Corticospinal excitability in human subjects during nonrapid eye movement sleep: single and paired-pulse transcranial magnetic stimulation study

Mirko Avesani, Emanuela Formaggio, Giorgio Fuggetta, Antonio Fiaschi, Paolo Manganotti

Research output: Contribution to journalArticlepeer-review


The mechanisms responsible for changes in brain function during normal sleep are poorly understood. In this study, we aimed to investigate the effects of sleep on human corticospinal excitability by estimating resting motor threshold (RMT), and latency and amplitude of motor-evoked potentials (MEPs) after delivering transcranial magnetic stimulation (TMS) in ten healthy subjects. We also aimed to study short-interval intracortical inhibition (SICI) during sleep with paired-pulse TMS (pp-TMS). Ten healthy volunteers were studied. They were monitored immediately before, during and after a 3-h sleep (from 1 p.m. to 4 p.m., immediately after the mid-day meal). EEG was continuously recorded during sleep and the various sleep stages were identified off line. Every 10 min, subjects received ten single stimuli (to estimate RMT, MEP latency and amplitude) and six paired stimuli (to estimate SICI). MEP amplitude decreased and latency and RMT increased during the various sleep stages and returned to baseline values on awakening. Post hoc comparisons showed a significant difference in pp-TMS MEP amplitudes between the sleep and all the other conditions. The changes in TMS evoked variables during the different sleep stages indicate that during nonrapid eye movement sleep, cortical pyramidal neuron excitability (as measured by RMT, MEP latency and amplitude) progressively diminishes and the efficiency of the intracortical GABA-ergic network (as assessed by three pp-TMS) increases. On awakening, these sleep-induced changes in corticospinal excitability return rapidly to values observed during wakefulness.

Original languageEnglish
Pages (from-to)17-23
Number of pages7
Issue number1
Publication statusPublished - May 2008


  • Adult
  • Brain Mapping
  • Electroencephalography
  • Evoked Potentials, Motor
  • Female
  • Humans
  • Male
  • Motor Cortex
  • Movement
  • Muscle, Skeletal
  • Nerve Net
  • Neural Conduction
  • Neural Inhibition
  • Neural Pathways
  • Pyramidal Tracts
  • Reaction Time
  • Sleep
  • Transcranial Magnetic Stimulation

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