Intracortical inhibition and facilitation upon awakening from different stages: A transcranial magnetic stimulation study

Luigi De Gennaro, Mario Bertini, Michele Ferrara, Giuseppe Curcio, Riccardo Cristiani, Vincenzo Romei, Fabiana Fratello, Flavia Pauri, Paolo Maria Rossini

Research output: Contribution to journalArticlepeer-review


Intracortical facilitation and inhibition, as assessed by the paired-pulse transcranial magnetic stimulation technique with a subthreshold conditioning pulse followed by a suprathreshold test pulse, was studied upon awakening from REM and slow-wave sleep (SWS). Ten normal subjects were studied for four consecutive nights. Intracortical facilitation and inhibition were assessed upon awakening from SWS and REM sleep, and during a presleep baseline. Independently of sleep stage at awakening, intracortical inhibition was found at 1-3-ms interstimulus intervals and facilitation at 7-15-ms interstimulus intervals. Motor thresholds were higher in SWS awakenings, with no differences between REM awakenings and wakefulness, while motor evoked potential amplitude to unconditioned stimuli decreased upon REM awakening as compared to the other conditions. REM sleep awakenings showed a significant increase of intracortical facilitation at 10 and 15 ms, while intracortical inhibition was not affected by sleep stage at awakening. While the dissociation between motor thresholds and motor evoked potential amplitudes could be explained by the different excitability of the corticospinal system during SWS and REM sleep, the heightened cortical facilitation upon awakening from REM sleep points to a cortical motor activation during this stage.

Original languageEnglish
Pages (from-to)3099-3104
Number of pages6
JournalEuropean Journal of Neuroscience
Issue number11
Publication statusPublished - Jun 2004


  • Intracortical facilitation
  • Intracortical inhibition
  • Paired-pulse technique
  • REM sleep
  • Transcranial magnetic stimulation (TMS)

ASJC Scopus subject areas

  • Neuroscience(all)


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