Brain activity during visual versus kinesthetic imagery: an fMRI study

The Development and Evaluation of the Kinesthetic Motor Imagery of Pelvic Floor Muscle Contraction Questionnaire (KMI-PFQ) in Spanish Women

Practitioners have begun using motor imagery (MI) for preventing and treating some pelvic floor disorders. Due to requirements for imagining before performing a MI intervention and because there are few instruments available for assessing this specific ability in the pelvic floor musculature, we sought to develop and test a new MI questionnaire, the Kinesthetic Motor Imagery of Pelvic Floor Muscle Contraction Questionnaire (KMI-PFQ). We focused in this study on the development and analysis of the instrument's factorial structure and internal reliability in a participant sample of 162 healthy Spanish women (M age = 20.1, SD = 2.2 years). We developed and evaluated the KMI-PFQ's psychometric properties, finding it to have good internal consistency, with Cronbach's α = .838, ω coefficient = .839, and an intraclass correlation coefficient = .809, with two factors ("ability" and "mental effort") explaining 58.36% of response variance. The standard error of measurement was 3.58, and the minimal detectable change was 9.92. No floor or ceiling effects were identified. There was also good convergent validity as seen by statistically significant positive correlations between KMI-PFQ scores and the revised-Movement Image Questionnaire and Vividness of Visual Imagery Questionnaire. There were no statistically significant correlations between KMI-PFQ scores and the Orientation to Life Questionnaire. The KMI-PFQ is a valid and reliable instrument for measuring kinesthetic ability to feel/imagine pelvic floor muscle contractions in healthy Spanish women.

Influence of Motor Imagery Modality on First-Serve Performance in Tennis Players

Motor imagery (MI) is frequently used in tennis players. This pilot study aimed to assess whether the MI modality and preference of skilled tennis players could influence their service performance when using MI before serving first balls. Twenty expert players (Mage = 18.6 years) completed the movement imagery questionnaire (third version) to assess their MI modality scores (internal visual, external visual, and kinesthetic) and their MI preference. Participants completed 4 experimental counterbalanced sessions spread over 4 weeks, each including the completion of 20 first-serve balls in match condition. The sessions included a control condition (i.e., only physical practice trials) and three MI conditions during which the players had to mentally imagine themselves performing a serve according to one of the imagery modalities, either internal visual, external visual, or kinesthetic, before serving. The percentage of success, the speed of the service balls (measured by a tablet with SWING VISION and a radar gun), and an efficiency score were recorded and then evaluated by experts and served as performance indicators and dependent variables. The results of this study showed that players benefited from MI before serving and that almost a third of the participants achieved a higher percentage of success and efficiency scores when using their preferred MI modality. These results lead us, in an applied way, to suggest to skilled tennis players to determine their MI preference and to have recourse to the mental simulation of a successful serve before serving the first balls in match condition.

Neural signatures of imaginary motivational states: desire for music, movement and social play

The literature has demonstrated the potential for detecting accurate electrical signals that correspond to the will or intention to move, as well as decoding the thoughts of individuals who imagine houses, faces or objects. This investigation examines the presence of precise neural markers of imagined motivational states through the combining of electrophysiological and neuroimaging methods. 20 participants were instructed to vividly imagine the desire to move, listen to music or engage in social activities. Their EEG was recorded from 128 scalp sites and analysed using individual standardized Low-Resolution Brain Electromagnetic Tomographies (LORETAs) in the N400 time window (400-600 ms). The activation of 1056 voxels was examined in relation to the 3 motivational states. The most active dipoles were grouped in eight regions of interest (ROI), including Occipital, Temporal, Fusiform, Premotor, Frontal, OBF/IF, Parietal, and Limbic areas. The statistical analysis revealed that all motivational imaginary states engaged the right hemisphere more than the left hemisphere. Distinct markers were identified for the three motivational states. Specifically, the right temporal area was more relevant for "Social Play", the orbitofrontal/inferior frontal cortex for listening to music, and the left premotor cortex for the "Movement" desire. This outcome is encouraging in terms of the potential use of neural indicators in the realm of brain-computer interface, for interpreting the thoughts and desires of individuals with locked-in syndrome.

Does context matter for memory? Testing the effectiveness of learning by imagining situated interactions with objects

Mounting evidence supports the efficacy of mental imagery for verbal information retention. Motor imagery, imagining oneself interacting physically with the object to be learned, emerges as an optimal form compared to less physically engaging imagery. Yet, when engaging in mental imagery, it occurs within a specific context that may affect imagined actions and consequently impact the mnemonic benefits of mental imagery. In a first study, participants were given instructions for incidental learning: mental rehearsal, visual imagery, motor imagery or situated motor imagery. The latter, which involved imagining physical interaction with an item within a coherent situation, produced the highest proportion of correct recalls. This highlights memory's role in supporting situated actions and offers the possibility for further developing the mnemonic potential of embodied mental imagery. Furthermore, item-level analysis showed that individuals who engaged in situated motor imagery remembered words primarily due to the sensorimotor characteristics of the words' referent. A second study investigating the role of inter-item distinctiveness in this effect failed to determine the extent to which the situational and motor elements need to be distinctive in order to be considered useful retrieval cues and produce an optimal memory performance.

Individual-finger motor imagery classification: a data-driven approach with Shapley-informed augmentation

Objective. Classifying motor imagery (MI) tasks that involve fine motor control of the individual five fingers presents unique challenges when utilizing electroencephalography (EEG) data. In this paper, we systematically assess the classification of MI functions for the individual five fingers using single-trial time-domain EEG signals. This assessment encompasses both within-subject and cross-subject scenarios, supported by data-driven analysis that provides statistical validation of the neural correlate that could potentially discriminate between the five fingers.Approach. We present Shapley-informed augmentation, an informed approach to enhance within-subject classification accuracy. This method is rooted in insights gained from our data-driven analysis, which revealed inconsistent temporal features encoding the five fingers MI across sessions of the same subject. To evaluate its impact, we compare within-subject classification performance both before and after implementing this augmentation technique.Main results. Both the data-driven approach and the model explainability analysis revealed that the parietal cortex contains neural information that helps discriminate the individual five fingers' MI apart. Shapley-informed augmentation successfully improved classification accuracy in sessions severely affected by inconsistent temporal features. The accuracy for sessions impacted by inconsistency in their temporal features increased by an average of26.3%±6.70, thereby enabling a broader range of subjects to benefit from brain-computer interaction (BCI) applications involving five-fingers MI classification. Conversely, non-impacted sessions experienced only a negligible average accuracy decrease of2.01±5.44%. The average classification accuracy achieved is around 60.0% (within-session), 50.0% (within-subject) and 40.0% (leave-one-subject-out).Significance. This research offers data-driven evidence of neural correlates that could discriminate between the individual five fingers MI and introduces a novel Shapley-informed augmentation method to address temporal variability of features, ultimately contributing to the development of personalized systems.

Psychophysiological strategies for enhancing performance through imagery-skin conductance level analysis in guided vs. self-produced imagery

Athletes need to achieve their optimal level of arousal for peak performance. Visualization or mental rehearsal (i.e., Imagery) often helps to obtain an appropriate level of activation, which can be detected by monitoring Skin Conductance Level (SCL). However, different types of imagery could elicit different amount of physiological arousal. Therefore, this study aims: (1) to investigate differences in SCL associated with two instructional modalities of imagery (guided vs. self-produced) and six different scripts; (2) to check if SCL could differentiate respondents according to their sport expertise. Thirty participants, aged between 14 and 42 years (M = 22.93; SD = 5.24), with different sport levels took part in the study. Participants listened to each previously recorded script and then were asked to imagine the scene for a minute. During the task, SCL was monitored. We analysed the mean value, variance, slope and number of fluctuations per minute of the electrodermal signal. Unsupervised machine learning models were used for measuring the resemblance of the signal. The Wilcoxon signed-rank test was used for distinguishing guided and self-produced imagery, and The Mann-Whitney U test was used for distinguishing results of different level athletes. We discovered that among others, self-produced imagery generates lower SCL, higher variance, and a higher number of fluctuations compared to guided imagery. Moreover, we found similarities of the SCL signal among the groups of athletes (i.e. expertise level). From a practical point of view, our findings suggest that different imagery instructional modalities can be implemented for specific purposes of mental preparation.

Motor imagery in autism: a systematic review

Introduction

Motor Imagery (MI) is when an individual imagines performing an action without physically executing that action and is thought to involve similar neural processes used for execution of physical movement. As motor coordination difficulties are common in autistic individuals it is possible that these may affect MI ability. The aim of this systematic review was to assess the current knowledge around MI ability in autistic individuals.

Methods

A systematic search was conducted for articles published before September 2023, following PRISMA guidance. Search engines were PsycINFO, PubMed, Web of Science, Scopus, Wiley Online Library and PsyArXiv. Inclusion criteria included: (a) Original peer-reviewed and pre-print publications; (b) Autistic and a non-autistic group (c) Implicit or explicit imagery tasks (d) Behavioral, neurophysiological or self-rating measures, (e) Written in the English language. Exclusion criteria were (a) Articles only about MI or autism (b) Articles where the autism data is not presented separately (c) Articles on action observation, recognition or imitation only (d) Review articles. A narrative synthesis of the evidence was conducted.

Results

Sixteen studies across fourteen articles were included. Tasks were divided into implicit (unconscious) or explicit (conscious) MI. The implicit tasks used either hand (6) or body (4) rotation tasks. Explicit tasks consisted of perspective taking tasks (3), a questionnaire (1) and explicit instructions to imagine performing a movement (2). A MI strategy was apparent for the hand rotation task in autistic children, although may have been more challenging. Evidence was mixed and inconclusive for the remaining task types due to the varied range of different tasks and, measures conducted and design limitations. Further limitations included a sex bias toward males and the hand rotation task only being conducted in children.

Discussion

There is currently an incomplete understanding of MI ability in autistic individuals. The field would benefit from a battery of fully described implicit and explicit MI tasks, conducted across the same groups of autistic children and adults. Improved knowledge around MI in autistic individuals is important for understanding whether MI techniques may benefit motor coordination in some autistic people.

Early sleep after action observation plus motor imagery improves gait and balance abilities in older adults

Action observation plus motor imagery (AOMI) is a rehabilitative approach to improve gait and balance performance. However, limited benefits have been reported in older adults. Early sleep after motor practice represents a strategy to enhance the consolidation of trained skills. Here, we investigated the effects of AOMI followed by early sleep on gait and balance performance in older adults. Forty-five older adults (mean age: 70.4 ± 5.2 years) were randomized into three groups performing a 3-week training. Specifically, AOMI-sleep and AOMI-control groups underwent observation and motor imagery of gait and balance tasks between 8:00 and 10:00 p.m. or between 8:00 and 10:00 a.m. respectively, whereas Control group observed landscape video-clips. Participants were assessed for gait performance, static and dynamic balance and fear of falling before and after training and at 1-month follow-up. The results revealed that early sleep after AOMI training sessions improved gait and balance abilities in older adults compared to AOMI-control and Control groups. Furthermore, these benefits were retained at 1-month after the training end. These findings suggested that early sleep after AOMI may represent a safe and easy-applicable intervention to minimize the functional decay in older adults.

Can they touch? A novel mental motor imagery task for the assessment of back pain

Introduction

As motor imagery is informed by the anticipated sensory consequences of action, including pain, we reasoned that motor imagery could provide a useful indicator of chronic back pain. We tested the hypothesis that mental motor imagery regarding body movements can provide a reliable assessment of low back pain.

Methods

Eighty-five subjects with back pain and forty-five age-matched controls were shown two names of body parts and asked to indicate if they could imagine moving so that the named body parts touched. Three types of imagined movements were interrogated: movements of arms, movements of legs and movements requiring flexion and/or rotation of the low back.

Results

Accuracy and reaction times were measured. Subjects with back pain were less likely to indicate that they could touch body parts than age-matched controls. The effect was observed only for those movements that required movement of the low back or legs, suggesting that the effect was not attributable to task difficulty or non-specific effects. There was an effect of pain severity. Compared to subjects with mild pain, subjects with severe pain were significantly less likely to indicate that they could move so that named body parts touched. There was a correlation between pain ratings and impaired performance for stimuli that involved the lower but not upper body.

Discussion

As the Can They Touch task is quick, easy to administer and does not require an explicit judgment of pain severity, it may provide useful information to supplement the assessment of subjects with chronic pain.

M-FANet: Multi-Feature Attention Convolutional Neural Network for Motor Imagery Decoding

Motor imagery (MI) decoding methods are pivotal in advancing rehabilitation and motor control research. Effective extraction of spectral-spatial-temporal features is crucial for MI decoding from limited and low signal-to-noise ratio electroencephalogram (EEG) signal samples based on brain-computer interface (BCI). In this paper, we propose a lightweight Multi-Feature Attention Neural Network (M-FANet) for feature extraction and selection of multi-feature data. M-FANet employs several unique attention modules to eliminate redundant information in the frequency domain, enhance local spatial feature extraction and calibrate feature maps. We introduce a training method called Regularized Dropout (R-Drop) to address training-inference inconsistency caused by dropout and improve the model's generalization capability. We conduct extensive experiments on the BCI Competition IV 2a (BCIC-IV-2a) dataset and the 2019 World robot conference contest-BCI Robot Contest MI (WBCIC-MI) dataset. M-FANet achieves superior performance compared to state-of-the-art MI decoding methods, with 79.28% 4-class classification accuracy (kappa: 0.7259) on the BCIC-IV-2a dataset and 77.86% 3-class classification accuracy (kappa: 0.6650) on the WBCIC-MI dataset. The application of multi-feature attention modules and R-Drop in our lightweight model significantly enhances its performance, validated through comprehensive ablation experiments and visualizations.

Motor cortex activation during visuomotor transformations: evoked potentials during overt and imagined movements

Despite the prevalence of visuomotor transformations in our motor skills, their mechanisms remain incompletely understood, especially when imagery actions are considered such as mentally picking up a cup or pressing a button. Here, we used a stimulus-response task to directly compare the visuomotor transformation underlying overt and imagined button presses. Electroencephalographic activity was recorded while participants responded to highlights of the target button while ignoring the second, non-target button. Movement-related potentials (MRPs) and event-related desynchronization occurred for both overt movements and motor imagery (MI), with responses present even for non-target stimuli. Consistent with the activity accumulation model where visual stimuli are evaluated and transformed into the eventual motor response, the timing of MRPs matched the response time on individual trials. Activity-accumulation patterns were observed for MI, as well. Yet, unlike overt movements, MI-related MRPs were not lateralized, which appears to be a neural marker for the distinction between generating a mental image and transforming it into an overt action. Top-down response strategies governing this hemispheric specificity should be accounted for in future research on MI, including basic studies and medical practice.

Guidelines for reporting action simulation studies (GRASS): Proposals to improve reporting of research in motor imagery and action observation

Researchers from multiple disciplines have studied the simulation of actions through motor imagery, action observation, or their combination. Procedures used in these studies vary considerably between research groups, and no standardized approach to reporting experimental protocols has been proposed. This has led to under-reporting of critical details, impairing the assessment, replication, synthesis, and potential clinical translation of effects. We provide an overview of issues related to the reporting of information in action simulation studies, and discuss the benefits of standardized reporting. We propose a series of checklists that identify key details of research protocols to include when reporting action simulation studies. Each checklist comprises A) essential methodological details, B) essential details that are relevant to a specific mode of action simulation, and C) further points that may be useful on a case-by-case basis. We anticipate that the use of these guidelines will improve the understanding, reproduction, and synthesis of studies using action simulation, and enhance the translation of research using motor imagery and action observation to applied and clinical settings.

Distinguishing Laparoscopic Surgery Experts from Novices Using EEG Topographic Features

The study aimed to differentiate experts from novices in laparoscopic surgery tasks using electroencephalogram (EEG) topographic features. A microstate-based common spatial pattern (CSP) analysis with linear discriminant analysis (LDA) was compared to a topography-preserving convolutional neural network (CNN) approach. Expert surgeons (N = 10) and novice medical residents (N = 13) performed laparoscopic suturing tasks, and EEG data from 8 experts and 13 novices were analysed. Microstate-based CSP with LDA revealed distinct spatial patterns in the frontal and parietal cortices for experts, while novices showed frontal cortex involvement. The 3D CNN model (ESNet) demonstrated a superior classification performance (accuracy > 98%, sensitivity 99.30%, specificity 99.70%, F1 score 98.51%, MCC 97.56%) compared to the microstate based CSP analysis with LDA (accuracy ~90%). Combining spatial and temporal information in the 3D CNN model enhanced classifier accuracy and highlighted the importance of the parietal-temporal-occipital association region in differentiating experts and novices.

Brain plasticity underlying sleep-dependent motor consolidation after motor imagery

Motor imagery can, similarly to physical practice, improve motor performance through experience-based plasticity. Using magnetoencephalography, we investigated changes in brain activity associated with offline consolidation of motor sequence learning through physical practice or motor imagery. After an initial training session with either physical practice or motor imagery, participants underwent overnight consolidation. As control condition, participants underwent wake-related consolidation after training with motor imagery. Behavioral analyses revealed that overnight consolidation of motor learning through motor imagery outperformed wake-related consolidation (95% CI [0.02, 0.07], P < 0.001, RP2 = 0.05). As regions of interest, we selected the generators of event-related synchronization/desynchronization of alpha (8-12 Hz) and beta (15-30 Hz) oscillations, which predicted the level of performance on the motor sequence. This yielded a primary sensorimotor-premotor network for alpha oscillations and a cortico-cerebellar network for beta oscillations. The alpha network exhibited increased neural desynchronization after overnight consolidation compared to wake-related consolidation. By contrast, the beta network exhibited an increase in neural synchronization after wake-related consolidation compared to overnight consolidation. We provide the first evidence of parallel brain plasticity underlying behavioral changes associated with sleep-dependent consolidation of motor skill learning through motor imagery and physical practice.

Relationship between resting-state functional connectivity and change in motor function after motor imagery intervention in patients with stroke: a scoping review

BACKGROUND

In clinical practice, motor imagery has been proposed as a treatment modality for stroke owing to its feasibility in patients with severe motor impairment. Motor imagery-based interventions can be categorized as open- or closed-loop. Closed-loop intervention is based on voluntary motor imagery and induced peripheral sensory afferent (e.g., Brain Computer Interface (BCI)-based interventions). Meanwhile, open-loop interventions include methods without voluntary motor imagery or sensory afferent. Resting-state functional connectivity (rs-FC) is defined as a significant temporal correlated signal among functionally related brain regions without any stimulus. rs-FC is a powerful tool for exploring the baseline characteristics of brain connectivity. Previous studies reported changes in rs-FC after motor imagery interventions. Systematic reviews also reported the effects of motor imagery-based interventions at the behavioral level. This study aimed to review and describe the relationship between the improvement in motor function and changes in rs-FC after motor imagery in patients with stroke.

REVIEW PROCESS

The literature review was based on Arksey and O'Malley's framework. PubMed, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science were searched up to September 30, 2023. The included studies covered the following topics: illusion without voluntary action, motor imagery, action imitation, and BCI-based interventions. The correlation between rs-FC and motor function before and after the intervention was analyzed. After screening by two independent researchers, 13 studies on BCI-based intervention, motor imagery intervention, and kinesthetic illusion induced by visual stimulation therapy were included.

CONCLUSION

All studies relating to motor imagery in this review reported improvement in motor function post-intervention. Furthermore, all those studies demonstrated a significant relationship between the change in motor function and rs-FC (e.g., sensorimotor network and parietal cortex).

Brief Visual Deprivation Effects on Brain Oscillations During Kinesthetic and Visual-motor Imagery

It is widely recognized that opening and closing the eyes can direct attention to external or internal stimuli processing. This has been confirmed by studies showing the effects of changes in visual stimulation changes on cerebral activity during different tasks, e.g., motor imagery and execution. However, an essential aspect of creating a mental representation of motion, such as imagery perspective, has not yet been investigated in the present context. Our study aimed to verify the effect of brief visual deprivation (under eyes open [EO] and eyes closed [EC] conditions) on brain wave oscillations and behavioral performance during kinesthetic imagery (KMI) and visual-motor imagery (VMI) tasks. We focused on the alpha and beta rhythms from visual- and motor-related EEG activity sources. Additionally, we used machine learning algorithms to establish whether the registered differences in brain oscillations might affect motor imagery brain-computer interface (MI-BCI) performance. The results showed that the occipital areas in the EC condition presented significantly stronger desynchronization during VMI tasks, which is typical for enhanced visual stimuli processing. Furthermore, the stronger desynchronization of alpha rhythms from motor areas in the EO, than EC condition confirmed previous effects obtained during real movements. It was also found that simulating movement under EC/EO conditions affected signal classification accuracy, which has practical implications for MI-BCI effectiveness. These findings suggest that shifting processing toward external or internal stimuli modulates brain rhythm oscillations associated with different perspectives on the mental representation of movement.

Imagery, emotion, and bioinformational theory: From body to brain

The bioinformational theory of emotional imagery is a model of the hypothetical mental representations activated when people imagine emotionally engaging events, and was initially proposed to guide research and practice in the use of imaginal exposure as a treatment for fear and anxiety (Lang, 1979). In this 50 year overview, we discuss the development of bioinformational theory and its impact on the study of psychophysiology and psychopathology, most importantly assessing its viability and predictions in light of more recent brain-based studies of neural functional activation. Bioinformational theory proposes that narrative imagery, typically cued by language scripts, activates an associative memory network in the brain that includes stimulus (e.g., agents, contexts), semantic (e.g., facts and beliefs) and, most critically for emotion, response information (e.g., autonomic and somatic) that represents relevant real-world coping actions and reactions. Psychophysiological studies in healthy and clinical samples reliably find measurable response output during aversive and appetitive narrative imagery. Neuroimaging studies confirm that emotional imagery is associated with significant activation in motor regions of the brain, as well as in regions implicated in episodic and semantic memory retrieval, supporting the bioinformational view that narrative imagery prompts mental simulation of events that critically includes the actions and reactions engaged in emotional contexts.

Visual and kinesthetic motor imagery in adults with different degrees of self-reported motor coordination difficulties

Developmental Coordination Disorder (DCD) involves difficulties in performing coordinated movements with fine and/or gross motor skills deficits. Several studies showed that DCD is characterized by motor imagery deficits as well. Here we investigated in neurotypical adults (N = 334) the relationships between the ease of imaging two main motor imagery components, that is the visual and the kinesthetic one, self-reported motor coordination difficulties and handwriting speed. Self-reported motor difficulties were measured by the Adult Developmental Co-ordination Disorders/Dyspraxia Checklist (ADC) and scores were used to distinguish three groups: participants at risk of DCD (with both relevant childhood and current motor coordination difficulties); with motor coordination difficulties (relevant current but not childhood difficulties); without motor coordination difficulties (neither current nor childhood difficulties). The main results showed more kinesthetic and visual imagery difficulties in participants at risk of DCD than in those both with and without motor coordination difficulties. Interestingly, the relationships between the two imagery components and motor difficulties were different in the three groups, depending on: 1) the developmental phase (childhood or adulthood) to which motor coordination difficulties referred, and 2) the point of view (self or other), from which images were judged. Instead, no relationship was found between imagery abilities and handwriting speed. Thus, a nuanced pattern of the ease of imaging motor imagery emerged in adults with different degrees of self-reported motor coordination difficulties. These findings could be relevant for the assessment of people candidate to undergo a motor imagery training.

EEG Reveals Alterations in Motor Imagery in People With Amnestic Mild Cognitive Impairment

OBJECTIVES

Motor imagery has been used to investigate the cognitive mechanism of motor control. Although behavioral and electrophysiological changes in motor imagery in people with amnestic mild cognitive impairment (aMCI) have been reported, deficits in different types of imagery remain unclear. To explore this question, we used electroencephalography (EEG) to study neural correlates of visual imagery (VI) and kinesthetic imagery (KI) and their relationship to cognitive function in people with aMCI.

METHODS

A hand laterality judgment task was used to induce implicit motor imagery in 29 people with aMCI and 40 healthy controls during EEG recording. Mass univariate and multivariate EEG analysis was applied to explore group differences in a data-driven manner.

RESULTS

Modulation of stimuli orientation to event-related potential (ERP) amplitudes differed significantly between groups at 2 clusters located in the posterior-parietal and frontal areas. Multivariate decoding revealed sufficient representation of VI-related orientation features in both groups. Relative to healthy controls, the aMCI group lacked accurate representation of KI-related biomechanical features, suggesting deficits in automatic activation of KI strategy. Electrophysiological correlates were associated with episodic memory, visuospatial function, and executive function. Higher decoding accuracy of biomechanical features predicted better executive function via longer response time in the imagery task in the aMCI group.

DISCUSSION

These findings reveal electrophysiological correlates related to motor imagery deficits in aMCI, including local ERP amplitudes and large-scale activity patterns. Alterations in EEG activity are related to cognitive function in multiple domains, including episodic memory, suggesting the potential of these EEG indices as biomarkers of cognitive impairment.

Neural Plasticity Changes Induced by Motor Robotic Rehabilitation in Stroke Patients: The Contribution of Functional Neuroimaging

Robotic rehabilitation is one of the most advanced treatments helping people with stroke to faster recovery from motor deficits. The clinical impact of this type of treatment has been widely defined and established using clinical scales. The neurofunctional indicators of motor recovery following conventional rehabilitation treatments have already been identified by previous meta-analytic investigations. However, a clear definition of the neural correlates associated with robotic neurorehabilitation treatment has never been performed. This systematic review assesses the neurofunctional correlates (fMRI, fNIRS) of cutting-edge robotic therapies in enhancing motor recovery of stroke populations in accordance with PRISMA standards. A total of 7, of the initial yield of 150 articles, have been included in this review. Lessons from these studies suggest that neural plasticity within the ipsilateral primary motor cortex, the contralateral sensorimotor cortex, and the premotor cortices are more sensitive to compensation strategies reflecting upper and lower limbs' motor recovery despite the high heterogeneity in robotic devices, clinical status, and neuroimaging procedures. Unfortunately, the paucity of RCT studies prevents us from understanding the neurobiological differences induced by robotic devices with respect to traditional rehabilitation approaches. Despite this technology dating to the early 1990s, there is a need to translate more functional neuroimaging markers in clinical settings since they provide a unique opportunity to examine, in-depth, the brain plasticity changes induced by robotic rehabilitation.

Inter-task transfer of force gains is facilitated by motor imagery

Introduction

There is compelling evidence that motor imagery (MI) contributes to improve muscle strength. While strong effects have been observed for finger muscles, only few experiments with moderate benefits were conducted within applied settings targeting large upper or lower limb muscles. The aim of the present study was therefore to extend the investigation of embedded MI practice designed to improve maximal voluntary strength on a multi-joint dynamic exercise involving the lower limbs. Additionally, we tested whether targeting the content of MI on another movement than that physically performed and involving the same body parts might promote inter-task transfer of strength gains.

Methods

A total of 75 participants were randomly assigned into three groups who underwent a physical training on back squat. During inter-trial recovery periods, a first MI group (n = 25) mentally rehearsed the back squat, while a second MI group (n = 25) performed MI of a different movement involving the lower limbs (deadlift). Participants from the control group (n = 25) completed a neutral cognitive task during equivalent time. Strength and power gains were assessed ecologically using a velocity transducer device at 4 different time periods.

Results

Data first revealed that participants who engaged in MI of the back squat improved their back squat performance (p < 0.03 and p < 0.01, respectively), more than the control group (p < 0.05), hence supporting the positive effects of MI on strength. Data further supported the inter-task transfer of strength gains when MI targeted a movement that was not physically trained (p = 0.05).

Discussion

These findings provide experimental support for the use of MI during physical training sessions to improve and transfer force development.

Neuropsychological Activations and Networks While Performing Visual and Kinesthetic Motor Imagery

This study aimed to answer the questions 'What are the neural networks and mechanisms involved in visual and kinesthetic motor imagery?', and 'Is part of cognitive processing included during visual and kinesthetic motor imagery?' by investigating the neurophysiological networks and activations during visual and kinesthetic motor imagery using motor imagery tasks (golf putting). The experiment was conducted with 19 healthy adults. Functional magnetic resonance imaging (fMRI) was used to examine neural activations and networks during visual and kinesthetic motor imagery using golf putting tasks. The findings of the analysis on cerebral activation patterns based on the two distinct types of motor imagery indicate that the posterior lobe, occipital lobe, and limbic lobe exhibited activation, and the right hemisphere was activated during the process of visual motor imagery. The activation of the temporal lobe and the parietal lobe were observed during the process of kinesthetic motor imagery. This study revealed that visual motor imagery elicited stronger activation in the right frontal lobe, whereas kinesthetic motor imagery resulted in greater activation in the left frontal lobe. It seems that kinesthetic motor imagery activates the primary somatosensory cortex (BA 2), the secondary somatosensory cortex (BA 5 and 7), and the temporal lobe areas and induces human sensibility. The present investigation evinced that the neural network and the regions of the brain that are activated exhibit variability contingent on the category of motor imagery.

Interventions for motor rehabilitation in people with transtibial amputation due to peripheral arterial disease or diabetes

BACKGROUND

Amputation is described as the removal of an external part of the body by trauma, medical illness or surgery. Amputations caused by vascular diseases (dysvascular amputations) are increasingly frequent, commonly due to peripheral arterial disease (PAD), associated with an ageing population, and increased incidence of diabetes and atherosclerotic disease. Interventions for motor rehabilitation might work as a precursor to enhance the rehabilitation process and prosthetic use. Effective rehabilitation can improve mobility, allow people to take up activities again with minimum functional loss and may enhance the quality of life (QoL). Strength training is a commonly used technique for motor rehabilitation following transtibial (below-knee) amputation, aiming to increase muscular strength. Other interventions such as motor imaging (MI), virtual environments (VEs) and proprioceptive neuromuscular facilitation (PNF) may improve the rehabilitation process and, if these interventions can be performed at home, the overall expense of the rehabilitation process may decrease. Due to the increased prevalence, economic impact and long-term rehabilitation process in people with dysvascular amputations, a review investigating the effectiveness of motor rehabilitation interventions in people with dysvascular transtibial amputations is warranted.

OBJECTIVES

To evaluate the benefits and harms of interventions for motor rehabilitation in people with transtibial (below-knee) amputations resulting from peripheral arterial disease or diabetes (dysvascular causes).

SEARCH METHODS

We used standard, extensive Cochrane search methods. The latest search date was 9 January 2023.

SELECTION CRITERIA

We included randomised controlled trials (RCT) in people with transtibial amputations resulting from PAD or diabetes (dysvascular causes) comparing interventions for motor rehabilitation such as strength training (including gait training), MI, VEs and PNF against each other.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methods. Our primary outcomes were 1. prosthesis use, and 2.

ADVERSE EVENTS

Our secondary outcomes were 3. mortality, 4. QoL, 5. mobility assessment and 6. phantom limb pain. We use GRADE to assess certainty of evidence for each outcome.

MAIN RESULTS

We included two RCTs with a combined total of 30 participants. One study evaluated MI combined with physical practice of walking versus physical practice of walking alone. One study compared two different gait training protocols. The two studies recruited people who already used prosthesis; therefore, we could not assess prosthesis use. The studies did not report mortality, QoL or phantom limb pain. There was a lack of blinding of participants and imprecision as a result of the small number of participants, which downgraded the certainty of the evidence. We identified no studies that compared VE or PNF with usual care or with each other. MI combined with physical practice of walking versus physical practice of walking (one RCT, eight participants) showed very low-certainty evidence of no difference in mobility assessment assessed using walking speed, step length, asymmetry of step length, asymmetry of the mean amount of support on the prosthetic side and on the non-amputee side and Timed Up-and-Go test. The study did not assess adverse events. One study compared two different gait training protocols (one RCT, 22 participants). The study used change scores to evaluate if the different gait training strategies led to a difference in improvement between baseline (day three) and post-intervention (day 10). There were no clear differences using velocity, Berg Balance Scale (BBS) or Amputee Mobility Predictor with PROsthesis (AMPPRO) in training approaches in functional outcome (very low-certainty evidence). There was very low-certainty evidence of little or no difference in adverse events comparing the two different gait training protocols.

AUTHORS' CONCLUSIONS

Overall, there is a paucity of research in the field of motor rehabilitation in dysvascular amputation. We identified very low-certainty evidence that gait training protocols showed little or no difference between the groups in mobility assessments and adverse events. MI combined with physical practice of walking versus physical practice of walking alone showed no clear difference in mobility assessment (very low-certainty evidence). The included studies did not report mortality, QoL, and phantom limb pain, and evaluated participants already using prosthesis, precluding the evaluation of prosthesis use. Due to the very low-certainty evidence available based on only two small trials, it remains unclear whether these interventions have an effect on the prosthesis use, adverse events, mobility assessment, mortality, QoL and phantom limb pain. Further well-designed studies that address interventions for motor rehabilitation in dysvascular transtibial amputation may be important to clarify this uncertainty.

Transcranial Magnetic Stimulation of the Dorsolateral Prefrontal Cortex Increases Posterior Theta Rhythm and Reduces Latency of Motor Imagery

Experiments show activation of the left dorsolateral prefrontal cortex (DLPFC) in motor imagery (MI) tasks, but its functional role requires further investigation. Here, we address this issue by applying repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC and evaluating its effect on brain activity and the latency of MI response. This is a randomized, sham-controlled EEG study. Participants were randomly assigned to receive sham (15 subjects) or real high-frequency rTMS (15 subjects). We performed EEG sensor-level, source-level, and connectivity analyses to evaluate the rTMS effects. We revealed that excitatory stimulation of the left DLPFC increases theta-band power in the right precuneus (PrecuneusR) via the functional connectivity between them. The precuneus theta-band power negatively correlates with the latency of the MI response, so the rTMS speeds up the responses in 50% of participants. We suppose that posterior theta-band power reflects attention modulation of sensory processing; therefore, high power may indicate attentive processing and cause faster responses.

Recognizable Rehabilitation Movements of Multiple Unilateral Upper Limb: an fMRI Study of Motor Execution and Motor Imagery

BACKGROUND

This paper presents a study investigating the recognizability of multiple unilateral upper limb movements in stroke rehabilitation.

METHODS

A functional magnetic experiment is employed to study motor execution (ME) and motor imagery (MI) of four movements for the unilateral upper limb: hand-grasping, hand-handling, arm-reaching, and wrist-twisting. The functional magnetic resonance imaging (fMRI) images of ME and MI tasks are statistically analyzed to delineate the region of interest (ROI). Then parameter estimation associated with ROIs for each ME and MI task are evaluated, where differences in ROIs for different movements are compared using analysis of covariance (ANCOVA).

RESULTS

All movements of ME and MI tasks activate motor areas of the brain, and there are significant differences (p<0.05) in ROIs evoked by different movements. The activation area is larger when executing the hand-grasping task instead of the others.

CONCLUSION

The four movements we propose can be adopted as MI tasks, especially for stroke rehabilitation, since they are highly recognizable and capable of activating more brain areas during MI and ME.

Deciphering Functional Connectivity Differences Between Motor Imagery and Execution of Target-Oriented Grasping

This study aimed to delineate overlapping and distinctive functional connectivity in visual motor imagery, kinesthetic motor imagery, and motor execution of target-oriented grasping action of the right hand. Functional magnetic resonance imaging data were obtained from 18 right-handed healthy individuals during each condition. Seed-based connectivity and multi-voxel pattern analyses were employed after selecting seed regions with the left primary motor cortex and supplementary motor area. There was equivalent seed-based connectivity during the three conditions in the bilateral frontoparietal and temporal areas. When the seed region was the left primary motor cortex, increased connectivity was observed in the left cuneus and superior frontal area during visual and kinesthetic motor imageries, respectively, compared with that during motor execution. Multi-voxel pattern analyses revealed that each condition was differentiated by spatially distributed connectivity patterns of the left primary motor cortex within the right cerebellum VI, cerebellum crus II, and left lingual area. When the seed region was the left supplementary motor area, the connectivity patterns within the right putamen, thalamus, cerebellar areas IV-V, and left superior parietal lobule were significantly classified above chance level across the three conditions. The present findings improve our understanding of the spatial representation of functional connectivity and its specific patterns among motor imagery and motor execution. The strength and fine-grained connectivity patterns of the brain areas can discriminate between motor imagery and motor execution.

Mental imagery content is associated with disease severity and specific brain functional connectivity changes in patients with Parkinson's disease

Mental imagery is the mental re-creation of perceptual experiences, events and scenarios, and motor acts. In our previous study, we assessed whether motor imagery (MI) training combined with functional magnetic resonance imaging-based neurofeedback could improve the motor function of nondemented subjects with mild Parkinson's disease (PD) (N = 22). We used visual imagery (VI) (e.g., of scenes or events, but not of self-movements) training without neurofeedback for the control group (N = 22). Notably, both groups showed significant and comparable improvement in motor function after four weeks of daily imagery practice. In this study, we further examined the neural correlates of the motor enhancement as a result of the VI training by analyzing the self-reported VI content during daily practice and relating its quality to the functional connectivity characteristics of the same subjects. We demonstrated that the VI practice encompassed multisensory, spatial, affective, and executive processes all of which are also important for motor function in real life. Subjects with worse global disease severity also showed poorer quality of the VI content. Finally, the quality of the VI content showed significant positive correlations with the functional connectivity changes during the VI tasks in brain areas supporting visuospatial and sensorimotor processes. Our findings suggest that mental imagery training combining VI and MI may enhance motor function in patients with mild PD, and more broadly, underline the importance of incorporating self-reports of thoughts and experiences in neuroimaging studies that examine the brain mechanisms of complex cognitive processes especially in neuropsychiatric patient populations.

Evaluation of residual cognition in patients with disorders of consciousness based on functional near-infrared spectroscopy

SIGNIFICANCE

Accurate evaluation of consciousness in patients with prolonged disorders of consciousness (DOC) is critical for designing therapeutic plans, determining rehabilitative services, and predicting prognosis. Effective ways for detecting consciousness in patients with DOC are still needed.

AIM

Evaluation of the residual awareness in patients with DOC and investigation of the spatiotemporal differences in the hemodynamic responses between the minimally conscious state (MCS) and the unresponsive wakefulness syndrome (UWS) groups using active command-driven motor imagery (MI) tasks.

APPROACH

In this study, functional near-infrared spectroscopy (fNIRS) was used to measure the changes of hemodynamic responses in 19 patients with DOC (9 MCS and 10 UWS) using active command-driven MI tasks. The characteristics of the hemodynamic responses were extracted to compare the differences between the MCS and UWS groups. Moreover, the correlations between the hemodynamic responses and the clinical behavioral evaluations were also studied.

RESULTS

The results showed significant differences in the spatiotemporal distribution of the hemodynamic responses between the MCS and UWS groups. For the patients with MCS, significant increases in task-evoked hemodynamic responses occurred during the "YES" questions of the command-driven MI tasks. Importantly, these changes were significantly correlated with their coma-recovery scale-revised (CRS-R) scores. However, for the patients with UWS, no significant changes of the hemodynamic responses were found. Additionally, the results did not show any statistical correlation between the hemodynamic responses and their CRS-R scores.

CONCLUSIONS

The fNIRS-based command-driven MI tasks can be used as a promising tool for detecting residual awareness in patients with DOC. We hope that the findings and the active paradigm used in this study will provide useful insights into the diagnosis, therapy, and prognosis of this challenging patient population.

Timing-specific patterns of cerebral activations during motor imagery: A case study of the expert brain signature

Brain activations elicited during motor imagery (MI) in experts are typically reduced compared to novices, which is interpreted as a neurophysiological correlate of increased neural efficiency. However, the modulatory effects of MI speed on expertise-related differences in brain activation remains largely unknown. In the present pilot study, we compared the magnetoencephalographic (MEG) correlates of MI in an Olympic medallist and an amateur athlete under conditions of slow, real-time and fast MI. Data revealed event-related changes in the time course of alpha (8-12 Hz) power of MEG oscillations, for all timing conditions. We found that slow MI was associated with a corollary increase in neural synchronization, in both participants. Sensor-level and source-level analyses however disclosed differences between the two expertise levels. The Olympic medallist achieved greater activation of cortical sensorimotor networks than the amateur athlete, particularly during fast MI. Fast MI elicited the strongest event-related desynchronization of alpha oscillations, which was generated from cortical sensorimotor sources in the Olympic medallist, but not in the amateur athlete. Taken together, data suggest that fast MI is a particularly demanding form of motor cognition, putting a specific emphasis on cortical sensorimotor networks to achieve the formation of accurate motor representations under demanding timing constraints.

The Effect of Motor Imaginary Combined with Transcranial Direct Current Stimulation (tDCS) on Balance in Middle-Aged Women with High Fall Risk: A Double-Blind Randomized Controlled Trial

Introduction. The risk of falling and its subsequent injuries increases with aging. Impaired balance and gait are important contributing factors to the increased risk of falling. A wide range of methods was examined to improve balance, but these interventions might produce small effects or be inapplicable for this population. The current study aimed at investigating the effect of motor imaginary (MI) training combined with transcranial direct current stimulation (tDCS) over the cerebellum on balance in middle-aged women with high fall risk. Methods. Thirty subjects aged 40-65 years old were divided into two groups including intervention ( $n=15$ ) and sham control ( $n=15$ ). The participants completed a 4-week program 3 times per week. The intervention group performed MI training combined with tDCS over the cerebellum, and the control group performed MI training combined with sham tDCS over the cerebellum. Static and dynamic balance were measured at baseline and after completing the 4-week program using balance error scoring system (BESS) and Y balance testing, respectively. Result. A one-way analysis of covariance and paired $t$ -tests were used to analyze the data. Significant improvement was observed in both balance tests in the intervention group after the implementation of the 4-week intervention program compared to the control group. The within-group analysis showed that both static and dynamic balance improved significantly from the baseline values only in the intervention group ( $p<0.05$ ) and not in the control group ( $p>0.05$ ). Conclusion. The results of the study indicate that MI training combined with tDCS over the cerebellum can lead to balance improvement in middle-aged women with high fall risk.

Interhemispheric parietal cortex connectivity reflects improvement in post-stroke spasticity due to treatment with botulinum toxin-A

In post-stroke spasticity (PSS), effective treatment with botulinum neurotoxin (BoNT) is associated with transient decrease in activation of the ipsilesional superior parietal lobule (SPL) and intraparietal sulcus (IPS). We hypothesized that this would be reflected in changes in resting-state functional connectivity (rsFC) of the SPL/IPS. Our aim was therefore to assess rsFC of the ipsilesional SPL/IPS in chronic stroke patients with hemiparesis both with and without PSS and to explore the relationship between SPL/IPS rsFC and PSS severity. To this end, fourteen chronic stroke patients with upper limb weakness and PSS (the PSS group) and 8 patients with comparable weakness but no PSS (the control group) underwent clinical evaluation and 3 fMRI examinations, at baseline (W0) and 4 and 11 weeks after BoNT (W4 and W11, respectively). Seed-based rsFC of the atlas-based SPL and IPS was evaluated using a group×time interaction analysis and a correlation analysis with PSS severity (modified Ashworth scale), integrity of the ipsilesional somatosensory afferent pathway (evoked potential N20 latency), and age. In the PSS group, transient improvement in PSS was associated with increase in rsFC between the ipsilesional IPS and the contralesional SPL at W4. The interhemispheric connectivity was negatively correlated with PSS severity at baseline and with PSS improvement at W4. We propose adaptation of the internal forward model as the putative underlying mechanism and discuss its possible association with increased limb use, diminished spastic dystonia, or improved motor performance, as well as its potential contribution to the clinical effects of BoNT.

Measuring brain potentials of imagination linked to physiological needs and motivational states

Introduction

While EEG signals reflecting motor and perceptual imagery are effectively used in brain computer interface (BCI) contexts, little is known about possible indices of motivational states. In the present study, electrophysiological markers of imagined motivational states, such as craves and desires were investigated.

Methods

Event-related potentials (ERPs) were recorded in 31 participants during perception and imagery elicited by the presentation of 360 pictograms. Twelve micro-categories of needs, subdivided into four macro-categories, were considered as most relevant for a possible BCI usage, namely: primary visceral needs (e.g., hunger, linked to desire of food); somatosensory thermal and pain sensations (e.g., cold, linked to desire of warm), affective states (e.g., fear: linked to desire of reassurance) and secondary needs (e.g., desire to exercise or listen to music). Anterior N400 and centroparietal late positive potential (LPP) were measured and statistically analyzed.

Results

N400 and LPP were differentially sensitive to the various volition stats, depending on their sensory, emotional and motivational poignancy. N400 was larger to imagined positive appetitive states (e.g., play, cheerfulness) than negative ones (sadness or fear). In addition, N400 was of greater amplitude during imagery of thermal and nociceptive sensations than other motivational or visceral states. Source reconstruction of electromagnetic dipoles showed the activation of sensorimotor areas and cerebellum for movement imagery, and of auditory and superior frontal areas for music imagery.

Discussion

Overall, ERPs were smaller and more anteriorly distributed during imagery than perception, but showed some similarity in terms of lateralization, distribution, and category response, thus indicating some overlap in neural processing, as also demonstrated by correlation analyses. In general, anterior frontal N400 provided clear markers of subjects’ physiological needs and motivational states, especially cold, pain, and fear (but also sadness, the urgency to move, etc.), than can signal life-threatening conditions. It is concluded that ERP markers might potentially allow the reconstruction of mental representations related to various motivational states through BCI systems.

Topology of the lateral visual system: The fundus of the superior temporal sulcus and parietal area H connect nonvisual cerebrum to the lateral occipital lobe

BACKGROUND AND PURPOSE

Mapping the topology of the visual system is critical for understanding how complex cognitive processes like reading can occur. We aim to describe the connectivity of the visual system to understand how the cerebrum accesses visual information in the lateral occipital lobe.

METHODS

Using meta-analytic software focused on task-based functional MRI studies, an activation likelihood estimation (ALE) of the visual network was created. Regions of interest corresponding to the cortical parcellation scheme previously published under the Human Connectome Project were co-registered onto the ALE to identify the hub-like regions of the visual network. Diffusion Spectrum Imaging-based fiber tractography was performed to determine the structural connectivity of these regions with extraoccipital cortices.

RESULTS

The fundus of the superior temporal sulcus (FST) and parietal area H (PH) were identified as hub-like regions for the visual network. FST and PH demonstrated several areas of coactivation beyond the occipital lobe and visual network. Furthermore, these parcellations were highly interconnected with other cortical regions throughout extraoccipital cortices related to their nonvisual functional roles. A cortical model demonstrating connections to these hub-like areas was created.

CONCLUSIONS

FST and PH are two hub-like areas that demonstrate extensive functional coactivation and structural connections to nonvisual cerebrum. Their structural interconnectedness with language cortices along with the abnormal activation of areas commonly located in the temporo-occipital region in dyslexic individuals suggests possible important roles of FST and PH in the integration of information related to language and reading. Future studies should refine our model by examining the functional roles of these hub areas and their clinical significance.

Development of the Paternal Brain in Humans throughout Pregnancy

Previous studies have demonstrated that paternal caregiving behaviors are reliant on neural pathways similar to those supporting maternal care. Interestingly, a greater variability exists in parental phenotypes in men than in women among individuals and mammalian species. However, less is known about when or how such variability emerges in men. We investigated the longitudinal changes in the neural, hormonal, and psychological bases of expression of paternal caregiving in humans throughout pregnancy and the first 4 months of the postnatal period. We measured oxytocin and testosterone, paternity-related psychological traits, and neural response to infant-interaction videos using fMRI in first-time fathers and childless men at three time points (early to mid-pregnancy, late pregnancy, and postnatal). We found that paternal-specific brain activity in prefrontal areas distinctly develops during middle-to-late pregnancy and is enhanced in the postnatal period. In addition, among fathers, the timing of the development of prefrontal brain activity was associated with specific parenting phenotypes.

Motor Imagery Training Is Beneficial for Motor Memory of Upper and Lower Limb Tasks in Very Old Adults

Human aging is associated with a decline in the capacity to memorize recently acquired motor skills. Motor imagery training is a beneficial method to compensate for this deterioration in old adults. It is not yet known whether these beneficial effects are maintained in very old adults (>80 years), who are more affected by the degeneration processes. The aim of this study was to evaluate the effectiveness of a mental training session of motor imagery on the memorization of new motor skills acquired through physical practice in very old adults. Thus, 30 very old adults performed 3 actual trials of a manual dexterity task (session 1) or a sequential footstep task (session 2) as fast as they could before and after a 20 min motor imagery training (mental-training group) or watching a documentary for 20 min (control group). Performance was improved after three actual trials for both tasks and both groups. For the control group, performance decreased in the manual dexterity task after the 20 min break and remained stable in the sequential footstep task. For the mental-training group, performance was maintained in the manual dexterity task after the 20 min motor imagery training and increased in the sequential footstep task. These results extended the benefits of motor imagery training to the very old population, showing that even a short motor imagery training session improved their performance and favored the motor memory process. These results confirmed that motor imagery training is an effective method to complement traditional rehabilitation protocols.

TMS over dorsolateral prefrontal cortex affects the timing of motor imagery but not overt action: Further support for the motor-cognitive model

The Motor-Cognitive model suggests a functional dissociation between motor imagery and overt action, in contrast to the Functional Equivalence view of common processes between the two behaviours. According to the Motor-Cognitive model, motor imagery differs from overt action primarily through the use of executive resources to monitor and elaborate a motor image during execution, which can result in a lack of correspondence between motor imagery and its overt action counterpart. The present study examined the importance of executive resources in motor imagery by using TMS to impair the function of the dorsolateral prefrontal cortex while measuring the time to complete imagined versus overt actions. In two experiments, TMS over the dorsolateral prefrontal cortex slowed motor imagery but did not affect overt actions. TMS over the same region also interfered with performance of a mental calculation task, though it did not reliably affect less demanding cognitive tasks also thought to rely on executive functions. Taken together, these results were consistent with the Motor-Cognitive model but not with the idea of functional equivalence. The implications of these results for the theoretical understanding of motor imagery, and potential applications of the Motor-Cognitive model to the use of motor imagery in training and rehabilitation, are discussed.

Motor imagery training to improve language processing: What are the arguments?

Studies showed that motor expertise was found to induce improvement in language processing. Grounded and situated approaches attributed this effect to an underlying automatic simulation of the motor experience elicited by action words, similar to motor imagery (MI), and suggest shared representations of action conceptualization. Interestingly, recent results also suggest that the mental simulation of action by MI training induces motor-system modifications and improves motor performance. Consequently, we hypothesize that, since MI training can induce motor-system modifications, it could be used to reinforce the functional connections between motor and language system, and could thus lead to improved language performance. Here, we explore these potential interactions by reviewing recent fundamental and clinical literature in the action-language and MI domains. We suggested that exploiting the link between action language and MI could open new avenues for complementary language improvement programs. We summarize the current literature to evaluate the rationale behind this novel training and to explore the mechanisms underlying MI and its impact on language performance.

A study of action difference on motor imagery based on delayed matching posture task

Objective. Motor imagery (MI)-based brain-computer interfaces (BCIs) provide an additional control pathway for people by decoding the intention of action imagination. The way people imagine greatly affects MI-BCI performance. Action itself is one of the factors that influence the way people imagine. Whether the different actions cause a difference in the MI performance is unknown. What is more important is how to manifest this action difference in the process of imagery, which has the potential to guide people to use their individualized actions to imagine more effectively.Approach.To explore action differences, this study proposes a novel paradigm named as action observation based delayed matching posture task. Ten subjects are required to observe, memorize, match, and imagine three types of actions (cutting, grasping and writing) given by visual images or videos, to accomplish the phases of encoding, retrieval and reinforcement of MI. Event-related potential (ERP), MI features, and classification accuracy of the left or the right hand are used to evaluate the effect of the action difference on the MI difference.Main results.Action differences cause different feature distributions, resulting in that the accuracy with high event-related (de)synchronization (ERD/ERS) is 27.75% higher than the ones with low ERD/ERS (p< 0.05), which indicates that the action difference has impact on the MI difference and the BCI performance. In addition, significant differences in the ERP amplitudes exists among the three actions: the amplitude of P300-N200 potential reaches 9.28μV of grasping, 5.64μV and 5.25μV higher than the cutting and the writing, respectively (p< 0.05).Significance.The ERP amplitudes derived from the supplementary motor area shows positive correlation to the MI classification accuracy, implying that the ERP might be an index of the MI performance when the people is faced with action selection. This study demonstrates that the MI difference is related to the action difference, and can be manifested by the ERP, which is important for improving MI training by selecting suitable action; the relationship between the ERP and the MI provides a novel index to find the suitable action to set up an individualized BCI and improve the performance further.

Relevance-based channel selection in motor imagery brain-computer interface

Objective.Channel selection in the electroencephalogram (EEG)-based brain-computer interface (BCI) has been extensively studied for over two decades, with the goal being to select optimal subject-specific channels that can enhance the overall decoding efficacy of the BCI. With the emergence of deep learning (DL)-based BCI models, there arises a need for fresh perspectives and novel techniques to conduct channel selection. In this regard, subject-independent channel selection is relevant, since DL models trained using cross-subject data offer superior performance, and the impact of inherent inter-subject variability of EEG characteristics on subject-independent DL training is not yet fully understood.Approach.Here, we propose a novel methodology for implementing subject-independent channel selection in DL-based motor imagery (MI)-BCI, using layer-wise relevance propagation (LRP) and neural network pruning. Experiments were conducted using Deep ConvNet and 62-channel MI data from the Korea University EEG dataset.Main Results.Using our proposed methodology, we achieved a 61% reduction in the number of channels without any significant drop (p = 0.09) in subject-independent classification accuracy, due to the selection of highly relevant channels by LRP. LRP relevance-based channel selections provide significantly better accuracies compared to conventional weight-based selections while using less than 40% of the total number of channels, with differences in accuracies ranging from 5.96% to 1.72%. The performance of the adapted sparse-LRP model using only 16% of the total number of channels is similar to that of the adapted baseline model (p = 0.13). Furthermore, the accuracy of the adapted sparse-LRP model using only 35% of the total number of channels exceeded that of the adapted baseline model by 0.53% (p = 0.81). Analyses of channels chosen by LRP confirm the neurophysiological plausibility of selection, and emphasize the influence of motor, parietal, and occipital channels in MI-EEG classification.Significance.The proposed method addresses a traditional issue in EEG-BCI decoding, while being relevant and applicable to the latest developments in the field of BCI. We believe that our work brings forth an interesting and important application of model interpretability as a problem-solving technique.

Learning motor actions via imagery-perceptual or motor learning?

It is well accepted that repeatedly imagining oneself acting without any overt behavior can lead to learning. The prominent theory accounting for why imagery practice is effective, motor simulation theory, posits that imagined action and overt action are functionally equivalent, the exception being activation of the end effector. If, as motor simulation theory states, one can compile the goal, plan, motor program and outcome of an action during imagined action similar to overt action, then learning of novel skills via imagery should proceed in a manner equivalent to that of overt action. While the evidence on motor simulation theory is both plentiful and diverse, it does not explicitly account for differences in neural and behavioural findings between imagined and overt action. In this position paper, we briefly review theoretical accounts to date and present a perceptual-cognitive theory that accounts for often observed outcomes of imagery practice. We suggest that learning by way of imagery reflects perceptual-cognitive scaffolding, and that this 'perceptual' learning transfers into 'motor' learning (or not) depending on various factors. Based on this theory, we characterize consistently reported learning effects that occur with imagery practice, against the background of well-known physical practice effects and show that perceptual-cognitive scaffolding is well-suited to explain what is being learnt during imagery practice.

Is cognitive control of perception and action via attentional focus moderated by motor imagery?

Motor imagery (MI) has emerged as an individual factor that may modulate the effects of attentional focus on motor skill performance. In this study, we investigated whether global MI, as well as its components (i.e., kinesthetic MI, internal visual MI, and external visual MI) moderate the effect of attentional focus on performance in a group of ninety-two young adult novice air-pistol shooters (age: M = 21.87, SD = 2.54). After completing the movement imagery questionnaire-3 (MIQ-3), participants were asked to complete a pistol shooting experiment in three different attentional focus conditions: (1) No focus instruction condition (control condition with no verbal instruction) (2) an internal focus instruction condition, and (3) an external focus condition. Shot accuracy, performance time, and aiming trace speed (i.e., stability of hold or weapon stability) were measured as the performance variables. Results revealed that shot accuracy was significantly poorer during internal relative to control focus condition. In addition, performance time was significantly higher during external relative to both control and internal condition. However, neither global MI, nor its subscales, moderated the effects of attentional focus on performance. This study supports the importance of attentional focus for perceptual and motor performance, yet global MI and its modalities/perspectives did not moderate pistol shooting performance. This study suggests that perception and action are cognitively controlled by attentional mechanisms, but not motor imagery. Future research with complementary assessment modalities is warranted to extend the present findings.

Engaging distributed cortical and cerebellar networks through motor execution, observation, and imagery

When we interact with the environment around us, we are sometimes active participants, making directed physical motor movements and other times only mentally engaging with our environment, taking in sensory information and internally planning our next move without directed physical movement. Traditionally, cortical motor regions and key subcortical structures such as the cerebellum have been tightly linked to motor initiation, coordination, and directed motor behavior. However, recent neuroimaging studies have noted the activation of the cerebellum and wider cortical networks specifically during various forms of motor processing, including the observations of actions and mental rehearsal of movements through motor imagery. This phenomenon of cognitive engagement of traditional motor networks raises the question of how these brain regions are involved in the initiation of movement without physical motor output. Here, we will review evidence for distributed brain network activation during motor execution, observation, and imagery in human neuroimaging studies as well as the potential for cerebellar involvement specifically in motor-related cognition. Converging evidence suggests that a common global brain network is involved in both movement execution and motor observation or imagery, with specific task-dependent shifts in these global activation patterns. We will further discuss underlying cross-species anatomical support for these cognitive motor-related functions as well as the role of cerebrocerebellar communication during action observation and motor imagery.

Quadriceps Weakness is Associated with Neuroplastic Changes Within Specific Corticospinal Pathways and Brain Areas After Anterior Cruciate Ligament Reconstruction: Theoretical Utility of Motor Imagery-Based Brain-Computer Interface Technology for Rehabilitation

Persistent quadriceps weakness is a problematic sequela of anterior cruciate ligament reconstruction (ACLR). The purposes of this review are to summarize neuroplastic changes after ACL reconstruction; provide an overview of a promising interventions, motor imagery (MI), and its utility in muscle activation; and propose a framework using a brain-computer interface (BCI) to augment quadriceps activation. A literature review of neuroplastic changes, MI training, and BCI-MI technology in postoperative neuromuscular rehabilitation was conducted in PubMed, Embase, and Scopus. Combinations of the following search terms were used to identify articles: "quadriceps muscle," "neurofeedback," "biofeedback," "muscle activation," "motor learning," "anterior cruciate ligament," and "cortical plasticity." We found that ACLR disrupts sensory input from the quadriceps, which results in reduced sensitivity to electrochemical neuronal signals, an increase in central inhibition of neurons regulating quadriceps control and dampening of reflexive motor activity. MI training consists of visualizing an action, without physically engaging in muscle activity. Imagined motor output during MI training increases the sensitivity and conductivity of corticospinal tracts emerging from the primary motor cortex, which helps "exercise" the connections between the brain and target muscle tissues. Motor rehabilitation studies using BCI-MI technology have demonstrated increased excitability of the motor cortex, corticospinal tract, spinal motor neurons, and disinhibition of inhibitory interneurons. This technology has been validated and successfully applied in the recovery of atrophied neuromuscular pathways in stroke patients but has yet to be investigated in peripheral neuromuscular insults, such as ACL injury and reconstruction. Well-designed clinical studies may assess the impact of BCI on clinical outcomes and recovery time. Quadriceps weakness is associated with neuroplastic changes within specific corticospinal pathways and brain areas. BCI-MI shows strong potential for facilitating recovery of atrophied neuromuscular pathways after ACLR and may offer an innovative, multidisciplinary approach to orthopaedic care.

Level of Evidence

V, expert opinion.

Imagining the way forward: A review of contemporary motor imagery theory

Over the past few decades, researchers have become interested in the mechanisms behind motor imagery (i.e., the mental rehearsal of action). During this time several theories of motor imagery have been proposed, offering diverging accounts of the processes responsible for motor imagery and its neural overlap with movement. In this review, we summarize the core claims of five contemporary theories of motor imagery: motor simulation theory, motor emulation theory, the motor-cognitive model, the perceptual-cognitive model, and the effects imagery model. Afterwards, we identify the key testable differences between them as well as their various points of overlap. Finally, we discuss potential future directions for theories of motor imagery.

Consistent under-reporting of task details in motor imagery research

Motor Imagery is a subject of longstanding scientific interest. However, critical details of motor imagery protocols are not always reported in full, hampering direct replication and translation of this work. The present review provides a quantitative assessment of the prevalence of under-reporting in the recent motor imagery literature. Publications from the years 2018-2020 were examined, with 695 meeting the inclusion criteria for further examination. Of these studies, 64% (445/695) did not provide information about the modality of motor imagery (i.e., kinesthetic, visual, or a mixture of both) used in the study. When visual or mixed imagery was specified, the details of the visual perspective to be used (i.e., first person, third person, or combinations of both) were not reported in 24% (25/103) of studies. Further analysis indicated that studies using questionnaires to assess motor imagery reported more information than those that did not. We conclude that studies using motor imagery consistently under-report key details of their protocols, which poses a significant problem for understanding, replicating, and translating motor imagery effects.

The multisensory nature of human action imagery

Imagination can appeal to all our senses and may, therefore, manifest in very different qualities (e.g., visual, tactile, proprioceptive, or kinesthetic). One line of research addresses action imagery that refers to a process by which people imagine the execution of an action without actual body movements. In action imagery, visual and kinesthetic aspects of the imagined action are particularly important. However, other sensory modalities may also play a role. The purpose of the paper will be to address issues that include: (i) the creation of an action image, (ii) how the brain generates images of movements and actions, (iii) the richness and vividness of action images. We will further address possible causes that determine the sensory impression of an action image, like task specificity, instruction and experience. In the end, we will outline open questions and future directions.

Repetitive Peripheral Magnetic Stimulation Combined with Motor Imagery Changes Resting-State EEG Activity: A Randomized Controlled Trial

Repetitive peripheral magnetic stimulation is a novel non-invasive technique for applying repetitive magnetic stimulation to the peripheral nerves and muscles. Contrarily, a person imagines that he/she is exercising during motor imagery. Resting-state electroencephalography can evaluate the ability of motor imagery; however, the effects of motor imagery and repetitive peripheral magnetic stimulation on resting-state electroencephalography are unknown. We examined the effects of motor imagery and repetitive peripheral magnetic stimulation on the vividness of motor imagery and resting-state electroencephalography. The participants were divided into a motor imagery group and motor imagery and repetitive peripheral magnetic stimulation group. They performed 60 motor imagery tasks involving wrist dorsiflexion movement. In the motor imagery and repetitive peripheral magnetic stimulation group, we applied repetitive peripheral magnetic stimulation to the extensor carpi radialis longus muscle during motor imagery. We measured the vividness of motor imagery and resting-state electroencephalography before and after the task. Both groups displayed a significant increase in the vividness of motor imagery. The motor imagery and repetitive peripheral magnetic stimulation group exhibited increased β activity in the anterior cingulate cortex by source localization for electroencephalography. Hence, combined motor imagery and repetitive peripheral magnetic stimulation changes the resting-state electroencephalography activity and may promote motor imagery.

Motor imagery training of goal-directed reaching in relation to imagery of reaching and grasping in healthy people

The study aimed to determine whether four weeks of motor imagery training (MIT) of goal-directed reaching (reaching to grasp task) would affect the cortical activity during motor imagery of reaching (MIR) and grasping (MIG) in the same way. We examined cortical activity regarding event-related potentials (ERPs) in healthy young participants. Our study also evaluated the subjective vividness of the imagery. Furthermore, we aimed to determine the relationship between the subjective assessment of motor imagery (MI) ability to reach and grasp and the cortical activity during those tasks before and after training to understand the underlying neuroplasticity mechanisms. Twenty-seven volunteers participated in MIT of goal-directed reaching and two measurement sessions before and after MIT. During the sessions 128-channel electroencephalography (EEG) was recorded during MIR and MIG. Also, participants assessed the vividness of the MI tasks using a visual analog scale (VAS). The vividness of imagination improved significantly (P < .05) after MIT. A repeated measures ANOVA showed that the task (MIR/MIG) and the location of electrodes had a significant effect on the ERP's amplitude (P < .05). The interaction between the task, location, and session (before/after MIT) also had a significant effect on the ERP's amplitude (P < .05). Finally, the location of electrodes and the interaction between location and session had a significant effect on the ERP's latency (P < .05). We found that MIT influenced the EEG signal associated with reaching differently than grasping. The effect was more pronounced for MIR than for MIG. Correlation analysis showed that changes in the assessed parameters due to MIT reduced the relationship between the subjective evaluation of imagining and the EEG signal. This finding means that the subjective evaluation of imagining cannot be a simple, functional insight into the bioelectrical activity of the cerebral cortex expressed by the ERPs in mental training. The changes we noted in ERPs after MIT may benefit the use of non-invasive EEG in the brain-computer interface (BCI) context.Trial registration: NCT04048083.

Reliability and validity of the Japanese movement imagery questionnaire-revised second version

Objective

Developing a Japanese version of the Movement Imagery Questionnaire-Revised Second Version (MIQ-RS) is essential for widespread evaluation and treatment based on motor imagery in physically disabled persons and patients in rehabilitation. This study aimed to investigate the reliability and validity of the Movement Imagery Questionnaire-Revised Second Version (MIQ-RS), which assesses motor imagery ability, by translating it into Japanese.

Results

This study enrolled twenty healthy participants (10 men and 10 women, mean age 21.17 ± 1.10 years). Reliability was examined for internal consistency using Cronbach’s alpha coefficient. Spearman’s rank correlation coefficient was used to examine the criterion-related validity of the MIQ-RS and the Kinesthetic and Visual Imagery Questionnaire (KVIQ-20). Results showed that Cronbach’s alpha coefficients for the MIQ-RS were 0.81 and 0.82 for visual and kinesthetic imagery, respectively. Significant positive correlations were found between each visual and kinesthetic imagery score, and each total on the MIQ-RS and KVIQ-20 scores (r = 0.73, p < 0.01; r = 0.84, p < 0.01; r = 0.80, p < 0.01, respectively). This study suggests that the Japanese version of the MIQ-RS is a reliable and valid method of assessing motor imagery ability.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13104-022-06220-y.