The effect of a contralateral contraction on maximal voluntary activation and central fatigue in elbow flexor muscles.

A long-duration, submaximal contraction of a hand muscle increases central fatigue during a subsequent contraction in the other hand. However, this 'cross-over' of central fatigue between limbs is small and the location within the central nervous system at which this effect occurs is unknown. We investigated this 'cross-over' by measurement of the force and EMG responses to transcranial magnetic stimulation of the motor cortex (TMS). To produce central fatigue, we used sustained maximal voluntary contractions (MVCs). In the first study, subjects (n=10) performed four 1-min sustained MVCs of the elbow flexors, alternating between the left and right arms (two MVCs per arm). The sustained MVCs were performed consecutively with no rest periods. In the second study, the same subjects made two sustained 1-min MVCs with the same arm with a 1-min rest between efforts. During each sustained MVC, a series of TMS and brachial plexus stimuli were delivered. Surface EMG was recorded from biceps brachii and brachioradialis muscles bilaterally. Voluntary activation was estimated during each MVC using measurement of the force increments to TMS. On average during each sustained MVC, voluntary activation declined by 7-12% (absolute change, P<0.001) and voluntary force declined by 35-45% MVC (P<0.001), whereas the cortical motor-evoked potential increased (P<0.001) and the subsequent silent period lengthened (P<0.001). The average voluntary activation and voluntary force were similar during two sustained MVCs performed by the same arm, when separated by 1 min of rest. However, when the 1-min rest interval was replaced with a sustained contraction performed by the other arm, the average voluntary activation was 2.9% worse in the second contraction (absolute change, P<0.05), while it did not alter voluntary force production or the EMG responses to TMS. Therefore, in maximal exercise of 4 min duration, the 'cross-over' of central fatigue between limbs is small in the elbow flexors and has a minor functional effect. Our data suggest that voluntary drive from the motor cortex is slightly less able to drive the muscle maximally after a fatiguing voluntary contraction on the contralateral side.