learning stages, with different time courses. The two frontal areas, DLPFC and pre-SMA, were activated in the earlier stages of learning, whereas the two parietal areas, precuneus and IPS, were activated in the later stages. Specifically, DLPFC, pre-SMA, precuneus, and IPS were most highly activated in the early stage, in both the early and intermediate stages, in the intermediate stage, and in both the intermediate and advanced stages, respectively. The results suggest that the acquisition of visuomotor sequences requires frontal activation, whereas the retrieval of visuomotor sequences requires parietal activation, which might reflect the transition from the declarative stage to the procedural stage.

fMRI was used to investigate the neural substrates supporting implicit and explicit sequence learning, focusing especially upon the role of the medial temporal lobe. Participants performed a serial reaction time task (SRTT). For implicit learning, they were naive about a repeating pattern, whereas for explicit learning, participants memorized another repeating sequence. fMRI analyses comparing repeating versus random sequence blocks demonstrated activation of frontal, parietal, cingulate, and striatal regions implicated in previous SRTT studies. Importantly, mediotemporal lobe regions were active in both explicit and implicit SRTT learning. Moreover, the results provide evidence of a role for the hippocampus and related cortices in the formation of higher order associations under both implicit and explicit learning conditions, regardless of conscious awareness of sequence knowledge.

In the domain of motor learning it has been difficult to separate the neural substrate of encoding from that of change in performance. Consequently, it has not been clear whether motor effector areas participate in learning or merely modulate changes in performance. Here, using a variant of the serial reaction time task that dissociated these two factors, we report that encoding during procedural motor learning does engage cortical motor areas and can be characterized by distinct early and late encoding phases. The highest correlation between activation and subsequent changes in motor performance was seen in the motor cortex during early encoding, and in the basal ganglia during the late encoding phase. Our results show that rapid encoding during procedural motor learning involves several distinct processes, and is represented primarily within motor system structures.

Computational studies suggest that acquisition of a motor skill involves learning an internal model of the dynamics of the task, which enables the brain to predict and compensate for mechanical behavior. During the hours that follow completion of practice, representation of the internal model gradually changes, becoming less fragile with respect to behavioral interference. Here, functional imaging of the brain demonstrates that within 6 hours after completion of practice, while performance remains unchanged, the brain engages new regions to perform the task; there is a shift from prefrontal regions of the cortex to the premotor, posterior parietal, and cerebellar cortex structures. This shift is specific to recall of an established motor skill and suggests that with the passage of time, there is a change in the neural representation of the internal model and that this change may underlie its increased functional stability.

The topic of multiple forms of memory is considered from a biological point of view. Fact-and-event (declarative, explicit) memory is contrasted with a collection of non conscious (non-declarative, implicit) memory abilities including skills and habits, priming, and simple conditioning. Recent evidence is reviewed indicating that declarative and non declarative forms of memory have different operating characteristics and depend on separate brain systems. A brain-systems framework for understanding memory phenomena is developed in light of lesion studies involving rats, monkeys, and humans, as well as recent studies with normal humans using the divided visual field technique, event-related potentials, and positron emission tomography (PET).

Inhibitory transcranial magnetic stimulation (TMS), of which continuous theta burst stimulation (cTBS) is a common form, has been used to inhibit cortical areas during investigations of their function. cTBS applied to the primary motor area (M1) depresses motor output excitability via a local effect and impairs procedural motor learning. This could be due to an effect on M1 itself and/or to changes in its connectivity with other nodes in the learning network. To investigate this issue, we used functional magnetic resonance imaging to measure changes in brain activation and connectivity during implicit procedural learning after real and sham cTBS of M1. Compared to sham, real cTBS impaired motor sequence learning, but caused no local or distant changes in brain activation. Rather, it reduced functional connectivity between motor (M1, dorsal premotor & supplementary motor areas) and visual (superior & inferior occipital gyri) areas. It also increased connectivity between frontal associative (superior & inferior frontal gyri), cingulate (dorsal & middle cingulate), and temporal areas. This potentially compensatory shift in coupling, from a motor-based learning network to an associative learning network accounts for the behavioral effects of cTBS of M1. The findings suggest that the inhibitory TMS affects behavior via relatively subtle and distributed effects on connectivity within networks, rather than by taking the stimulated area "offline".

A novel Hebbian stimulation paradigm was employed to examine physiological correlates of motor memory formation in humans. Repetitive pairing of median nerve stimulation with transcranial magnetic stimulation over the contralateral motor cortex (paired associative stimulation, PAS) may decrease human motor cortical excitability at interstimulus intervals of 10 ms (PAS10) or increase excitability at 25 ms (PAS25). The properties of this plasticity have previously been shown to resemble associative timing-dependent long-term depression (LTD) and long-term potentiation (LTP) as established in vitro. Immediately after training a novel dynamic motor task, the capacity of the motor cortex to undergo plasticity in response to PAS25 was abolished. PAS10-induced plasticity remained unchanged. When retested after 6 h, PAS25-induced plasticity recovered to baseline levels. After training, normal PAS25-induced plasticity was observed in the contralateral training-naive motor cortex. Motor training did not reduce the efficacy of PAS25 to enhance cortical excitability when PAS10 was interspersed between the training and application of the PAS25 protocol. This indicated that the mechanism supporting PAS25-induced plasticity had remained intact immediately after training. Behavioral evidence was obtained for continued optimization of force generation at a time when PAS25-induced plasticity was blocked in the training motor cortex. Application of the PAS protocols after motor training did not prevent the consolidation of motor skills evident as performance gains at later retesting. The results are consistent with a concept of temporary suppression of associative cortical plasticity by neuronal mechanisms involved in motor training. Although it remains an open question exactly which element of motor training was responsible for this effect, our findings may link dynamic properties of LTP formation, as established in animal experiments, with human motor memory formation and possibly dynamic motor learning.

There is a discrepancy between the results of imaging studies in which subjects learn motor sequences. Some experiments have shown decreases in the activation of some areas as learning increased, whereas others have reported learning-related increases as learning progressed. We have exploited fMRI to measure changes in blood oxygen leve-dependent (BOLD) signal throughout the course of learning. T2*-weighted echo-planar images were acquired over the whole brain for 40 min while the subjects learned a sequence eight moves long by trial and error. The movements were visually paced every 3.2 s and visual feedback was provided to the subjects. A baseline period followed each activation period. The effect due to the experimental conditions was modeled using a square-wave function, time locked to their occurrence. Changes over time in the difference between activation and baseline signal were modeled using a set of polynomial basis functions. This allowed us to take into account linear as well as nonlinear changes over time. Low-frequency changes over time common to both activation and baseline conditions (and thus not learning related) were modeled and removed. Linear and nonlinear changes of BOLD signal over time were found in prefrontal, premotor, and parietal cortex and in neostriatal and cerebellar areas. Single-unit recordings in nonhuman primates during the learning of motor tasks have clearly shown increased activity early in learning, followed by a decrease as learning progressed. Both phenomena can be observed at the population level in the present study.

The aim of this study was to investigate the neural mechanisms underlying the changes in the ipsilateral primary motor cortex (ipsi-M1) excitability induced during the unilateral rhythmic muscle contraction of the first dorsal interosseous (FDI) (rhythmic contraction) muscle with three different frequencies of auditory cues (1, 2, and 3 Hz). The effect of different frequencies of unilateral rhythmic contraction on changes in the ipsi-M1 excitability was assessed using a single-pulse transcranial magnetic stimulation (TMS) technique when subjects were performing the unilateral rhythmic contractions according to each auditory cue frequency. After that, the changes in short intracortical inhibition (SICI)/facilitation (ICF), long intracortical inhibition (LICI) within the ipsi-M1, and interhemispheric inhibition (IHI), as well as dorsal premotor cortex to M1 (PMd-M1), and dorsolateral prefrontal cortex to M1 (DLPFC-M1) connectivity from the contralateral hemisphere to the ipsi-M1 were assessed using paired-pulse TMS techniques. The motor evoked potentials (MEP) induced in the right FDI were recorded. In the results, the ipsi-M1 excitability induced in response to single-pulse TMS was significantly decreased in the 2 Hz conditions, compared with the 1Hz and 3Hz conditions. Furthermore, PMd-M1 connectivity and LICI were significantly modulated depending on the frequency of the unilateral rhythmic contraction. In contrast, the changes in the SICI, ICF, IHI, and DLPFC-M1 were not directly associated with the rhythm frequency. These results suggest that PMd-M1 connectivity and LICI within the ipsi-M1 are likely to preferentially operate to modulate ipsi-M1 excitability during the performance of unilateral rhythmic contraction with different frequencies.

An alternatively spliced isoform of the P2X1 receptor (P2X1a) was cloned from rat mesenteric artery. The spliced isoform does not have the 27 amino acids that are in the middle of the putative extracellular loop domain of the P2X1 original subunit (P2X1). Reverse transcriptase polymerase chain reaction (RT-PCR) revealed co-localization of P2X1a mRNA and P2X1 mRNA in vascular and other smooth muscle tissues and heart, but not in the spinal cord. In HEK293 cells transfected with P2X1 cDNA, ATP (1 microM) evoked an inward current which strongly desensitized, and an intense signal for GFP (green fluorescent protein) fused with P2X1 was detected at the membrane. Neither of these results was obtained in HEK293 cells expressing P2X1a alone. The fluorescent GFP signal was detected at the membrane when GFP-fused P2X1a was co-expressed with P2X1, and no significant difference in the ATP-activated current was noted between cells expressing P2X1 and those coexpressing P2X1 and P2X1a. These results indicate that the 27-amino-acid sequence (175-201) is important for protein trafficking to the membrane and for the formation of a functional P2X1 receptor. Our results also show that P2X1a is transported to the membrane when P2X1a is co-expressed with P2X1, although the co-expression of P2X1a does not modify the channel's current properties.

The structure of the brain as a product of morphogenesis is difficult to reconcile with the observed complexity of cerebral connectivity. We therefore analyzed relationships of adjacency and crossing between cerebral fiber pathways in four nonhuman primate species and in humans by using diffusion magnetic resonance imaging. The cerebral fiber pathways formed a rectilinear three-dimensional grid continuous with the three principal axes of development. Cortico-cortical pathways formed parallel sheets of interwoven paths in the longitudinal and medio-lateral axes, in which major pathways were local condensations. Cross-species homology was strong and showed emergence of complex gyral connectivity by continuous elaboration of this grid structure. This architecture naturally supports functional spatio-temporal coherence, developmental path-finding, and incremental rewiring with correlated adaptation of structure and function in cerebral plasticity and evolution.

This article describes a neuropsychological theory of motor skill learning that is based on the idea that learning grows directly out of motor control processes. Three motor control processes may be tuned to specific tasks, thereby improving performance: selecting spatial targets for movement, sequencing these targets, and transforming them into muscle commands. These processes operate outside of awareness. A 4th, conscious process can improve performance in either of 2 ways: by selecting more effective goals of what should be changed in the environment or by selecting and sequencing spatial targets. The theory accounts for patterns of impairment of motor skill learning in patient populations and for learning-related changes in activity in functional imaging studies. It also makes a number of predictions about the purely cognitive, including accounts of mental practice, the representation of motor skill, and the interaction of conscious and unconscious processes in motor skill learning.

Procedural learning, such as perceptual-motor sequence learning, has been suggested to be an obligatory consequence of practiced performance and to reflect adaptive plasticity in the neural systems mediating performance. Prior neuroimaging studies, however, have found that sequence learning accompanied with awareness (declarative learning) of the sequence activates entirely different brain regions than learning without awareness of the sequence (procedural learning). Functional neuroimaging was used to assess whether declarative sequence learning prevents procedural learning in the brain. Awareness of the sequence was controlled by changing the color of the stimuli to match or differ from the color used for random sequences. This allowed direct comparison of brain activation associated with procedural and declarative memory for an identical sequence. Activation occurred in a common neural network whether initial learning had occurred with or without awareness of the sequence, and whether subjects were aware or not aware of the sequence during performance. There was widespread additional activation associated with awareness of the sequence. This supports the view that some types of unconscious procedural learning occurs in the brain whether or not it is accompanied by conscious declarative knowledge.

There are three theories of implicit sequence learning consciousness: global workspace theory, neural plasticity theory and extraneous stimulus theory. All of them ignore body sense which is the key factor of consciousness. Therefore it is difficult for them to reveal the fundamental cause of consciousness. Embodied consciousness theory and its studies showed that motor/emotional mirror neuron system and their interaction with self and control systems are the source of primary/advanced consciousness. However, they did not involve the rule consciousness of implicit sequence learning which is very important to human study and cognition. In essence, previous researches on implicit sequence learning were close to reveal that the mechanism of implicit sequence learning is just sense/motor embodied learning, that its consciousness mechanism is likely to be motor/emotional embodied consciousness, and that the consciousness processing brain areas of implicit sequence learning mostly overlap the embodied consciousness brain areas. Future research should use Granger causality brain network technology to prove the embodied origin of implicit sequence learning consciousness, to examine the embodied basis of the three kinds of consciousness theories, and to explore the embodied mechanism of factors influencing consciousness.

The application of a single dose of a CNS active drug with a well-defined mode of action on a neurotransmitter or neuromodulator system may be used for testing pharmaco-physiological properties of transcranial magnetic stimulation (TMS) measures of cortical excitability. Conversely, a physiologically well-defined single TMS measure of cortical excitability may be used as a biological marker of acute drug effects at the systems level of the cerebral cortex. An array of defined TMS measures may be used to study the pattern of effects of a drug with unknown or multiple modes of action. Acute drug effects may be rather different from chronic drug effects. These differences can also be studied by TMS measures. Finally, TMS or repetitive TMS by themselves may induce changes in endogenous neurotransmitters or neuromodulators. All these possible interactions are the focus of this in-depth review on TMS and drugs.

The combination of pharmacology and transcranial magnetic stimulation to study the effects of drugs on TMS-evoked EMG responses (pharmaco-TMS-EMG) has considerably improved our understanding of the effects of TMS on the human brain. Ten years have elapsed since an influential review on this topic has been published in this journal (Ziemann, 2004). Since then, several major developments have taken place: TMS has been combined with EEG to measure TMS evoked responses directly from brain activity rather than by motor evoked potentials in a muscle, and pharmacological characterization of the TMS-evoked EEG potentials, although still in its infancy, has started (pharmaco-TMS-EEG). Furthermore, the knowledge from pharmaco-TMS-EMG that has been primarily obtained in healthy subjects is now applied to clinical settings, for instance, to monitor or even predict clinical drug responses in neurological or psychiatric patients. Finally, pharmaco-TMS-EMG has been applied to understand the effects of CNS active drugs on non-invasive brain stimulation induced long-term potentiation-like and long-term depression-like plasticity. This is a new field that may help to develop rationales of pharmacological treatment for enhancement of recovery and re-learning after CNS lesions. This up-dated review will highlight important knowledge and recent advances in the contribution of pharmaco-TMS-EMG and pharmaco-TMS-EEG to our understanding of normal and dysfunctional excitability, connectivity and plasticity of the human brain.