{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T08:50:34Z","timestamp":1782118234105,"version":"3.54.5"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88887.817054\/2023\u201000"],"award-info":[{"award-number":["88887.817054\/2023\u201000"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J of Neuroscience"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Intersegmental neural modulation refers to the influence of voluntary activation of one limb on the excitability and inhibitory balance of remote motor representations. Recent evidence suggests that high\u2010intensity upper\u2010limb isometric contractions can transiently enhance corticospinal excitability and modulate intracortical or interhemispheric inhibition of lower\u2010limb motor areas, yet the consistency of these findings remains unclear. This systematic review synthesized evidence on the effects of upper\u2010limb isometric contractions on corticospinal excitability and inhibitory mechanisms of lower\u2010limb motor representations in healthy adults. Following PRISMA 2020 guidelines, searches were conducted in PubMed\/MEDLINE, Scopus, Web of Science, Embase, and Cochrane CENTRAL. Eligible studies included healthy adults (18\u201365\u2009years) performing upper\u2010limb isometric contractions quantified as percentage maximal voluntary contraction (%MVC), with outcomes assessing lower\u2010limb corticospinal excitability or intracortical\/interhemispheric inhibition. Two independent reviewers screened studies, extracted data, and assessed risk of bias. Seventeen studies (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009351) met inclusion criteria. Most reported increases in lower\u2010limb motor evoked potential amplitude during upper\u2010limb contractions, particularly at intensities \u2265\u200970% MVC. Reductions in short\u2010interval intracortical inhibition were common, indicating transient disinhibition of lower\u2010limb primary motor cortex representations. Findings for interhemispheric inhibition were inconsistent, likely attributable to variability in contraction tasks and transcranial magnetic stimulation parameters. Upper\u2010limb isometric contractions consistently facilitate lower\u2010limb corticospinal excitability and reduce intracortical inhibition in healthy adults. Although mechanistic patterns converge, methodological heterogeneity limits confidence in the magnitude of effects. Future studies require standardized experimental protocols and adequate sample sizes to clarify intensity\u2013response relationships and underlying neurophysiological mechanisms.\n                  <\/jats:p>","DOI":"10.1111\/ejn.70501","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:05:07Z","timestamp":1776056707000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intersegmental Modulation of Lower\u2010Limb Corticospinal Excitability and Inhibition Induced by Upper\u2010Limb Isometric Contractions: A Systematic Review"],"prefix":"10.1111","volume":"63","author":[{"given":"Gustavo\u00a0Henrique","family":"de Mello\u00a0Rosa","sequence":"first","affiliation":[{"name":"Neuropsychobiology and Motor Control Laboratory, Department of Health Sciences, Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo  S\u00e3o Paulo 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