Andrea Casarotto

and 5 more

Goal-directed actions, such as picking up, manipulating, or using objects, are so ubiquitous that impairments in these skills can severely impact quality of life. Reaching-grasping behaviours are driven by a frontoparietal network, with the ventral premotor cortex (PMv) and the primary motor cortex (M1) serving as critical frontal nodes. PMv-M1 connectivity can be modulated using cortico-cortical paired associative stimulation (cc-PAS), which involves repeated paired Transcranial Magnetic Stimulation (TMS) of both nodes. Stimulating M1 with an anterior-posterior (AP) current direction, selectively enhances corticospinal excitability during isometric precision grip, but not during isometric power grip. However, it is unclear how the plasticity induction in the more superficial PMv-M1 connectivity may influence the preparation and execution of goal-directed, naturalistic reaching-grasping actions. In this study, participants performed reaching-grasping actions toward small or large objects, requiring precision or power grip, before and after applying the PMv-M1 cc-PASAP protocol. The plasticity-induction protocol selectively modulated the reaching acceleration profile of precision grip actions, shifting the balance in favour of the final deceleration phase, which represents the sensory feedback-based control component of reaching. Joint angles temporal synergies analysis confirmed this selectivity, extending the observation to whole-arm, goal-directed, reaching-grasping precision grip coordination. Given that such basic skills are often permanently lost in stroke patients, our findings may offer valuable insight for the development of innovative therapeutic approaches for this clinical population.