Mental rotation of body parts and non-corporeal objects in patients with idiopathic cervical dystonia

Mental motor imagery indexes pain: the hand laterality task

Mental motor imagery is subserved by the same cognitive systems that underlie action. In turn, action is informed by the anticipated sensory consequences of movement, including pain. In light of these considerations, one would predict that motor imagery would provide a useful measure pain-related functional interference. We report a study in which 19 patients with chronic musculoskeletal or radiculopathic arm or shoulder pain, 24 subjects with chronic pain not involving the arm/shoulder and 41 normal controls were asked to indicate if a line drawing was a right or left hand. Previous work demonstrated that this task is performed by mental rotation of the subject's hand to match the stimulus. Relative to normal and pain control subjects, arm/shoulder pain subjects were significantly slower for stimuli that required greater amplitude rotations. For the arm/shoulder pain subjects only there was a correlation between degree of slowing and the rating of severity of pain with movement but not the non-specific pain rating. The hand laterality task may supplement the assessment of subjects with chronic arm/shoulder pain.

Mental motor imagery and chronic pain: the foot laterality task

Several lines of evidence suggest that mental motor imagery is subserved by the same cognitive operations and brain structures that underlie action. Additionally, motor imagery is informed by the anticipated sensory consequences of action, including pain. We reasoned that motor imagery could provide a useful measure of chronic leg or foot pain. Forty subjects with leg pain (19 bilateral, 11 right, and 10 left leg pain), 42 subjects with chronic pain not involving the legs, and 38 controls were shown 12 different line drawings of the right or left foot and asked to indicate which foot was depicted. Previous work suggests that subjects perform this task by mentally rotating their foot to match the visually presented stimulus. All groups of subjects were slower and less accurate with stimuli that required a greater degree of mental rotation of their foot. Subjects with leg pain were both slower and less accurate than normal and pain control subjects in responding to drawings of a painful extremity. Furthermore, subjects with leg pain exhibited a significantly greater decrement in performance for stimuli that required larger amplitude mental rotations. These data suggest that motor imagery may provide important insights into the nature of the pain experience.

Long-Term Adaptation to Neck/Shoulder Pain and Perceptual Performance in a Hand Laterality Motor Imagery Test

The effect of neck/shoulder pain on the performance in a hand laterality motor imagery test was studied. Responses to the Cooper and Shepard (1975, Journal of Experimental Psychology: Human Perception and Performance104 48–56) hand laterality test were explored in twenty-four individuals with chronic non-specific neck pain and twenty-one subjects with chronic neck pain of traumatic origin (whiplash-associated disorder). Twenty-two controls were also included in the study. Digitalised right- or left-hand stimuli were presented at five different stimulus angles (0°, 45° laterally, 90° laterally, 135° laterally, and 180°). The experimental task was to decide the laterality as fast and accurately as possible. The performance, both reaction time (RT) and accuracy, of the two experimental groups was contrasted with that of the control group. The main results revealed that the subjects afflicted with whiplash injury on the average exhibited a faster response pattern than symptom-free healthy controls. Despite their musculoskeletal deficits and experience of pain these volunteers also exhibited a preserved speed–accuracy tradeoff. Longer duration of time with symptoms of neck pain was, moreover, associated with progressively faster RTs. These results point to perceptual learning and may reflect different stages of adaptation to neck pain.

Neuronal Responses to Passive Movement in the Globus Pallidus Internus in Primary Dystonia

Abnormal sensory processing has been implicated in the pathophysiology of primary dystonia. In the globus pallidus internus (GPi), the primary output structure of the basal ganglia, many neurons respond to sensory (proprioceptive) stimulation. Here we have characterized GPi neuronal responses to passive movement of the contralateral limbs in 22 patients with primary dystonia undergoing microelectrode recording for placement of deep brain stimulator leads. We plotted coordinates of cells responding to limb movement in a common space. We observed distinct representations of leg and arm movement localized to the dorsal and ventral part of the posterior GPi, respectively. Comparing patients with generalized dystonia versus patients with segmental craniocervical dystonia, there was no difference in the volumes or separations of leg and arm related territories. In contrast to parkinsonism, only a small minority of units were responsive to movement across multiple joints. Abnormally increased directional selectivity was found in units responding to dystonic limbs compared with nondystonic limbs. Some affected GPi neurons therefore appear to have altered proprioceptive tuning for movement direction. There is an apparent preservation of GPi somatotopic organization in dystonia in comparison with prior studies of GPi somatotopic organization in non-human primates and humans with Parkinson's disease.