READY, STEADY, AND GO. A Transcranial Magnetic Stimulation Study of Set-Related Inhibitory Activity in the Human Dorsal Precentral Region

Successfully acting largely depends on moving at the right time. Consider a member of an orchestra just few instants before starting to play her piece. She should be ready not only to launch the planned movements when appropriate, but also to stop them if required. Action initiation and control are characteristic features of many of our daily life actions. There is a large amount of evidence in monkeys and humans suggesting that the dorsal premotor cortex (PMD) and the supplementary motor areas (SMA) might be critically involved in these features. However, the distinctive role of these areas is still matter of controversy. The aim of the present thesis is to provide some preliminary steps toward a comprehension of whether and how the human dorsal precentral areas may selectively contribute to action initiation and control. In doing this we shall introduce and discuss a series of transcranial magnetic stimulation (TMS) experiments carried out with two different paradigms, namely dual-coil TMS and single pulse TMS paradigm. These experiments were primarily devoted to explore the structural and functional properties of PMD. They also allowed us to assess whether PMD and SMA may be differentially and selectively involved in action control. In more detail, we first investigated the structural connectivity between PMD and the ipsilateral orofacial M1, introducing a novel dual-coil TMS approach. Results displayed the existence of short-latency influences of the left PMD on the ipsilateral orofacial M1, measured by recording motor evoked potentials (MEPs) in the orofacial muscles. Then, taking advantage of this novel approach, we started to explore the functional PMD-M1 connectivity. We tested the short-latency effects of TMS, as measured by changes in orofacial MEPs, during a delayed motor task. The results showed an inhibitory activity in the PMD-M1 module during the SET-period. We also manipulated the duration of the SET-period, to establish whether the effects were time-locked to the start of the delay period or rather time-locked to the predicted GO-signal. Hence, the investigation of the PMD-M1 connectivity paved us the way to explore, first, the role of PMD in initiating action and, then, the differential role of PMD and SMA in controlling and inhibiting action. Indeed, we run a further study, in which we carried out two single pulse TMS experiments. We first stimulated PMD during a stop-signal task, then we contrasted the PMD stimulation with SMA stimulation when participants underwent the same stop-signal task. There are five chapters to come. In Chapter 1 we shall review some key studies exploring anatomical and functional properties of PMD and SMA in both monkeys and humans, with particular emphasis on their putative role in action initiation and control. In Chapter 2 we shall focus on the methodological aspects of our experimental studies. In particular, we shall introduce the so-called twin- or dual-coil TMS paradigm, discuss its main approaches present in the literature and propose a variant of them. In Chapter 3 we shall present and discuss our first dual-coil TMS study exploring, for the first time, the ipsilateral PMD-corticofacial system connectivity. In Chapter 4 we shall examine three dual-coil TMS studies investigating the functional connectivity between PMD and ipsilateral M1 during a motor delayed task. Finally, in Chapter 5 we shall scrutinize two single pulse TMS studies capitalizing on a stop-signal task in order to assess the role of PMD and SMA in action control. Results and future lines of research will be sketched in the Concluding remarks.