Imagery of Voluntary Movement of Fingers, Toes, and Tongue Activates Corresponding Body-Part-Specific Motor Representations

Brisk heart rate and EEG changes during execution and withholding of cue-paced foot motor imagery

Cue-paced motor imagery (MI) is a frequently used mental strategy to realize a Brain-Computer Interface (BCI). Recently it has been reported that two MI tasks can be separated with a high accuracy within the first second after cue presentation onset. To investigate this phenomenon in detail we studied the dynamics of motor cortex beta oscillations in EEG and the changes in heart rate (HR) during visual cue-paced foot MI using a go (execution of imagery) vs. nogo (withholding of imagery) paradigm in 16 healthy subjects. Both execution and withholding of MI resulted in a brisk centrally localized beta event-related desynchronization (ERD) with a maximum at ~400 ms and a concomitant HR deceleration. We found that response patterns within the first second after stimulation differed between conditions. The ERD was significantly larger in go as compared to nogo. In contrast the HR deceleration was somewhat smaller and followed by an acceleration in go as compared to nogo. These findings suggest that the early beta ERD reflects visually induced preparatory activity in motor cortex networks. Both the early beta ERD and the HR deceleration are the result of automatic operating processes that are likely part of the orienting reflex (OR). Of interest, however, is that the preparatory cortical activity is strengthened and the HR modulated already within the first second after stimulation during the execution of MI. The subtraction of the HR time course of the nogo from the go condition revealed a slight HR acceleration in the first seconds most likely due to the increased mental effort associated with the imagery process.

Modulation of corticospinal excitability dependent upon imagined force level

Motor imagery is defined as the mental execution of a movement without any muscle activity. In the present study, corticospinal excitability was assessed by motor evoked potentials (MEPs) when the subjects imagined isometric elbow flexion at various force levels. Electromyography was recorded from the right brachioradialis, the biceps brachii and the triceps brachii muscles. First, the maximum voluntary contraction (MVC) of elbow flexion was recorded in each subject. Subjects practiced performing 10, 30 and 60 % MVC using visual feedback. After the practice, MEPs were recorded during the imagery of elbow flexion with the forces of 10, 30 and 60 % MVC without any feedback. After the MEPs recording, we assigned subjects to reproduce the actual elbow flexion force at 10, 30 and 60 % MVC. The MEPs amplitudes in the brachioradialis and biceps brachii in the 60 % MVC condition were significantly greater than those in the 10 % MVC condition (p < 0.05). These findings suggest that the enhancement of corticospinal excitability during motor imagery is associated with an increase in imagined force level.

Cortico-subcortical activation patterns for itch and pain imagery

The imagery of itch and pain evokes emotional responses and covert motor responses (scratching to itch and withdrawal to pain). This suggests some similarity in cerebral mechanisms. However, itch is more socially contagious than pain, as evidenced by the fact that scratching behaviors can be easily initiated by watching itch-inducing situations, whereas withdrawal is less easily initiated by watching painful situations. Thus, we assumed that the cerebral mechanisms of itch imagery partly differ from those of pain imagery in particular with respect to motor regions. We addressed this issue in 18 healthy subjects using functional magnetic resonance imaging. The subjects were instructed to imagine itch and pain sensations in their own bodies while viewing pictures depicting stimuli associated with these sensations. Itch and pain imagery activated the anterior insular cortex (aIC) and motor-related regions such as supplementary motor area, basal ganglia, thalamus, and cerebellum. Activity in these regions was not significantly different between itch and pain imagery. However, functional connectivity between motor-related regions and the aIC showed marked differences between itch and pain imagery. Connectivity with the aIC was stronger in the primary motor and premotor cortices during pain imagery and stronger in the globus pallidus during itch imagery. These findings indicate that brain regions associated with imagery of itch are the same as those involved in imagery of pain, but their functional networks differ. These differences in brain networks may explain why motor responses to itch are more socially contagious than those related to pain.

BRAIN-COMPUTER-INTERFACE – SUPPORTED MOTOR IMAGERY TRAININTG FOR PATIENTS WITH HEMIPARESIS

The aim of study was to assess the feasibility of motor imagery supported brain-computer interface in patients with hemiparesis. 13 patients with central paresis of the hand and 15 healthy volunteers were learning to control EEG-based interface with feedback. No differences on interface control quality were found between patients and healthy subjects. The trainings were accompanied by the desynchronization of sensorimotor rhythm. In patients with cortical damage the source of EEG-activity was dislocated.

The effect of imagination on stimulation: the functional specificity of efference copies in speech processing

The computational role of efference copies is widely appreciated in action and perception research, but their properties for speech processing remain murky. We tested the functional specificity of auditory efference copies using magnetoencephalography recordings in an unconventional pairing: We used a classical cognitive manipulation (mental imagery--to elicit internal simulation and estimation) with a well-established experimental paradigm (one shot repetition--to assess neuronal specificity). Participants performed tasks that differentially implicated internal prediction of sensory consequences (overt speaking, imagined speaking, and imagined hearing) and their modulatory effects on the perception of an auditory (syllable) probe were assessed. Remarkably, the neural responses to overt syllable probes vary systematically, both in terms of directionality (suppression, enhancement) and temporal dynamics (early, late), as a function of the preceding covert mental imagery adaptor. We show, in the context of a dual-pathway model, that internal simulation shapes perception in a context-dependent manner.

Interhemispheric inhibition during mental actions of different complexity

Several investigations suggest that actual and mental actions trigger similar neural substrates. Yet, neurophysiological evidences on the nature of interhemispheric interactions during mental movements are still meagre. Here, we asked whether the content of mental images, investigated by task complexity, is finely represented in the inhibitory interactions between the two primary motor cortices (M1s). Subjects' left M1 was stimulated by means of transcranial magnetic stimulation (TMS) while they were performing actual or mental movements of increasing complexity with their right hand and exerting a maximum isometric force with their left thumb and index. Thus, we simultaneously assessed the corticospinal excitability in the right opponent pollicis muscle (OP) and the ipsilateral silent period (iSP) in the left OP during actual and mental movements. Corticospinal excitability in right OP increased during actual and mental movements, but task complexity-dependent changes were only observed during actual movements. Interhemispheric motor inhibition in the left OP was similarly modulated by task complexity in both mental and actual movements. Precisely, the duration and the area of the iSP increased with task complexity in both movement conditions. Our findings suggest that mental and actual movements share similar inhibitory neural circuits between the two homologous primary motor cortex areas.

Neural simulation of actions: effector- versus action-specific motor maps within the human premotor and posterior parietal area?

This study addresses the controversy over how motor maps are organized during action simulation by examining whether action simulation states, that is, motor imagery and action observation, run on either effector-specific and/or action-specific motor maps. Subjects had to observe or imagine three types of movements effected by the right hand or the right foot with different action goals. The functional magnetic resonance imaging results showed an action-specific organization within premotor and posterior parietal areas of both hemispheres during action simulation, especially during action observation. There were also less pronounced effector-specific activation sites during both simulation processes. It is concluded that the premotor and parietal areas contain multiple motor maps rather than a single, continuous map of the body. The forms of simulation (observation, imagery), the task contexts (movements related to an object, with usual/unusual effector), and the underlying reason for performing the simulation (rate your subjective success afterwards) lead to the specific use of different representational motor maps within both regions. In our experimental setting, action-specific maps are dominant especially, during action observation, whereas effector-specific maps are recruited to only a lesser degree.

Dissociable somatotopic representations of Chinese action verbs in the motor and premotor cortex

The embodied view of language processing holds that language comprehension involves the recruitment of sensorimotor information, as evidenced by the somatotopic representation of action verbs in the motor system. However, this review has not yet been examined in logographic scripts such as Chinese, in which action verbs can provide explicit linguistic cues to the effectors (arm, leg, mouth) that conduct the action (hit, jump, drink). We compared the somatotopic representation of Chinese verbs that contain such effector cues and those that do not. The results showed that uncued verbs elicited similar somatotopic representation in the motor and premotor cortex as found in alphabetic scripts. However, effector-cued verbs demonstrated an inverse somatotopic pattern by showing reduced activation in corresponding motor areas, despite that effector-cued verbs actually are rated higher in imageability than uncued verbs. Our results support the universality of somatotopic representation of action verbs in the motor system.

Brain Activation in Primary Motor and Somatosensory Cortices during Motor Imagery Correlates with Motor Imagery Ability in Stroke Patients

Aims. While studies on healthy subjects have shown a partial overlap between the motor execution and motor imagery neural circuits, few have investigated brain activity during motor imagery in stroke patients with hemiparesis. This work is aimed at examining similarities between motor imagery and execution in a group of stroke patients. Materials and Methods. Eleven patients were asked to perform a visuomotor tracking task by either physically or mentally tracking a sine wave force target using their thumb and index finger during fMRI scanning. MIQ-RS questionnaire has been administered. Results and Conclusion. Whole-brain analyses confirmed shared neural substrates between motor imagery and motor execution in bilateral premotor cortex, SMA, and in the contralesional inferior parietal lobule. Additional region of interest-based analyses revealed a negative correlation between kinaesthetic imagery ability and percentage BOLD change in areas 4p and 3a; higher imagery ability was associated with negative and lower percentage BOLD change in primary sensorimotor areas during motor imagery.

The relation between geometry and time in mental actions

Mental imagery is a cognitive tool that helps humans take decisions by simulating past and future events. The hypothesis has been advanced that there is a functional equivalence between actual and mental movements. Yet, we do not know whether there are any limitations to its validity even in terms of some fundamental features of actual movements, such as the relationship between space and time. Although it is impossible to directly measure the spatiotemporal features of mental actions, an indirect investigation can be conducted by taking advantage of the constraints existing in planar drawing movements and described by the two-thirds power law (2/3PL). This kinematic law describes one of the most impressive regularities observed in biological movements: movement speed decreases when curvature increases. Here, we compared the duration of identical actual and mental arm movements by changing the constraints imposed by the 2/3PL. In the first two experiments, the length of the trajectory remained constant, while its curvature (Experiment 1) or its number of inflexions (Experiment 2) was manipulated. The results showed that curvature, but not the number of inflexions, proportionally and similarly affected actual and mental movement duration, as expected from the 2/3PL. Two other control experiments confirmed that the results of Experiment 1 were not attributable to eye movements (Experiment 3) or to the perceived length of the displayed trajectory (Experiment 4). Altogether, our findings suggest that mental movement simulation is tuned to the kinematic laws characterizing actions and that kinematics of actual and mental movements is completely specified by the representation of their geometry.

Mental imagery of speech: linking motor and perceptual systems through internal simulation and estimation

The neural basis of mental imagery has been investigated by localizing the underlying neural networks, mostly in motor and perceptual systems, separately. However, how modality-specific representations are top-down induced and how the action and perception systems interact in the context of mental imagery is not well understood. Imagined speech production ("articulation imagery"), which induces the kinesthetic feeling of articulator movement and its auditory consequences, provides a new angle because of the concurrent involvement of motor and perceptual systems. On the basis of previous findings in mental imagery of speech, we argue for the following regarding the induction mechanisms of mental imagery and the interaction between motor and perceptual systems: (1) Two distinct top-down mechanisms, memory retrieval and motor simulation, exist to induce estimation in perceptual systems. (2) Motor simulation is sufficient to internally induce the representation of perceptual changes that would be caused by actual movement (perceptual associations); however, this simulation process only has modulatory effects on the perception of external stimuli, which critically depends on context and task demands. Considering the proposed simulation-estimation processes as common mechanisms for interaction between motor and perceptual systems, we outline how mental imagery (of speech) relates to perception and production, and how these hypothesized mechanisms might underpin certain neural disorders.

Real movement vs. motor imagery in healthy subjects

Motor imagery tasks are well established procedures in brain computer interfaces, but are also used in the assessment of patients with disorders of consciousness. For testing awareness in unresponsive patients it is necessary to know the natural variance of brain responses to motor imagery in healthy subjects. We examined 22 healthy subjects using EEG in three conditions: movement of both hands, imagery of the same movement, and an instruction to hold both hands still. Single-subject non-parametric statistics were applied to the fast-Fourier transformed data. Most effects were found in the α- and β-frequency ranges over central electrodes, that is, in the μ-rhythm. We found significant power changes in 18 subjects during movement and in 11 subjects during motor imagery. In 8 subjects these changes were consistent over both conditions. The significant power changes during movement were a decrease of μ-rhythm. There were 2 subjects with an increase and 9 subjects with a decrease of μ-rhythm during imagery. α and β are the most responsive frequency ranges, but there is a minor number of subjects who show a synchronization instead of the more common desynchronization during motor imagery. A (de)synchronization of μ-rhythm can be considered to be a normal response.

Has brain imaging discovered anything new about how the brain works?

There have now been roughly 130,000 papers on fMRI. While these have clearly contributed to our understanding of the functional anatomy of the human brain, it is less clear that they have changed the way in which we think about the brain. The issue, in other words, is whether they have established new principles about how the brain works. In this paper we offer as an example one new principle, partly to lay down the criteria that are required for establishing a new principle, and partly to encourage others to offer other principles. Our example concerns the flexible flow of information through the cortex that must occur according to the demands of the task or current context. We suggest that this flexibility is achieved by feedback connections from the prefrontal and parietal cortex, and that these include connections to sensory and motor areas. However, the nature of the selective effect differs. The parietal cortex can select both within and across processing streams. By across streams we mean that it can have the same influence on different streams, for example the dorsal and ventral visual systems. However, only the prefrontal cortex can also select between processing streams. The difference between the prefrontal and parietal effects is due to their different positions within the processing hierarchy.

Selective effect of physical fatigue on motor imagery accuracy

While the use of motor imagery (the mental representation of an action without overt execution) during actual training sessions is usually recommended, experimental studies examining the effect of physical fatigue on subsequent motor imagery performance are sparse and yielded divergent findings. Here, we investigated whether physical fatigue occurring during an intense sport training session affected motor imagery ability. Twelve swimmers (nine males, mean age 15.5 years) conducted a 45 min physically-fatiguing protocol where they swam from 70% to 100% of their maximal aerobic speed. We tested motor imagery ability immediately before and after fatigue state. Participants randomly imagined performing a swim turn using internal and external visual imagery. Self-reports ratings, imagery times and electrodermal responses, an index of alertness from the autonomic nervous system, were the dependent variables. Self-reports ratings indicated that participants did not encounter difficulty when performing motor imagery after fatigue. However, motor imagery times were significantly shortened during posttest compared to both pretest and actual turn times, thus indicating reduced timing accuracy. Looking at the selective effect of physical fatigue on external visual imagery did not reveal any difference before and after fatigue, whereas significantly shorter imagined times and electrodermal responses (respectively 15% and 48% decrease, p<0.001) were observed during the posttest for internal visual imagery. A significant correlation (r = 0.64; p<0.05) was observed between motor imagery vividness (estimated through imagery questionnaire) and autonomic responses during motor imagery after fatigue. These data support that unlike local muscle fatigue, physical fatigue occurring during intense sport training sessions is likely to affect motor imagery accuracy. These results might be explained by the updating of the internal representation of the motor sequence, due to temporary feedback originating from actual motor practice under fatigue. These findings provide insights to the co-dependent relationship between mental and motor processes.

Functional MRI assessment of orofacial articulators: neural correlates of lip, jaw, larynx, and tongue movements

Compared with complex coordinated orofacial actions, few neuroimaging studies have attempted to determine the shared and distinct neural substrates of supralaryngeal and laryngeal articulatory movements when performed independently. To determine cortical and subcortical regions associated with supralaryngeal motor control, participants produced lip, tongue and jaw movements while undergoing functional magnetic resonance imaging (fMRI). For laryngeal motor activity, participants produced the steady-state/i/vowel. A sparse temporal sampling acquisition method was used to minimize movement-related artifacts. Three main findings were observed. First, the four tasks activated a set of largely overlapping, common brain areas: the sensorimotor and premotor cortices, the right inferior frontal gyrus, the supplementary motor area, the left parietal operculum and the adjacent inferior parietal lobule, the basal ganglia and the cerebellum. Second, differences between tasks were restricted to the bilateral auditory cortices and to the left ventrolateral sensorimotor cortex, with greater signal intensity for vowel vocalization. Finally, a dorso-ventral somatotopic organization of lip, jaw, vocalic/laryngeal, and tongue movements was observed within the primary motor and somatosensory cortices using individual region-of-interest (ROI) analyses. These results provide evidence for a core neural network involved in laryngeal and supralaryngeal motor control and further refine the sensorimotor somatotopic organization of orofacial articulators.

On-line changing of thinking about words: the effect of cognitive context on neural responses to verb reading

Activity in frontocentral motor regions is routinely reported when individuals process action words and is often interpreted as the implicit simulation of the word content. We hypothesized that these neural responses are not invariant components of action word processing but are modulated by the context in which they are evoked. Using fMRI, we assessed the relative weight of stimulus features (i.e., the intrinsic semantics of words) and contextual factors, in eliciting word-related sensorimotor activity. Participants silently read action-related and state verbs after performing a mental rotation task engaging either a motor strategy (i.e., referring visual stimuli to their own bodily movements) or a visuospatial strategy. The mental rotation tasks were used to induce, respectively, a motor and a nonmotor "cognitive context" into the following silent reading. Irrespective of the verb category, reading in the motor context, compared with reading in the nonmotor context, increased the activity in the left primary motor cortex, the bilateral premotor cortex, and the right somatosensory cortex. Thus, the cognitive context induced by the preceding motor strategy-based mental rotation modulated word-related sensorimotor responses, possibly reflecting the strategy of referring a word meaning to one's own bodily activity. This pattern, common to action and state verbs, suggests that the context in which words are encountered prevails over the intrinsic semantics of the stimuli in mediating the recruitment of sensorimotor regions.

Increased prefrontal activity and reduced motor cortex activity during imagined eccentric compared to concentric muscle actions

In this study we used functional magnetic resonance imaging (fMRI) to examine differences in recruited brain regions during the concentric and the eccentric phase of an imagined maximum resistance training task of the elbow flexors in healthy young subjects. The results showed that during the eccentric phase, pre-frontal cortex (BA44) bilaterally was recruited when contrasted to the concentric phase. During the concentric phase, however, the motor and pre-motor cortex (BA 4/6) was recruited when contrasted to the eccentric phase. Interestingly, the brain activity of this region was reduced, when compared to the mean activity of the session, during the eccentric phase. Thus, the neural mechanisms governing imagined concentric and eccentric contractions appear to differ. We propose that the recruitment of the pre-frontal cortex is due to an increased demand of regulating force during the eccentric phase. Moreover, it is possible that the inability to fully activate a muscle during eccentric contractions may partly be explained by a reduction of activity in the motor and pre-motor cortex.

Imagining is Not Doing but Involves Specific Motor Commands: A Review of Experimental Data Related to Motor Inhibition

There is now compelling evidence that motor imagery (MI) and actual movement share common neural substrate. However, the question of how MI inhibits the transmission of motor commands into the efferent pathways in order to prevent any movement is largely unresolved. Similarly, little is known about the nature of the electromyographic activity that is apparent during MI. In addressing these gaps in the literature, the present paper argues that MI includes motor execution commands for muscle contractions which are blocked at some level of the motor system by inhibitory mechanisms. We first assemble data from neuroimaging studies that demonstrate that the neural networks mediating MI and motor performance are not totally overlapping, thereby highlighting potential differences between MI and actual motor execution. We then review MI data indicating the presence of subliminal muscular activity reflecting the intrinsic characteristics of the motor command as well as increased corticomotor excitability. The third section not only considers the inhibitory mechanisms involved during MI but also examines how the brain resolves the problem of issuing the motor command for action while supervising motor inhibition when people engage in voluntary movement during MI. The last part of the paper draws on imagery research in clinical contexts to suggest that some patients move while imagining an action, although they are not aware of such movements. In particular, experimental data from amputees as well as from patients with Parkinson’s disease are discussed. We also review recent studies based on comparing brain activity in tetraplegic patients with that from healthy matched controls that provide insights into inhibitory processes during MI. We conclude by arguing that based on available evidence, a multifactorial explanation of motor inhibition during MI is warranted.

Effectiveness of the gaze direction recognition task for chronic neck pain and cervical range of motion: a randomized controlled pilot study

We developed a mental task with gaze direction recognition (GDR) by which subjects observed neck rotation of another individual from behind and attempted to recognize the direction of gaze. A randomized controlled trial was performed in test (n = 9) and control (n = 8) groups of subjects with chronic neck pain undergoing physical therapy either with or without the GDR task carried out over 12 sessions during a three-week period. Primary outcome measures were defined as the active range of motion and pain on rotation of the neck. Secondary outcome measures were reaction time (RT) and response accuracy in the GDR task group. ANOVA indicated a main effect for task session and group, and interaction of session. Post hoc testing showed that the GDR task group exhibited a significant simple main effect upon session, and significant sequential improvement of neck motion and relief of neck pain. Rapid effectiveness was significant in both groups. The GDR task group had a significant session-to-session reduction of RTs in correct responses. In conclusion, the GDR task we developed provides a promising rehabilitation measure for chronic neck pain.

Phantom digit somatotopy: a functional magnetic resonance imaging study in forearm amputees

Forearm amputees often experience non-painful sensations in their phantom when the amputation stump is touched. Cutaneous stimulation of specific stump areas may be perceived as stimulation of specific phantom fingers (stump hand map). The neuronal basis of referred phantom limb sensations is unknown. We used functional magnetic resonance imaging to demonstrate a somatotopic map of the phantom fingers in the hand region of the primary somatosensory cortex after tactile stump stimulation. The location and extent of phantom finger activation in the primary somatosensory cortex corresponded well to the location of normal fingers in a reference population. Stimulation of the stump hand map resulted in an increased bilateral activation of the primary somatosensory cortex compared with stimulation of forearm regions outside the stump hand map. Increased activation was also seen in contralateral posterior parietal cortex and premotor cortex. Ipsilateral primary somatosensory cortex activation might represent a compensatory mechanism and activation of the non-primary fronto-parietal areas might correspond to awareness of the phantom limb, which is enhanced when experiencing the referred sensations. It is concluded that phantom sensation elicited by stimulation of stump hand map areas is associated with activation of finger-specific somatotopical representations in the primary somatosensory cortex. This suggests that the primary somatosensory cortex could be a neural substrate of non-painful phantom sensations. The stump hand map phenomenon might be useful in the development of prosthetic hand devices.

The anxiety spectrum and the reflex physiology of defense: from circumscribed fear to broad distress

Guided by the diagnostic nosology, anxiety patients are expected to show defensive hyperarousal during affective challenge, irrespective of the principal phenotype. In the current study, patients representing the whole spectrum of anxiety disorders (i.e., specific phobia, social phobia, panic disorder with or without agoraphobia, obsessive-compulsive disorder, generalized anxiety disorder (GAD), posttraumatic stress disorder(PTSD)), and healthy community control participants, completed an imagery-based fear elicitation paradigm paralleling conventional intervention techniques. Participants imagined threatening and neutral narratives as physiological responses were recorded. Clear evidence emerged for exaggerated reactivity to clinically relevant imagery--most pronounced in startle reflex responding. However, defensive propensity varied across principal anxiety disorders. Disorders characterized by focal fear and impairment (e.g., specific phobia) showed robust fear potentiation. Conversely, for disorders of long-enduring, pervasive apprehension and avoidance with broad anxiety and depression comorbidity (e.g., PTSD secondary to cumulative trauma, GAD), startle responses were paradoxically diminished to all aversive contents. Patients whose expressed symptom profiles were intermediate between focal fearfulness and broad anxious-misery in both severity and chronicity exhibited a still heightened but more generalized physiological propensity to respond defensively. Importantly, this defensive physiological gradient--the inverse of self-reported distress--was evident not only between but also within disorders. These results highlight that fear circuitry could be dysregulated in chronic, pervasive anxiety, and preliminary functional neuroimaging findings suggest that deficient amygdala recruitment could underlie attenuated reflex responding. In summary, adaptive defensive engagement during imagery may be compromised by long-term dysphoria and stress-a phenomenon with implications for prognosis and treatment planning.

Motor-language coupling: direct evidence from early Parkinson's disease and intracranial cortical recordings

Language and action systems are functionally coupled in the brain as demonstrated by converging evidence using Functional magnetic resonance imaging (fMRI), electroencephalography (EEG), transcranial magnetic stimulation (TMS), and lesion studies. In particular, this coupling has been demonstrated using the action-sentence compatibility effect (ACE) in which motor activity and language interact. The ACE task requires participants to listen to sentences that described actions typically performed with an open hand (e.g., clapping), a closed hand (e.g., hammering), or without any hand action (neutral); and to press a large button with either an open hand position or closed hand position immediately upon comprehending each sentence. The ACE is defined as a longer reaction time (RT) in the action-sentence incompatible conditions than in the compatible conditions. Here we investigated direct motor-language coupling in two novel and uniquely informative ways. First, we measured the behavioural ACE in patients with motor impairment (early Parkinson's disease - EPD), and second, in epileptic patients with direct electrocorticography (ECoG) recordings. In experiment 1, EPD participants with preserved general cognitive repertoire, showed a much diminished ACE relative to non-EPD volunteers. Moreover, a correlation between ACE performance and action-verb processing (kissing and dancing test - KDT) was observed. Direct cortical recordings (ECoG) in motor and language areas (experiment 2) demonstrated simultaneous bidirectional effects: motor preparation affected language processing (N400 at left inferior frontal gyrus and middle/superior temporal gyrus), and language processing affected activity in movement-related areas (motor potential at premotor and M1). Our findings show that the ACE paradigm requires ongoing integration of preserved motor and language coupling (abolished in EPD) and engages motor-temporal cortices in a bidirectional way. In addition, both experiments suggest the presence of a motor-language network which is not restricted to somatotopically defined brain areas. These results open new pathways in the fields of motor diseases, theoretical approaches to language understanding, and models of action-perception coupling.

Secondary sensory area SII is crucially involved in the preparation of familiar movements compared to movements never made before

Secondary sensorimotor regions are involved in sensorimotor integration and movement preparation. These regions take part in parietal-premotor circuitry that is not only active during motor execution but also during movement observation and imagery. This activation particularly occurs when observed movements belong to one's own motor repertoire, consistent with the finding that motor imagery only improves performance when one can actually make such movement. We aimed to investigate whether imagery or observation of a movement that was never made before causes parietal-premotor activation or that the ability to perform this movement is indeed a precondition. Nine subjects [group Already Knowing It (AKI)] could abduct their hallux (moving big toe outward). Seven subjects initially failed to make such movement (Absolute Zero A0 group). They had to imagine, observe, or execute this movement, whereas fMRI data were obtained both before and after training. Contrasting abduction observation between the AKI-group and A0-group showed increased left SII and supplementary motor area activation. Comparing the observation of hallux flexion with abduction showed increased bilateral SII activation in the A0 and not in the AKI group. Prolonged training resulted in equal performance and similar cerebral activation patterns in the two groups. Thereby, conjunction analysis of the correlations on subject's range of abduction during execution, imagery, and observation of hallux abduction showed exclusive bilateral SII activation. The reduced SII involvement in A0 may imply that effective interplay between sensory predictions and feedback does not take place without actual movement experience. However, this can be acquired by training.

Basal ganglia-premotor dysfunction during movement imagination in writer's cramp

The pathophysiology of idiopathic focal hand dystonia (writer's cramp) is characterized by deficient inhibitory basal ganglia function and altered cortical sensorimotor processing. To explore if this is already a primary finding in dystonia for internal movement simulation independent of dystonic motor output or abnormal sensory input, we investigated the neural correlates of movement imagination and observation in patients with writer's cramp. Event-related fMRI was applied during kinesthetic motor imagery of drawing simple geometric figures (imagination task) and passively observing videos of hands drawing identical figures (observation task). Compared with healthy controls, patients with writer's cramp showed deficient activation of the left primary sensorimotor cortex, mesial and left dorsal premotor cortex, bilateral putamen, and bilateral thalamus during motor imagery. No significant signal differences between both groups were found during the observation task. We conclude that internal movement simulation and planning as tested during imagination of hand movements appear to be dysfunctional in patients with writer's cramp, whereas visual signal processing and observation-induced activation are unaffected. Deficient basal ganglia-premotor activation could be a correlate of impaired basal ganglia inhibition and focusing during the selection of motor programs in dystonia. This finding seems to be an intrinsic deficit, as it is found during motor imagery in the absence of dystonic symptoms.

Brain simulation of action may be grounded in physical experience

An intriguing quality of our brain is that when actions are imagined, corresponding brain regions are recruited as when the actions are actually performed. It has been hypothesized that the similarity between real and simulated actions depends on the nature of motor representations. Here we tested this hypothesis by examining S.D., who never used her legs but is an elite wheel chair athlete. Controls recruited motor brain regions during imagery of stair walking and frontal regions during imagery of wheel chair slalom. S.D. showed the opposite pattern. Thus, brain simulation of actions may be grounded in specific physical experiences.

Imagery Rescripting of Early Traumatic Memories in Social Phobia

Negative self-images appear to play a role in the maintenance of social phobia and research suggests they are often linked to earlier memories of socially traumatic events. Imagery rescripting is a clinical intervention that aims to update such unpleasant or traumatic memories, and is increasingly being incorporated in cognitive behavioral therapy programs. In previous research, we have found that imagery rescripting was superior to a control condition in terms of its beneficial effects on negative beliefs, image and memory distress, fear of negative evaluation, and anxiety in social situations. In this article, we describe our imagery rescripting procedure. We consider the importance of updating negative imagery in social phobia, the theoretical basis for imagery rescripting, directions for future research, and how to conduct imagery rescripting, including potential problems and their solutions.

Action representation in patients with bilateral vestibular impairments

During mental actions subjects feel themselves performing a movement without any corresponding motor output. Although broad information is available regarding the influence of central lesions on action representation, little is known about how peripheral damages affect mental events. In the current study, we investigated whether lack of vestibular information influences action representation. Twelve healthy adults and twelve patients with bilateral vestibular damage actually performed and mentally simulated walking and drawing. The locomotor paths implied one (first walking task) and four (second walking task) changes in the walking direction. In the drawing task, participants drew on a sheet of paper a path that was similar to that of the second walking task. We recorded and compared between the two groups the timing of actual and mental movements. We found significant temporal discrepancies between actual and mental walking movements in the group of patients. Conversely, drawing actual and drawing mental durations were similar. For the control group, an isochrony between mental and actual movements was observed for the three tasks. This result denotes an inconsistency between action representation and action execution following vestibular damage, which is specific to walking movements, and emphasizes the role of the vestibular system upon mental states of actions. This observation may have important clinical implications. During action planning vestibular patients may overestimate the capacity of their motor system (imaging faster, executing slower) with harmful consequences for their health.

Neural representations involved in observed, imagined, and imitated actions are dissociable and hierarchically organized

The fact that action observation, motor imagery and execution are associated with partially overlapping increases in parieto-frontal areas has been interpreted as evidence for reliance of these behaviors on a common system of motor representations. However, studies that include all three conditions within a single paradigm are rare, and consequently, there is a dearth of knowledge concerning the distinct mechanisms involved in these functions. Here we report key differences in neural representations subserving observation, imagery, and synchronous imitation of a repetitive bimanual finger-tapping task using fMRI under conditions in which visual stimulation is carefully controlled. Relative to rest, observation, imagery, and synchronous imitation are all associated with widespread increases in cortical activity. Importantly, when effects of visual stimulation are properly controlled, each of these conditions is found to have its own unique neural signature. Relative to observation or imagery, synchronous imitation shows increased bilateral activity along the central sulcus (extending into precentral and postcentral gyri), in the cerebellum, supplementary motor area (SMA), parietal operculum, and several motor-related subcortical areas. No areas show greater increases for imagery vs. synchronous imitation; however, relative to synchronous imitation, observation is associated with greater increases in caudal SMA activity than synchronous imitation. Compared to observation, imagery increases activation in pre-SMA and left inferior frontal cortex, while no areas show the inverse effect. Region-of-interest (ROI) analyses reveal that areas involved in bimanual open-loop movements respond most to synchronous imitation (primary sensorimotor, classic SMA, and cerebellum), and less vigorously to imagery and observation. The differential activity between conditions suggests an alternative hierarchical model in which these behaviors all rely on partially independent mechanisms.

Muscle fatigue affects mental simulation of action

Several studies suggest that when subjects mentally rehearse or execute a familiar action, they engage similar neural and cognitive operations. Here, we examined whether muscle fatigue could influence mental movements. Participants mentally and actually performed a sequence of vertical arm movements (rotation around the shoulder joint) before and after a fatiguing exercise involving the right arm. We found similar durations for actual and mental movements before fatigue, but significant temporal discrepancies after fatigue. Specifically, mental simulation was accelerated immediately after fatigue, while the opposite was observed for actual execution. Furthermore, actual movements showed faster adaptation (i.e., return to prefatigue values) than mental movements. The EMG analysis showed that postfatigue participants programmed larger, compared to prefatigue, neural drives. Therefore, immediately after fatigue, the forward model received dramatically greater efferent copies and predicted faster, compared to prefatigue, arm movements. During actual movements, the discrepancy between estimated (forward model output) and actual state (sensory feedback) of the arm guided motor adaptation; i.e., durations returned rapidly to prefatigue values. Since during mental movements there is no sensory information and state estimation derives from the forward model alone, mental durations remained faster after fatigue and their adaptation was longer than those of actual movements. This effect was specific to the fatigued arm because actual and mental movements of the left nonfatigued arm were unaffected. The current results underline the interdependence of motor and cognitive states and suggest that mental actions integrate the current state of the motor system.

The functional equivalence between movement imagery, observation, and execution influences imagery ability

Based on literature identifying movement imagery, observation, and execution to elicit similar areas of neural activity, research has demonstrated that movement imagery and observation successfully prime movement execution. To investigate whether movement and observation could prime ease of imaging from an external visual-imagery perspective, an internal visual-imagery perspective, and kinesthetic modality, 36 participants (M age = 20.58; SD = 3.11; 18 women and 18 men) completed an adapted version of the Movement Imagery Questionnaire-Revised under four modes of delivery (movement prime, external observation prime, internal observation prime, and image-only). The results revealed that ease of imaging was significantly greater during the movement and observation prime conditions compared to the image-only condition (p < .05). Specifically when priming external visual imagery and internal visual imagery, observation facilitated ease of imaging only when the perspective was congruent with the imagery perspective. The results support the use of movement and observation to facilitate ease of imaging, but highlight the importance of considering the visual perspective when using observation.

Neural correlates of an illusory touch experience investigated with fMRI

When asked to judge the presence or absence of near-threshold tactile stimuli, participants often report touch experiences when no tactile stimulation has been delivered ('false alarms'). The simultaneous presentation of a light flash during the stimulation period can increase the frequency of touch reports, both when touch is and is not present. Using fMRI, we investigated the BOLD response during both light-present and light-absent false alarms, testing predictions concerning two possible neural mechanisms underlying these illusory touch experiences: activation of a tactile representation in primary somatosensory cortex (SI) and/or activation of a tactile representation in late processing areas outside of sensory-specific cortex, such as medial prefrontal cortex (MPC). Our behavioural results showed that participants made false alarms in light-present and light-absent trials, both of which activated regions of the medial parietal and medial prefrontal cortex including precuneus, posterior cingulate and paracingulate cortex, suggesting the same underlying mechanism. However, only a non-significant increase in SI activity was measured in response to false alarm vs. correct rejection trials. We argue that our results provide evidence for the role of top-down regions in somatic misperception, consistent with findings from studies in humans and non-human primates.

Single-trial classification of antagonistic oxyhemoglobin responses during mental arithmetic

Near-infrared spectroscopy (NIRS) is a non-invasive optical technique that can be used for brain-computer interfaces (BCIs) systems. A common challenge for BCIs is a stable and reliable classification of single-trial data, especially for cognitive (mental) tasks. With antagonistic activation pattern, recently found for mental arithmetic (MA) tasks, an improved online classification for optical BCIs using MA should become possible. For this investigation, we used the data of a previous study where we found antagonistic activation patterns (focal bilateral increase of [oxy-Hb] in the dorsolateral prefrontal cortex in parallel with a [oxy-Hb] decrease in the medial area of the anterior prefrontal cortex) in eight subjects. We used the [oxy-Hb] responses to search for the best antagonistic feature combination and compared it to individual features from the same regions. In addition, we investigated the use of antagonistic [deoxy-Hb], total hemoglobin [Hbtot] and pairs of [oxy-Hb] and [deoxy-Hb] features as well as the existence of a group-related feature set. Our results indicate that the use of the antagonistic [oxy-Hb] features significantly increases the classification accuracy from 63.3 to 79.7%. These results support the hypothesis that antagonistic hemodynamic response patterns are a suitable control strategy for optical BCI, and that only two prefrontal NIRS channels are needed for good performance.

Cognitive and cognitive-motor interventions affecting physical functioning: a systematic review

BACKGROUND

Several types of cognitive or combined cognitive-motor intervention types that might influence physical functions have been proposed in the past: training of dual-tasking abilities, and improving cognitive function through behavioral interventions or the use of computer games. The objective of this systematic review was to examine the literature regarding the use of cognitive and cognitive-motor interventions to improve physical functioning in older adults or people with neurological impairments that are similar to cognitive impairments seen in aging. The aim was to identify potentially promising methods that might be used in future intervention type studies for older adults.

METHODS

A systematic search was conducted for the Medline/Premedline, PsycINFO, CINAHL and EMBASE databases. The search was focused on older adults over the age of 65. To increase the number of articles for review, we also included those discussing adult patients with neurological impairments due to trauma, as these cognitive impairments are similar to those seen in the aging population. The search was restricted to English, German and French language literature without any limitation of publication date or restriction by study design. Cognitive or cognitive-motor interventions were defined as dual-tasking, virtual reality exercise, cognitive exercise, or a combination of these.

RESULTS

28 articles met our inclusion criteria. Three articles used an isolated cognitive rehabilitation intervention, seven articles used a dual-task intervention and 19 applied a computerized intervention. There is evidence to suggest that cognitive or motor-cognitive methods positively affects physical functioning, such as postural control, walking abilities and general functions of the upper and lower extremities, respectively. The majority of the included studies resulted in improvements of the assessed functional outcome measures.

CONCLUSIONS

The current evidence on the effectiveness of cognitive or motor-cognitive interventions to improve physical functioning in older adults or people with neurological impairments is limited. The heterogeneity of the studies published so far does not allow defining the training methodology with the greatest effectiveness. This review nevertheless provides important foundational information in order to encourage further development of novel cognitive or cognitive-motor interventions, preferably with a randomized control design. Future research that aims to examine the relation between improvements in cognitive skills and the translation to better performance on selected physical tasks should explicitly take the relation between the cognitive and physical skills into account.

Rostral premotor cortex as a gateway between motor and cognitive networks

This article presents a hypothesis that the rostral premotor-subcortical networks may serve as a gateway between the cognitive and motor networks. Accumulating evidence has propelled an idea that motor and cognitive behaviors considerably share neural substrates and probably computational principles regardless of the species. Here I conducted a meta-analysis of previous neuroimaging studies on motor planning and different cognitive tasks (mental calculation, visuospatial processing and cognitive control), which showed overlap of all activations in the rostral premotor cortex, with a possible rostro-caudal functional gradient. It was also suggested that the rostral premotor areas might form circuits with specific portions of the cerebellum and the basal ganglia. The rostral premotor areas may provide context-dependent connectivity and mediate information flow between the cognitive and motor networks, thereby making the two networks operating interactively or independently.

Music's relevance for adolescents and young adults with cancer: a constructivist research approach

PURPOSE

Music is one of the most widely used activities amongst young people, significant in personal and group identity, motivation, physical release, and emotional support. Adolescents and young adults with cancer (AYA) require specialized care because of intensified challenges related to developmental vulnerability, treatment toxicity effects, and slower improvements in survival rates compared to other age groups. To advance effective supportive care for AYA, understanding their thoughts about music is necessary. This study examines AYAs' perspectives about music's role in their lives.

METHODS

A constructivist research approach with grounded theory design was applied. Twelve people, 15 to 25 years old, known to onTrac@PeterMac Victorian Adolescent & Young Adult Cancer Service, participated. Respondents completed a brief music demographic questionnaire and participated in a semi-structured interview. Qualitative inter-rater reliability was integrated.

RESULTS

Participants mostly reported music's calming, supportive, and relaxing effects, which alleviated hardship associated with their cancer diagnoses. Themes encompassed: music backgrounds, changed "musicking", endurance and adjustment, time with music therapists, and wisdom. Music provided supportive messages, enabled personal and shared understandings about cancer's effects, and elicited helpful physical, emotional, and imagery states. Music therapy could also promote normalized and supportive connections with others. A musician, however, struggled to get music "back" post-treatment. Supportive music-based strategies were recommended for other AYA and their health care providers.

CONCLUSIONS

Music can signify and creatively enable AYAs' hope, endurance, identity development, and adjustment through cancer treatment and post-treatment phases. Health professionals are encouraged to support AYAs' music-based self-care and "normalized" activities.