Solving a mental rotation task in congenital hemiparesis: motor imagery versus visual imagery

Motor imagery for paediatric neurorehabilitation: how much do we know? Perspectives from a systematic review

Background

Motor Imagery (MI) is a cognitive process consisting in mental simulation of body movements without executing physical actions: its clinical use has been investigated prevalently in adults with neurological disorders.

Objectives

Review of the best-available evidence on the use and efficacy of MI interventions for neurorehabilitation purposes in common and rare childhood neurological disorders.

Methods

systematic literature search conducted according to PRISMA by using the Scopus, PsycArticles, Cinahl, PUBMED, Web of Science (Clarivate), EMBASE, PsychINFO, and COCHRANE databases, with levels of evidence scored by OCEBM and PEDro Scales.

Results

Twenty-two original studies were retrieved and included for the analysis; MI was the unique or complementary rehabilitative treatment in 476 individuals (aged 5 to 18 years) with 10 different neurological conditions including, cerebral palsies, stroke, coordination disorders, intellectual disabilities, brain and/or spinal cord injuries, autism, pain syndromes, and hyperactivity. The sample size ranged from single case reports to cohorts and control groups. Treatment lasted 2 days to 6 months with 1 to 24 sessions. MI tasks were conventional, graded or ad-hoc. MI measurement tools included movement assessment batteries, mental chronometry tests, scales, and questionnaires, EEG, and EMG. Overall, the use of MI was stated as effective in 19/22, and uncertain in the remnant studies.

Conclusion

MI could be a reliable supportive/add-on (home-based) rehabilitative tool for pediatric neurorehabilitation; its clinical use, in children, is highly dependent on the complexity of MI mechanisms, which are related to the underlying neurodevelopmental disorder.

Low frequency oscillations during hand laterality judgment task with and without personal perspectives: a preliminary study

Sense of personal perspective is crucial for understanding in attentional mechanisms of the perception in "self" or "other's" body. In a hand laterality judgment (HLJ) task, perception of perspective can be assessed by arranging angular orientations and depths of images. A total of 11 healthy, right-handed participants (8 females, mean age: 38.36 years, education: 14 years) were included in the study. The purpose of this study was to investigate behavioural and cortical responses in low-frequency cortical rhythms during a HLJ task. A total of 80-visual hand stimuli were presented through the experiment. Hand visuals were categorized in the way of side (right vs. left) and perspective (1st vs. 3rd personal perspective). Both behavioural outcomes and brain oscillatory characteristics (i.e., frequency and amplitude) of the Electroencephalography were analysed. All reaction time and incorrect answers for 3rd person perspective were higher than the ones for 1st person perspective. Location effect was statistically significant in event-related theta responses confirming the dominant activity of theta frequency in spatial memory tasks on parietal and occipital areas. In addition, we found there were increasing in delta power and phase in hand visuals with 1st person perspective and increasing theta phase in hand visuals with 3rd person perspective (p < 0.05). Accordingly, a clear dissociation in the perception of perspectives in low-frequency bands was revealed. These different cortical strategy in the perception of hand visual with and without perspectives may be interpreted as delta activity may be related in self-body perception, whereas theta activity may be related in allocentric perception.

Representational Processes of Actions Toward and Away from the Body

The aim of the present study was to investigate the role of mental representation processes during the planning, reaching, and use phases of actions with tools commonly used toward the body (TB, e.g., toothbrush) or away from the body (AB, e.g., pencil). In the first session, healthy participants were asked to perform TB (i.e., making circular movements with the toothbrush near the mouth) and AB (i.e., making circular movements with the pencil near the desk) actions both with (i.e., actual use) and without the tool in hand (i.e., the pantomime of tool use). In the second session, the same participants performed a series of mental rotation tasks involving body- (i.e., face and hands) and object-related (i.e., abstract lines) stimuli. The temporal and kinematic analysis of the motor actions showed that the time required to start the pantomimes (i.e., the planning phase) was shorter for the AB action than for the TB action. In contrast, the reaching phase lasted longer for the AB action than for the TB action. Furthermore, the TB pantomime was associated with the performance in the mental rotation of body-related stimuli, especially during the planning and reaching phases, whereas the AB pantomime was more related to the performance in the mental rotation of object-related stimuli, especially during the tool use phase. Thus, the results revealed that the direction of a goal-directed motor action influences the dynamics of the different phases of the motor action and can determine the type of mental images involved in the planning and execution of the action.

From Hemispheric Asymmetry through Sensorimotor Experiences to Cognitive Outcomes in Children with Cerebral Palsy

Recent neuroimaging studies allowed us to explore abnormal brain structures and interhemispheric connectivity in children with cerebral palsy (CP). Behavioral researchers have long reported that children with CP exhibit suboptimal performance in different cognitive domains (e.g., receptive and expressive language skills, reading, mental imagery, spatial processing, subitizing, math, and executive functions). However, there has been very limited cross-domain research involving these two areas of scientific inquiry. To stimulate such research, this perspective paper proposes some possible neurological mechanisms involved in the cognitive delays and impairments in children with CP. Additionally, the paper examines the ways motor and sensorimotor experience during the development of these neural substrates could enable more optimal development for children with CP. Understanding these developmental mechanisms could guide more effective interventions to promote the development of both sensorimotor and cognitive skills in children with CP.

Motor imagery in congenital hemiplegia: Impairments are not universal

BACKGROUND

Motor imagery (MI) training may benefit children with congenital hemiplegia, but reports on MI ability are mixed. This study considered individual patterns of performance to better understand MI ability in children with hemiplegia.

METHOD

Twenty children with hemiplegia (7-13 years; 10 with right hemiplegia), completed a MI task, IQ estimate and functional tests. Children with hemiplegia scoring above chance on the MI task were compared to a group of age-matched peers. The performance patterns of those scoring below chance were considered individually.

RESULTS

Three children with right hemiplegia were excluded due to low IQ. Seven of 10 children with left hemiplegia and three of seven with right hemiplegia performed MI at an equivalent level to peers without hemiplegia. The seven children with hemiplegia who scored significantly below chance scored lower on functional tests, but differences here failed to reach an adjusted significance level. Four of the seven appeared engaged in MI, but performed very poorly. The remaining three had unique performance patterns explored in more detail.

CONCLUSION

Motor imagery deficits are not universally observed in children with congenital hemiplegia and individual performance should be examined before completing group analyses. Recommendations for exclusions and reporting in future studies are made.

Towards Strong Inference in Research on Embodiment - Possibilities and Limitations of Causal Paradigms

A central question in the cognitive sciences is which role embodiment plays for high-level cognitive functions, such as conceptual processing. Here, we propose that one reason why progress regarding this question has been slow is a lacking focus on what Platt (1964) called “strong inference”. Strong inference is possible when results from an experimental paradigm are not merely consistent with a hypothesis, but they provide decisive evidence for one particular hypothesis compared to competing hypotheses. We discuss how causal paradigms, which test the functional relevance of sensory-motor processes for high-level cognitive functions, can move the field forward. In particular, we explore how congenital sensory-motor disorders, acquired sensory-motor deficits, and interference paradigms with healthy participants can be utilized as an opportunity to better understand the role of sensory experience in conceptual processing. Whereas all three approaches can bring about valuable insights, we highlight that the study of congenitally and acquired sensorimotor disorders is particularly effective in the case of conceptual domains with strong unimodal basis (e.g., colors), whereas interference paradigms with healthy participants have a broader application, avoid many of the practical and interpretational limitations of patient studies, and allow a systematic and step-wise progressive inference approach to causal mechanisms.

Visual Hand Recognition in Hand Laterality and Self-Other Discrimination Tasks: Relationships to Autistic Traits and Positive Body Image

In a study concerning visual body part recognition, a "self-advantage" effect, whereby self-related body stimuli are processed faster and more accurately than other-related body stimuli, was revealed, and the emergence of this effect is assumed to be tightly linked to implicit motor simulation, which is activated when performing a hand laterality judgment task in which hand ownership is not explicitly required. Here, we ran two visual hand recognition tasks, namely, a hand laterality judgment task and a self-other discrimination task, to investigate (i) whether the self-advantage emerged even if implicit motor imagery was assumed to be working less efficiently and (ii) how individual traits [such as autistic traits and the extent of positive self-body image, as assessed via the Autism Spectrum Quotient (AQ) and the Body Appreciation Scale-2 (BAS-2), respectively] modulate performance in these hand recognition tasks. Participants were presented with hand images in two orientations [i.e., upright (egocentric) and upside-down (allocentric)] and asked to judge whether it was a left or right hand (an implicit hand laterality judgment task). They were also asked to determine whether it was their own, or another person's hand (an explicit self-other discrimination task). Data collected from men and women were analyzed separately. The self-advantage effect in the hand laterality judgment task was not revealed, suggesting that only two orientation conditions are not enough to trigger this motor simulation. Furthermore, the men's group showed a significant positive correlation between AQ scores and reaction times (RTs) in the laterality judgment task, while the women's group showed a significant negative correlation between AQ scores and differences in RTs and a significant positive correlation between BAS-2 scores and dprime in the self-other discrimination task. These results suggest that men and women differentially adopt specific strategies and/or execution processes for implicit and explicit hand recognition tasks.

Motor imagery in children with unilateral cerebral palsy: a case-control study

AIM

To evaluate whether children with cerebral palsy (CP) are able to engage in a motor imagery task. Possible associations between motor imagery and functional performance, working memory, age, and intelligence were also investigated.

METHOD

This is a case-control study that assessed 57 children (25 females, 32 males) with unilateral CP, aged 6 to 14 years (mean age: 10y 4mo; SD 2y 8mo) and 175 typically developing (control) children, aged 6 to 13 years (87 females, 88 males; mean age: 9y 4mo; SD 1y 11mo). The hand laterality judgment task was used to measure motor imagery ability. Reaction time, accuracy, and the effect of the biomechanical constraints were assessed in this task.

RESULTS

Performance in both groups followed the biomechanical constraints of the task, that is, longer reaction times to recognize stimuli rotated laterally when compared to medial stimuli. Reaction time means did not differ significantly between groups (p>0.05). Significant differences between the unilateral CP and control groups were observed for accuracy (p<0.05). Functional performance and working memory were correlates of motor imagery tasks.

INTERPRETATION

Results suggest that children with unilateral CP can engage in motor imagery; however, they commit more errors than typically developing controls. In addition, their performance in tasks of motor imagery is influenced by functional performance and working memory.

Body Representations in Children with Cerebral Palsy

We constantly process top-down and bottom-up inputs concerning our own body that interact to form body representations (BR). Even if some evidence showed BR deficits in children with cerebral palsy, a systematic study that evaluates different kinds of BR in these children, taking into account the possible presence of a general deficit affecting non-body mental representations, is currently lacking. Here we aimed at investigating BR (i.e., Body Semantics, Body Structural Representation and Body Schema) in children with cerebral palsy (CP) taking into account performance in tasks involving body stimuli and performance in tasks involving non-body stimuli. Thirty-three CP (age range: 5-12 years) were compared with a group of 103 typically-developing children (TDC), matched for age and sex. 63.64% of children with CP showed a very poor performance in body representation processing. Present data also show alterations in different body representations in CP in specific developmental stages. In particular, CP and TDC performances did not differ between 5 to 7 years old, whereas CP between 8 and 12 years old showed deficits in the Body Structural Representation and Body Schema but not in Body Semantics. These findings revealed the importance of taking into account the overall development of cognitive domains when investigating specific stimuli processing in children who do not present a typical development and were discussed in terms of their clinical implications.

The vividness of imagining emotional feelings in positive situations is attenuated in non-clinical dysphoria and predicts the experience of positive emotional feelings

OBJECTIVE

The vividness of imagining emotional feelings in positive situations (EFP) in non-clinically dysphoric and non-dysphoric individuals and its relation to dysphoric and positive feelings was examined.

METHOD

Participants were university students in Study 1 (N = 106, 84 women; 18-45 years), in Study 2 (N = 43, 39 women; 20-47 years), in Study 3 (N = 109, 92 women; 18-50 years) who filled out a set of questionnaires assessing depressive symptoms, cognition measures, and then completed an affective imagery task, using a cross-sectional design.

RESULTS

Non-clinically dysphoric participants imagined less vividly EFP than non-dysphoric participants. The vividness of imagining EFP accounted for group differences in positive feelings beyond positive and negative cognition and negative mood.

CONCLUSIONS

In addition to deficits in the general imagery of positive events, the attenuation of vividness of EFP in non-clinical dysphoric individuals warrants attention as a separate pathway by which non-clinically dysphoric individuals develop deficiencies of conscious positive feelings.

Examining Developmental Changes in Children's Motor Imagery: A Longitudinal Study

Using a longitudinal design, the present study examined developmental changes in the employment of (motor) imagery strategies on the hand laterality judgment (HLJ) task in children. All children (N = 23) participated three times, at ages of 5, 6, and 7 years. Error percentages and response durations were compared to a priori defined sinusoid models, representing different strategies to judge hand laterality. Response durations of correct and incorrect trials were included. Observed data showed that task performance was affected by motor constraints, both in children who performed accurately at 5 years of age and in the children who did not. This is the first study to show that 5-year-olds—even when not successful at the task—employ motor imagery when engaged in this task. Importantly, although the children became faster and more accurate with age, no developmental changes in the employed motor imagery strategy were observed at ages of 5, 6, and 7 years. We found that 5-year-old children are able to use a motor imagery strategy to perform the HL J task. Although performance on this task improved with age, our analyses showed that the employed strategy to solve this task remained invariant across age.

(Lack of) Corticospinal facilitation in association with hand laterality judgments

In recent years, mental practice strategies have drawn much interest in the field of rehabilitation. One form of mental practice particularly advocated involves judging the laterality of images depicting body parts. Such laterality judgments are thought to rely on implicit motor imagery via mental rotation of one own's limb. In this study, we sought to further characterize the involvement of the primary motor cortex (M1) in hand laterality judgments (HLJ) as performed in the context of an application designed for rehabilitation. To this end, we measured variations in corticospinal excitability in both hemispheres with motor evoked potentials (MEPs) while participants (n = 18, young adults) performed either HLJ or a mental counting task. A third condition (foot observation) provided additional control. We hypothesized that HLJ would lead to a selective MEP facilitation when compared to the other tasks and that this facilitation would be greater on the right than the left hemisphere. Contrary to our predictions, we found no evidence of task effects and hemispheric effects for the HLJ task. Significant task-related MEP facilitation was detected only for the mental counting task. A secondary experiment performed in a subset of participants (n = 6) to further test modulation during HLJ yielded the same results. We interpret the lack of facilitation with HLJ in the light of evidence that participants may rely on alternative strategies when asked to judge laterality when viewing depictions of body parts. The use of visual strategies notably would reduce the need to engage in mental rotation, thus reducing M1 involvement. These results have implications for applications of laterality tasks in the context of the rehabilitation program.

Differential neural encoding of sensorimotor and visual body representations

Sensorimotor processing specifically impacts mental body representations. In particular, deteriorated somatosensory input (as after complete spinal cord injury) increases the relative weight of visual aspects of body parts’ representations, leading to aberrancies in how images of body parts are mentally manipulated (e.g. mental rotation). This suggests that a sensorimotor or visual reference frame, respectively, can be relatively dominant in local (hands) versus global (full-body) bodily representations. On this basis, we hypothesized that the recruitment of a specific reference frame could be reflected in the activation of sensorimotor versus visual brain networks. To this aim, we directly compared the brain activity associated with mental rotation of hands versus full-bodies. Mental rotation of hands recruited more strongly the supplementary motor area, premotor cortex, and secondary somatosensory cortex. Conversely, mental rotation of full-bodies determined stronger activity in temporo-occipital regions, including the functionally-localized extrastriate body area. These results support that (1) sensorimotor and visual frames of reference are used to represent the body, (2) two distinct brain networks encode local or global bodily representations, and (3) the extrastriate body area is a multimodal region involved in body processing both at the perceptual and representational level.

Imagery perspective among young athletes: Differentiation between external and internal visual imagery

PURPOSE

This study aimed to investigate the construct of external visual imagery (EVI) vs. internal visual imagery (IVI) by comparing the athletes' imagery ability with their levels of skill and types of sports.

METHODS

Seventy-two young athletes in open (n = 45) or closed (n = 27) sports and with different skill levels completed 2 custom-designed tasks. The EVI task involved the subject generating and visualizing the rotated images of different body parts, whereas the IVI task involved the subject visualizing himself or herself performing specific movements.

RESULTS

The significant Skill-Level × Sport Type interactions for the EVI task revealed that participants who specialized in open sports and had higher skill-levels had a higher accuracy rate as compared to the other subgroups. For the IVI task, the differences between the groups were less clear: those with higher skill-levels or open sports had a higher accuracy rate than those with lower skill-levels or closed sports.

CONCLUSION

EVI involves the visualization of others and the environment, and would be relevant to higher skill-level athletes who engage in open sports. IVI, in contrast, tends to be more self-oriented and would be relevant for utilization by higher skill-level athletes regardless of sport type.

Children with unilateral cerebral palsy show diminished implicit motor imagery with the affected hand

AIM

Motor imagery refers to the mental simulation of a motor action without producing an overt movement. Implicit motor imagery can be regarded as a first-person kinesthetic perceptual judgement, and addresses the capacity to engage into the manipulation of one's body schema. In this study, we examined whether children with unilateral cerebral palsy (CP) are able to engage in implicit motor imagery.

METHOD

A modified version of the hand laterality judgment task was employed. Erroneous responses, reaction times, and event-related potentials from the electroencephalograph were analysed.

RESULTS

In 13 children with typical development (mean age 10y 7mo, SD 1y 2mo; seven male, six female), we observed the classic rotation direction effect. Specifically, when comparing outward rotated with inward rotated hand pictures, decreased accuracy and increased response times were observed. Event-related potentials analyses of the electroencephalogram revealed a more marked N1 and an enhanced rotation-related negativity.

INTERPRETATION

These findings suggest that an implicit motor imagery strategy was used to solve the task. However, in 10 children with unilateral CP (mean age 10y 7mo, SD 2y 5mo; five male, five female), these effects were observed only when the less-affected hand was involved. This observation suggests that children with CP could benefit from visual training strategies.

Rapid On-Line Control to Reaching Is Preserved in Children With Congenital Spastic Hemiplegia: Evidence From Double-Step Reaching Performance

This study aimed to investigate the integrity of on-line control of reaching in congenital spastic hemiplegia in light of disparate evidence. Twelve children with and without spastic hemiplegia (11-17 years old) completed a double-step reaching task requiring them to reach and touch a target that remained stationary for most trials (viz nonjump trial) but unexpectedly displaced laterally at movement onset for a minority of trials (20%: known as jump trials). Although children with spastic hemiplegia were generally slower than age-matched controls, they could account for target perturbation at age-appropriate levels shown by a lack of interaction effect on movement time and nonsignificant group difference for time to reach trajectory correction on jump trials. Our data suggest that at a group level, on-line control of reaching may be age-appropriate in spastic hemiplegia. However, our data also highlight the need to experimentally acknowledge the considerable heterogeneity of the spastic hemiplegia population when investigating motor cognition.

Predictive models to determine imagery strategies employed by children to judge hand laterality

A commonly used paradigm to study motor imagery is the hand laterality judgment task. The present study aimed to determine which strategies young children employ to successfully perform this task. Children of 5 to 8 years old (N = 92) judged laterality of back and palm view hand pictures in different rotation angles. Response accuracy and response duration were registered. Response durations of the trials with a correct judgment were fitted to a-priori defined predictive sinusoid models, representing different strategies to successfully perform the hand laterality judgment task. The first model predicted systematic changes in response duration as a function of rotation angle of the displayed hand. The second model predicted that response durations are affected by biomechanical constraints of hand rotation. If observed data could be best described by the first model, this would argue for a mental imagery strategy that does not involve motor processes to solve the task. The second model reflects a motor imagery strategy to solve the task. In line with previous research, we showed an age-related increase in response accuracy and decrease in response duration in children. Observed data for both back and palm view showed that motor imagery strategies were used to perform hand laterality judgments, but that not all the children use these strategies (appropriately) at all times. A direct comparison of response duration patterns across age sheds new light on age-related differences in the strategies employed to solve the task. Importantly, the employment of the motor imagery strategy for successful task performance did not change with age.

Motor imagery for walking: a comparison between cerebral palsy adolescents with hemiplegia and diplegia

The goal of the study was to investigate whether motor imagery (MI) could be observed in cerebral palsy (CP) participants presenting a bilateral affected body side (diplegia) as it has been previously revealed in participants presenting a unilateral body affected sided (hemiplegia). MI capacity for walking was investigated in CP adolescents diagnosed with hemiplegia (n=10) or diplegia (n=10) and in adolescents with typical motor development (n=10). Participants were explicitly asked to imagine walking before and after actually walking toward a target located at 4 m and 8 m. Movement durations for executed and imagined trials were recorded. ANOVA and Pearson's correlation analyses revealed the existence of time invariance between executed and imagined movement durations for the control group and both groups of CP participants. However, results revealed that MI capacity in CP participants was observed for the short distance (4 m) but not for the long distance (8 m). Moreover, even for short distance, CP participants performed worse than typical adolescents. These results are discussed inline of recent researches suggesting that MI in CP participants may not depend on the side of the lesion.

Implementation of specific motor expertise during a mental rotation task of hands

Mental rotation of the hands classically induces kinesthetic effects according to the direction of the rotation, with faster response times to the hands' medial rotations compared with lateral rotations, and is thus commonly used to induce engagement in motor imagery (MI). In the present study, we compared the performances of table tennis players (experts on hand movements), who commonly execute and observe fast hand movements, to those of soccer players (non-experts on hand movements) on a mental rotation task of hands. Our results showed a significant effect of the direction of rotation (DOR) confirming the engagement of the participants in MI. In addition, only hand movement experts were faster when the task figures corresponded to their dominant hand compared with the non-dominant hand, revealing a selective effect of motor expertise. Interestingly, the effect of the DOR collapsed in hand movement experts only when the task figures corresponded to their dominant hand, but it is noteworthy that lateral and medial rotations of the right-hand stimuli were not faster than medial rotations of the left-hand stimuli. These results are discussed in relation to possible strategies during the task. Overall, the present study highlights the embodied nature of the mental rotation task of hands by revealing selective effects of motor expertise.

Effect of motor imagery in children with unilateral cerebral palsy: fMRI study

Background

Motor imagery is considered as a promising therapeutic tool for rehabilitation of motor planning problems in patients with cerebral palsy. However motor planning problems may lead to poor motor imagery ability.

Aim

The aim of this functional magnetic resonance imaging study was to examine and compare brain activation following motor imagery tasks in patients with hemiplegic cerebral palsy with left or right early brain lesions. We tested also the influence of the side of imagined hand movement.

Method

Twenty patients with clinical hemiplegic cerebral palsy (sixteen males, mean age 12 years and 10 months, aged 6 years 10 months to 20 years 10 months) participated in this study. Using block design, brain activations following motor imagery of a simple opening-closing hand movement performed by either the paretic or nonparetic hand was examined.

Results

During motor imagery tasks, patients with early right brain damages activated bilateral fronto-parietal network that comprise most of the nodes of the network well described in healthy subjects. Inversely, in patients with left early brain lesion brain activation following motor imagery tasks was reduced, compared to patients with right brain lesions. We found also a weak influence of the side of imagined hand movement.

Conclusion

Decreased activations following motor imagery in patients with right unilateral cerebral palsy highlight the dominance of the left hemisphere during motor imagery tasks. This study gives neuronal substrate to propose motor imagery tasks in unilateral cerebral palsy rehabilitation at least for patients with right brain lesions.

Immediate beneficial effects of mental rotation using foot stimuli on upright postural stability in healthy participants

The present study was designed to investigate whether an intervention during which participants were involved in mental rotation (MR) of a foot stimulus would have immediate beneficial effects on postural stability (Experiment 1) and to confirm whether it was the involvement of MR of the foot, rather than simply viewing foot stimuli, that could improve postural stability (Experiment 2). Two different groups of participants (n = 16 in each group) performed MR intervention of foot stimuli in each of the two experiments. Pre- and postmeasurements of postural stability during unipedal and bipedal standing were made using a force plate for the intervention. Consistently, postural sway values for unipedal standing, but not for bipedal standing, were decreased immediately after the MR intervention using the foot stimuli. Such beneficial effects were not observed after the MR intervention using car stimuli (Experiment 1) or when participants observed the same foot stimuli during a simple reaction task (Experiment 2). These findings suggest that the MR intervention using the foot stimuli could contribute to improving postural stability, at least when it was measured immediately after the intervention, under a challenging standing condition (i.e., unipedal standing).

Assessment of motor imagery in cerebral palsy via mental chronometry: the case of walking

Recent studies show varying results on whether motor imagery capacity is compromised in individuals with cerebral palsy (CP). Motor imagery studies in children predominantly used the implicit hand laterality task. In this task participants judge the laterality of displayed hand stimuli. A more explicit way of studying motor imagery is mental chronometry. This paradigm is based on the comparison between the movement durations of actually performing a task and imagining the same task. The current study explored motor imagery capacity in CP by means of mental chronometry of a whole body task. Movement durations of 20 individuals with CP (mean age=13 years, SD=3.6) were recorded in two conditions: actual walking and imagined walking. Six unique trajectories were used that varied in difficulty via manipulation of walking distance and path width. We found no main effect of condition (actual walking versus imagining) on movement durations. Difficulty of the walking trajectory did affect movement durations. In general, this was expressed by an increase in movement durations with increasing difficulty of the task. No interaction between task difficulty and movement condition was found. Our results show that task difficulty has similar effects on movement durations for both actual walking and imagined walking. These results exemplify that the tested individuals were able to use motor imagery in an explicit task involving walking. Previous studies using the implicit hand laterality task showed varying results on motor imagery capacity in CP. We therefore conclude that motor imagery capacity is task dependent and that an explicit paradigm as the one used in this study may reveal the true motor imagery capacity. The implications of these findings for the use of motor imagery training are discussed.

Impaired motor planning and motor imagery in children with unilateral spastic cerebral palsy: challenges for the future of pediatric rehabilitation

Compromised action performance is one of the most characteristic features of children with unilateral spastic cerebral palsy (USCP). Current rehabilitation efforts predominantly aim to improve the capacity and performance of the affected arm. Recent evidence, however, suggests that compromised motor planning may also negatively affect performance of activities of daily living. In this paper we will first discuss the recent evidence for this motor planning deficit, followed by studies on motor imagery in this population. Motor imagery is an experimental approach in which the contents of the motor plan become overt. Converging evidence indicates a compromised motor imagery ability in USCP. As the neural structures of both motor planning and motor imagery overlap, rehabilitation by motor imagery training may alleviate motor problems in USCP. Increasing evidence for this approach exists in older adults with stroke. We conclude this review with recommendations on such a training approach for children with USCP.

A Systematic Review of the End-State Comfort Effect in Normally Developing Children and in Children With Developmental Disorders

The end-state comfort (ESC) effect signifies the tendency to avoid uncomfortable postures at the end of goal-directed movements and can be reliably observed during object manipulation in adults, but only little is known about its development in children. The aim of the present paper is to provide a review of research on the ESC effect in normally developing children and in children with various developmental disorders, and to identify the factors constraining anticipatory planning skills. Three databases (Medline, Scopus, and PubMed) and relevant journals were scrutinized and a step-wise analysis procedure was employed to identify the relevant studies. Thirteen studies assessed the ESC effect in children, ranging from 1.5–14 years of age. Nine out of these thirteen studies reported the ESC effect to be present in normally developing children, but the results are inconsistent with regard to children’s age and the kind of ESC task used. Some evidence even suggests that these planning skills are intact in children with developmental disorders. Inconsistencies between findings are discussed in the light of moderating factors like the number of action steps, precision requirements, familiarity with the task, the task procedure, motivation, sample size, and age, as well as the cognitive and motor development of the participants. Further research is needed to investigate the onset and the developmental course of ESC planning, as well as the interdependencies with other cognitive abilities and sensory-motor skills.

On the relation between spontaneous perspective taking and other visuospatial processes

Common processes and representations engaged by visuospatial tasks were investigated by looking at four frequently used visuospatial research paradigms, the aim being to contribute to a better understanding of which specific processes are addressed in the different paradigms compared. In particular, the relation between spontaneous and instructed perspective taking, as well as mental rotation of body-part/non-body-part objects, was investigated. To this end, participants watched animations that have been shown to lead to spontaneous perspective taking. While they were watching these animations, participants were asked to explicitly adopt another perspective (Experiment 1), perform a mental object rotation task that involved a non-body-part object (Experiment 2), or perform a mental rotation of a body-part object (Experiment 3). Patterns of interference between the tasks, reflected in the reaction time patterns, showed that spontaneous and instructed perspective taking rely on similar representational elements to encode orientation. By contrast, no such overlap was found between spontaneous perspective taking and the rotation of non-body-part objects. Also, no overlap in orientation representation was evident with mental body-part rotations. Instead of an overlap in orientation representations, the results suggest that spontaneous perspective taking and the mental rotation of body parts rely on similar-presumably, motor-processes. These findings support the view that motor processes are involved in perspective taking and mental rotation of body parts.

Effect of biomechanical constraints in the hand laterality judgment task: where does it come from?

Several studies have reported that, when subjects have to judge the laterality of rotated hand drawings, their judgment is automatically influenced by the biomechanical constraints of the upper limbs. The prominent account for this effect is that, in order to perform the task, subjects mentally rotate their upper limbs toward the position of the displayed stimulus in a way that is consistent with the biomechanical constraints underlying the actual movement. However, the effect of such biomechanical constraints was also found in the responses of motor-impaired individuals performing the hand laterality judgment (HLJ) task, which seems at odds with the “motor imagery” account for this effect. In this study, we further explored the source of the biomechanical constraint effect by assessing the ability of an individual (DC) with a congenital absence of upper limbs to judge the laterality of rotated hand or foot drawings. We found that DC was as accurate and fast as control participants in judging the laterality of both hand and foot drawings, without any disadvantage for hands when compared to feet. Furthermore, DC's response latencies (RLs) for hand drawings were influenced by the biomechanical constraints of hand movements in the same way as control participants' RLs. These results suggest that the effect of biomechanical constraints in the HLJ task is not strictly dependent on “motor imagery” and can arise from the visual processing of body parts being sensitive to such constraints.

Effect of visual field presentation on action planning (estimating reach) in children

In this article, the authors examined the effects of target information presented in different visual fields (lower, upper, central) on estimates of reach via use of motor imagery in children (5-11 years old) and young adults. Results indicated an advantage for estimating reach movements for targets placed in lower visual field (LoVF), with all groups having greater difficulty in the upper visual field (UpVF) condition, especially 5- and 7-year-olds. Complementing these results was an overall age-related increase in accuracy. Based in part on the equivalence hypothesis suggesting that motor imagery and motor planning and execution are similar, the findings support previous work of executed behaviors showing that there is a LoVF bias for motor skill actions of the hand. Given that previous research hints that the UpVF may be bias for visuospatial (perceptual) qualities, research in that area and its association with visuomotor processing (LoVF) should be considered.

Hand-foot motor priming in the presence of temporary inability to use hands

To verify if the link between observed hand actions and executed foot actions found in aplasics is essentially induced by the constant use of foot substituting the hand, we investigated if the vision of a grasping hand is able to prime a foot response in normals. Participants were required to detect the time-to-contact of a hand grasping an object either with a suitable or a less suitable movement, an experimental paradigm known to induce a priming effect. Participants responded either with the hand or the foot, while having free or bound hands. Results showed that for hand responses motor priming effect was stronger when the hands were free, whereas for foot responses it was stronger when the hands were bound. These data are interpreted as a further evidence that a difficulty to move affects specific cognitive functions and that the vision of a grasping hand may prime a foot response.

Body context and posture affect mental imagery of hands

Different visual stimuli have been shown to recruit different mental imagery strategies. However the role of specific visual stimuli properties related to body context and posture in mental imagery is still under debate. Aiming to dissociate the behavioural correlates of mental processing of visual stimuli characterized by different body context, in the present study we investigated whether the mental rotation of stimuli showing either hands as attached to a body (hands-on-body) or not (hands-only), would be based on different mechanisms. We further examined the effects of postural changes on the mental rotation of both stimuli. Thirty healthy volunteers verbally judged the laterality of rotated hands-only and hands-on-body stimuli presented from the dorsum- or the palm-view, while positioning their hands on their knees (front postural condition) or behind their back (back postural condition). Mental rotation of hands-only, but not of hands-on-body, was modulated by the stimulus view and orientation. Additionally, only the hands-only stimuli were mentally rotated at different speeds according to the postural conditions. This indicates that different stimulus-related mechanisms are recruited in mental rotation by changing the bodily context in which a particular body part is presented. The present data suggest that, with respect to hands-only, mental rotation of hands-on-body is less dependent on biomechanical constraints and proprioceptive input. We interpret our results as evidence for preferential processing of visual- rather than kinesthetic-based mechanisms during mental transformation of hands-on-body and hands-only, respectively.

Typical and atypical (cerebral palsy) development of unimanual and bimanual grasp planning

In the present study we tested 13 children with cerebral palsy (CP) and 24 typically developing children (7-12 years old) in a unimanual and bimanual motor planning task. We focused on two research questions: (1) How does motor planning develop in children with and without CP? and (2) Is motor planning facilitated when the task is performed with both hands? Participants had to grasp one or two vertical oriented cylinder(s) and transport it/them to a platform that had different heights. As a measure of motor planning, we registered the height at which participants grasped the cylinder. Here, anticipation of grasp height upon the height of the upcoming target(s) is reflective of proper forward motor planning as it leads to a comfortable posture at the end of the task. In the unimanual task the typically developing children showed a significant grasp height effect, which increased with age. In contrast, no grasp height effect, or age related changes therein were found for the children with CP, suggesting a compromised development of motor planning in these children. Interestingly, when children had to transport one cylinder to a high shelf and one cylinder to a low shelf, the more affected hand of the CP children clearly anticipated the grasp height to the upcoming target height. The less affected hand did not show such anticipation. Taken collectively, these findings suggest a delayed or compromised development of motor planning in children with CP compared to typically developing children. At the same time, the facilitated motor planning of the more affected arm in the bimanual task offers a valuable entry point for intervention to improve motor planning in CP.

Motor imagery ability in children with congenital hemiplegia: effect of lesion side and functional level

In addition to motor execution problems, children with hemiplegia have motor planning deficits, which may stem from poor motor imagery ability. This study aimed to provide a greater understanding of motor imagery ability in children with hemiplegia using the hand rotation task. Three groups of children, aged 8-12 years, participated: right hemiplegia (R-HEMI; N=21), left hemiplegia (L-HEMI; N=19) and comparisons (N=21). All groups conformed to biomechanical limitations of the task, supporting the use of motor imagery, and all showed the expected response-time trade-off for angle. The general slowing of responses in the HEMI groups did not reach significance compared to their peers. The L-HEMI group were less accurate than the comparison group while the R-HEMI group were more variable in their performance. These results appeared to be linked to functional level. Using the Vineland Adaptive Behavior Composite, children were classified as low or normal functioning - of the seven classified as low function, six were in the L-HEMI group. Accuracy was lower in the low function subgroup, but this failed to reach significance with an adjusted critical value. However, there was a strong correlation between function level and mean accuracy. This indicates that motor imagery performance may be more closely linked to function level than to the neural hemisphere that has been damaged in cases of congenital hemiplegia. Function level may be linked to the site or extent of neural damage or the level of cortical reorganisation experienced and more attention should be paid to neural factors in future research.

Behavioral evidence for left-hemisphere specialization of motor planning

Recent studies suggest that the left hemisphere is dominant for the planning of motor actions. This left-hemisphere specialization hypothesis was proposed in various lines of research, including patient studies, motor imagery studies, and studies involving neurophysiological techniques. However, most of these studies are primarily based on experiments involving right-hand-dominant participants. Here, we present the results of a behavioral study with left-hand-dominant participants, which follows up previous work in right-hand-dominant participants. In our experiment, participants grasped CD casings and replaced them in a different, pre-cued orientation. Task performance was measured by the end-state comfort effect, i.e., the anticipated degree of physical comfort associated with the posture that is planned to be adopted at movement completion. Both left- and right-handed participants showed stronger end-state comfort effects for their right hand compared to their left hand. These results lend behavioral support to the left-hemisphere-dominance motion-planning hypothesis.

Neural evidence for compromised motor imagery in right hemiparetic cerebral palsy

In the present event-related potential (ERP) study we investigated the neural and temporal dynamics of motor imagery in participants with right-sided hemiparetic cerebral palsy (HCP; n = 10) and in left-handed control participants (n = 10). A mental rotation task was used in which participants were required to judge the laterality of hand pictures. At a behavioral level participants with HCP were slower in making hand laterality judgments compared to control subjects, especially when presented with pictures representing the affected hand. At a neural level, individuals with HCP were characterized by a reduced rotation-related negativity (RRN) over parietal areas, that was delayed in onset with respect to control participants. Interestingly, participants that were relatively mildly impaired showed a stronger RRN for the rotation of right-hand stimuli than participants that were more strongly impaired in their motor function, suggesting a direct relation between the motor imagery process and the biomechanical constraints of the participant. Together, the results provide new insights in the relation between motor imagery and motor capabilities and indicate that participants with HCP may be characterized by a compromised ability to use motor imagery.

Contribution of the primary motor cortex to motor imagery: a subthreshold TMS study

Motor imagery (MI) mostly activates the same brain regions as movement execution (ME) including the primary motor cortex (Brodmann area 4, BA4). However, whether BA4 is functionally relevant for MI remains controversial. The finding that MI tasks are impaired by BA4 virtual lesions induced by transcranial magnetic stimulation (TMS) supports this view, though previous studies do not permit to exclude that BA4 is also involved in other processes such as hand recognition. Additionally, previous works largely underestimated the possible negative consequences of TMS-induced muscle twitches on MI task performance. Here we investigated the role of BA4 in MI by interfering with the function of the left or right BA4 in healthy subjects performing a MI task in which they had to make laterality judgements on rotated hand drawings. We used a subthreshold repetitive TMS protocol and monitored electromyographic activity to exclude undesirable effects of hand muscle twitches. We found that BA4 virtual lesions selectively increased reaction times in laterality judgments on hand drawings, leaving unaffected a task of equal difficulty, involving judgments on letters. Interestingly, the effects of virtual lesions of left and right BA4 on MI task performance were the same irrespective of the laterality (left/right) of hand drawings. A second experiment allowed us to rule out the possibility that BA4 lesions affect visual or semantic processing of hand drawings. Altogether, these results indicate that BA4 contribution to MI tasks is specifically related to the mental simulation process and further emphasize the functional coupling between ME and MI.

Compromised motor planning and Motor Imagery in right Hemiparetic Cerebral Palsy

We investigated whether motor planning problems in people with Hemiparetic Cerebral Palsy (HCP) are paralleled by impaired ability to use Motor Imagery (MI). While some studies have shown that individuals with HCP can solve a mental rotation task, it was not clear if they used MI or Visual Imagery (VI). In the present study, motor planning and MI were examined in individuals with right HCP (n=10) and controls. Motor planning was measured using an object manipulation task, where participants had to anticipate the end of the motor action. MI was measured using a mental rotation paradigm, where participants judged laterality of hands presented from a back view and a palm view. To test if participants used MI or VI we compared reaction times of lateral versus medial rotations, under the assumption that MI is subject to biomechanical constraints of rotated hands, but VI is not. Individuals with HCP had a higher proportion of task failures due to inappropriate grip choice, exemplifying impaired planning. Second, individuals with HCP did not show a reaction time difference between lateral and medial rotations, indicating an impaired ability to use MI. These findings show that compromised motor planning in HCP is paralleled by an impairment in the ability to use MI. Training of MI may be a useful entry-point for rehabilitation of motor planning problems.

Mental rotation task of hands: differential influence number of rotational axes

Various studies on the hand laterality judgment task, using complex sets of stimuli, have shown that the judgments during this task are dependent on bodily constraints. More specific, these studies showed that reaction times are dependent on the participant’s posture or differ for hand pictures rotated away or toward the mid-sagittal plane (i.e., lateral or medial rotation, respectively). These findings point to the use of a cognitive embodied process referred to as motor imagery. We hypothesize that the number of axes of rotation of the displayed stimuli during the task is a critical factor for showing engagement in a mental rotation task, with an increased number of rotational axes leading to a facilitation of motor imagery. To test this hypothesis, we used a hand laterality judgment paradigm in which we manipulated the difficulty of the task via the manipulation of the number of rotational axes of the shown stimuli. Our results showed increased influence of bodily constraints for increasing number of axes of rotation. More specifically, for the stimulus set containing stimuli rotated over a single axis, no influence of biomechanical constraints was present. The stimulus sets containing stimuli rotated over more than one axes of rotation did induce the use of motor imagery, as a clear influence of bodily constraints on the reaction times was found. These findings extend and refine previous findings on motor imagery as our results show that engagement in motor imagery critically depends on the used number of axes of rotation of the stimulus set.

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

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