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Open Access Highly Accessed Open Badges Research article

Contribution of primary motor cortex to compensatory balance reactions

David A E Bolton12*, Laura Williams1, W Richard Staines12 and William E McIlroy123

Author affiliations

1 Department of Kinesiology, University of Waterloo, 200 University Avenue W, Waterloo, ON, N2L 3 G1, Canada

2 Heart and Stroke Foundation Centre for Stroke Recovery, Ottawa, ON, Canada

3 Sunnybrook Health Sciences Centre Research Institute, Toronto, ON, Canada

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Citation and License

BMC Neuroscience 2012, 13:102  doi:10.1186/1471-2202-13-102

Published: 16 August 2012



Rapid compensatory arm reactions represent important response strategies following an unexpected loss of balance. While it has been assumed that early corrective actions arise largely from sub-cortical networks, recent findings have prompted speculation about the potential role of cortical involvement. To test the idea that cortical motor regions are involved in early compensatory arm reactions, we used continuous theta burst stimulation (cTBS) to temporarily suppress the hand area of primary motor cortex (M1) in participants prior to evoking upper limb balance reactions in response to whole body perturbation. We hypothesized that following cTBS to the M1 hand area evoked EMG responses in the stimulated hand would be diminished. To isolate balance reactions to the upper limb participants were seated in an elevated tilt-chair while holding a stable handle with both hands. The chair was held vertical by a magnet and was triggered to fall backward unpredictably. To regain balance, participants used the handle to restore upright stability as quickly as possible with both hands. Muscle activity was recorded from proximal and distal muscles of both upper limbs.


Our results revealed an impact of cTBS on the amplitude of the EMG responses in the stimulated hand muscles often manifest as inhibition in the stimulated hand. The change in EMG amplitude was specific to the target hand muscles and occasionally their homologous pairs on the non-stimulated hand with no consistent effects on the remaining more proximal arm muscles.


Present findings offer support for cortical contributions to the control of early compensatory arm reactions following whole-body perturbation.

Balance; Compensatory reaction; Postural perturbation; Fixed-support reaction; cTBS