EMG-assessed paratonia: A novel approach to investigating motor response inhibition in healthy subjects

by Luca Puce, Lucio Marinelli, Antonio Currà, Laura Mori, Cristina Schenone, Filippo Cotellessa, Antonella Tatarelli, Daniele Pucci, Nicola Luigi Bragazzi, Carlo Trompetto

Paratonia is an involuntary muscle activity that occurs during passive joint mobilization and is common in people with dementia. It includes oppositional paratonia, in which muscle activity resists passive movement, and facilitatory paratonia, in which it assists movement. This phenomenon reflects a defect in motor response inhibition. In a recently published paper, we demonstrated that paratonia can be detected using surface electromyography (EMG) not only in patients with dementia but also in healthy individuals, the majority of whom do not exhibit clinically observable paratonia. This finding suggests that EMG-assessed paratonia may provide a novel approach to studying motor response inhibition in healthy subjects. The present study investigates this possibility for the first time. We recruited 120 healthy subjects under the age of 30, divided equally into three groups: sedentary, amateur, and professional athletes with low, moderate, and high levels of physical activity, respectively. Paratonia was assessed in the triceps and biceps brachii muscles during passive forearm movements performed manually. The results indicate that paratonia is more pronounced during fast and continuous passive movements, with facilitatory paratonia being more prevalent than oppositional paratonia. It is also more pronounced in the biceps than in the triceps. These findings, which mirror those previously observed in patients with dementia, suggest a similarity between paratonia in healthy subjects and those with cognitive impairment, supporting the hypothesis that paratonia in healthy individuals represents a form of impaired motor response inhibition. Furthermore, the comparison between groups showed that paratonia decreased with increasing physical activity, being least evident in athletes, more noticeable in amateurs, and most pronounced in sedentary individuals. This pattern confirms a key feature of motor response inhibition that has been shown in studies using traditional methods. Overall, our findings suggest that EMG-assessed paratonia provides a new method for studying motor response inhibition in healthy individuals.