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1 Section of Cardiology, The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey 17033; 2 Lebanon Veterans Affairs Medical Center, Lebanon, Pennsylvania 17042; and 3 Departments of Physiology and Neurology, State University of New York, Health Science Center of Brooklyn, Brooklyn, New York 11203
Single-pulse magnetic coil stimulation (Cadwell MES 10)
over the cranium induces without pain an electric pulse in the
underlying cerebral cortex. Stimulation over the motor cortex can
elicit a muscle twitch. In 10 subjects, we tested whether motor
cortical stimulation could also elicit skin sympathetic nerve activity (SSNA; n = 8) and muscle sympathetic nerve activity (MSNA;
n = 5) in the peroneal nerve. Focal motor cortical stimulation
predictably elicited bursts of SSNA but not MSNA; with successive
stimuli, the SSNA responses did not readily extinguish (94% of
discharges to the motor cortex evoked SSNA responses) and had
predictable latencies [739 ± 33 (SE) to 895 ± 13 ms].
The SSNA responses were similar after stimulation of dominant and
nondominant sides. Focal stimulation posterior to the motor cortex
elicited extinguishable SSNA responses. In three of six subjects,
anterior cortical stimulation evoked SSNA responses similar to those
seen with motor cortex stimulation but without detectable movement; in
the other subjects, anterior stimulation evoked less SSNA discharge
than that seen with motor cortex stimulation. Contrasting with motor
cortical stimulation, evoked SSNA responses were more readily
extinguished with 1) peripheral stimulation that directly
elicited forearm muscle activation accompanied by electromyograms
similar to those with motor cortical stimulation; 2) auditory
stimulation by the click of the energized coil when off the head; and
3) in preliminary experiments, finger afferent stimulation
sufficient to cause tingling. Our findings are consistent with the
hypothesis that motor cortex stimulation can cause activation of both
-motoneurons and SSNA.
central command; motor cortex; muscle sympathetic nerve activity; autonomic nervous system
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