Stimulation of the Dorsal Premotor Cortex, But Not of the Supplementary Motor Area Proper, Impairs the Stop Function in a STOP Signal Task.

Being able to inhibit an impending movement in response to a contextual change is a distinctive feature of action control. Such inhibitory control relies on a complex cortical-subcortical network, including posterior prefrontal regions such as caudal inferior frontal gyrus and pre-supplementary motor area. According to hierarchical models of action control, both areas represent the intermediate level between prefronto-dependent and motor-related cortices. Going at a lower level, accumulating evidence speaks for an involvement of the primary motor cortex (M1) to dorsal premotor cortex (PMCd) or supplementary motor area proper (SMA-proper) pathways in producing inhibitory control. However, the clear-cut evidence for this conjecture is still missing. The aim of the present paper was to start filling this gap, investigating this lowest level of inhibitory control. We stimulated PMCd in a group of healthy volunteers with transcranial magnetic stimulation (TMS) or sham TMS during the response phase of a STOP-signal task performed with the lips. In a separate experimental group, we applied effective TMS/sham TMS to SMA-proper during the same task. We found that effective TMS over PMCd increased false-start errors in STOP trials (p = 0.0005), but had no effect on GO trial performance (p = 0.85). Effective TMS on SMA-proper produced no effect on STOP trials' performance (p = 0.31) nor in the GO trial performance (p = 0.56). Our data show that there is at least a portion of PMCd playing a distinctive role in the control of mouth-related M1 during instructed visuomotor inhibitory behavior. This region could therefore represent a low-level hierarchical node for externally cued action inhibition.