Driving associative plasticity in premotor-motor connections through a novel paired associative stimulation based on long-latency cortico-cortical interactions

Repeated pre- and post-synaptic neuronal activation is fundamental for strengthening synaptic connections, a key mechanism referred to as spike-time-dependent plasticity (STDP) [1]. In humans, associative plasticity with STDP properties can be induced through a TMS protocol, named cortico-cortical paired associative stimulation (ccPAS) [2–4]. By administering repeated pairs of TMS pulses over two interconnected brain areas at specific inter-stimulus intervals (ISI), ccPAS allows for the modulation of cortico-cortical connections efficiency.