Dissociated effects of diazepam and lorazepam on short-latency afferent inhibition

J Physiol. 2005 Nov 15;569(Pt 1):315-23. doi: 10.1113/jphysiol.2005.092155. Epub 2005 Sep 1.


Peripheral nerve inputs have an inhibitory effect on motor cortex excitability at short intervals (short-latency afferent inhibition, SAI). This can be tested by coupling electrical stimulation of peripheral nerve with transcranial magnetic stimulation (TMS) of the motor cortex. SAI is reduced by the anticholinergic drug scopolamine, and in patients with Alzheimer's disease. Therefore, it is possible that SAI is a marker of central cholinergic activity important for memory function. The benzodiazepine lorazepam also reduces SAI. Since benzodiazepines impair memory formation, but do not do so uniformly, with a maximum amnesic effect after lorazepam but less or no effect after diazepam, we were interested in testing in this non-behavioural study to what extent the effects of lorazepam and diazepam on circuits involved in SAI could be dissociated. In addition, and for control, we tested the effects of lorazepam and diazepam on short-interval intracortical inhibition (SICI), a motor cortical inhibition mediated through the GABA(A) receptor. Lorazepam markedly reduced SAI, whereas diazepam slightly increased it. In contrast, both benzodiazepines uniformly increased SICI. Our findings demonstrate opposite effects of lorazepam and diazepam on SAI, an inhibition modulated by central cholinergic activity, but the same effects on SICI, a marker of neurotransmission through the GABA(A) receptor. This dissociation suggests, for the first time, that TMS measures of cortical inhibition provide the opportunity to segregate differences of benzodiazepine action in human central nervous system circuits.

Publication types

  • Comparative Study
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Afferent Pathways / drug effects
  • Afferent Pathways / physiology*
  • Diazepam / administration & dosage*
  • Dissociative Disorders / physiopathology
  • Drug Combinations
  • Evoked Potentials, Motor / physiology*
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Lorazepam / administration & dosage*
  • Male
  • Motor Cortex / drug effects
  • Motor Cortex / physiology*
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / physiology
  • Neural Inhibition / drug effects
  • Neural Inhibition / physiology*
  • Reaction Time / drug effects
  • Reaction Time / physiology*


  • Drug Combinations
  • Hypnotics and Sedatives
  • Lorazepam
  • Diazepam