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BACKGROUND: Heightened corticospinal pathway inhibition is evident in patellar tendinopathy, yet parallel descending pathway behavior remains unknown. Late components of the transcranial magnetic stimulation (TMS) motor evoked potential (MEP), thought to reflect polysynaptic cortico-reticulospinal transmission, may provide insight for compensatory routes preserving motor drive when corticospinal output is diminished. We therefore examined whether early (corticospinal) and late (cortico-reticulospinal) MEP components are differentially modulated in athletes with patellar tendinopathy compared with controls. METHODS: -mediated corticospinal inhibition. RESULTS: There was a group x phase interaction (p = 0.022), alongside main effects of phase (p < 0.001) and silent period (p = 0.006), but not group (p = 0.740). Late-phase MEP amplitudes were greater than early-phase amplitudes in patellar tendinopathy (p < 0.001), but not controls (p = 0.083). CONCLUSION: The putatively cortico-reticulospinal component of the MEP is preferentially enhanced in patellar tendinopathy, indicating increased reliance on polysynaptic brainstem pathways to maintain motor output.
Vallance et al. (Sat,) studied this question.