Motor imagery and cortico-spinal excitability: A review

Neuromuscular electrical stimulation at submaximal intensity combined with motor imagery increases corticospinal excitability

PURPOSE

There is sparse evidence in the literature that the combination of neuromuscular electrical stimulation (NMES) and motor imagery (MI) can increase corticospinal excitability more that the application of one or the other modality alone. However, the NMES intensity usually employed was below or at motor threshold, not allowing a proper activation of the whole neuromuscular system. This questions the effect of combined MI + NMES with higher intensities, closer to those used in clinical settings. The purpose here was to assess corticospinal excitability during either MI, NMES or a combination of both at different evoked forces.

METHODS

Seventeen healthy participants were enrolled in one session consisting of 6 conditions targeting flexor carpi radialis muscle (FCR): rest, MI, NMES at 5% and 20% of maximal voluntary contraction (MVC) and MI and NMES performed simultaneously (MI + NMES). During each condition, corticospinal excitability was assessed by evoking MEP of FCR by using transcranial magnetic stimulation. Maximal M-wave (Mmax) was measured by using the stimulation of the median nerve.

RESULTS

MEPs during MI were greater as compared to rest (P = 0.005). MEPs during MI were significantly lower than during MI + NMES at 5% (P = 0.02) and 20% (P = 0.001). Then, MEPs during NMES 5% was significantly lower than during MI + NMES 20% (P < 0.005).

CONCLUSION

The present study showed that MI + NMES increased corticospinal excitability more than MI alone. However, corticospinal excitability was not higher as the intensity increase during MI + NMES. Therefore, MI + NMES targeting FCR may not significantly increase the corticospinal excitability between different low-submaximal contractions intensities.

Multisensory approach in Mental Imagery: ALE meta-analyses comparing Motor, Visual and Auditory Imagery

Mental Imagery is a topic of longstanding and widespread scientific interest. Individual studies have typically focused on a single modality (e.g. Motor, Visual, Auditory) of Mental Imagery. Relatively little work has considered directly comparing and contrasting the brain networks associated with these different modalities of Imagery. The present study integrates data from 439 neuroimaging experiments to identify both modality-specific and shared neural networks involved in Mental Imagery. Comparing the networks involved in Motor, Visual, and Auditory Imagery identified a pattern whereby each form of Imagery preferentially recruited 'higher level' associative brain regions involved in the associated 'real' experience. Results also indicate significant overlap in a left-lateralized network including the pre-supplementary motor area, ventral premotor cortex and inferior parietal lobule. This pattern of results supports the existence of a 'core' network that supports the attentional, spatial, and decision-making demands of Mental Imagery. Together these results offer new insights into the brain networks underlying human imagination.

White matter organisation of sensorimotor tracts is associated with motor imagery in childhood

Despite the important role of motor imagery (MI) in motor development, our understanding of the contribution of white matter fibre properties to MI performance in childhood remains limited. To provide novel insight into the white matter correlates of MI performance, this study examined the association between white matter fibre properties and motor imagery performance in a sample of typically developing children. High angular diffusion weighted imaging data were collected from 22 typically developing children aged 6-14 years (12 female, MAge= 10.56). Implicit motor imagery performance was assessed using a mental hand rotation paradigm. The cerebellar peduncles and the superior longitudinal fasciculus were reconstructed using TractSeg, a semi-automated method. For each tract, white matter microstructure (fibre density, FD) and morphology (fibre bundle cross-section, FC) were estimated using Fixel-Based Analysis. Permutation-based inference testing and partial correlation analyses demonstrated that higher FC in the middle cerebellar peduncles was associated with better MI performance. Tract-based region of interest analyses showed that higher FC in the middle and superior cerebellar peduncles were associated with better MI performance. Results suggest that white matter connectivity along the cerebellar peduncles may facilitate MI performance in childhood. These findings advance our understanding of the neurobiological systems that underlie MI performance in childhood and provide early evidence for the relevance of white matter sensorimotor pathways to internal action representations.

Motor imagery from brain to muscle: a commentary on Bach et al., (2022)

In a recent article entitled "Why motor imagery is not really motoric: towards a re-conceptualization in terms of effect-based action control", Bach et al. nicely renewed the concept of motor equivalence between actual movement and motor imagery (MI), i.e. the mental simulation of an action without its corresponding motor output. Their approach is largely based on behavioral studies and, to a lesser extent, on the literature using cerebral imagery. However, the literature on cortico-spinal circuitry modulation during MI can provide further, interesting aspects. Indeed, when it comes to addressing the motor system, one should consider the whole path from brain region to muscle contraction, including sub-cortical structures such as the spinal circuitry. This commentary aims at bridging this gap by providing supplemental evidence and outlining a complementary approach.

Neuromuscular effects suggest that imagery engages motor components directly - a commentary on Frank et al. (2023)

Not applicable.

A 6-minute protocol, combining mental imagery practices and breathing exercises, promotes hand-grip strength in firefighters: a series of "N-of-1" trials

BACKGROUND

To carry out their victim rescue and fire-fighting missions, firefighters perform high levels of physical exertion and among them strenuous muscular activity. A specific mental preparation protocol that could induce better strength performance throughout their 24-hour schedule is a major issue for firefighters.

OBJECTIVE

This case report aims to examine whether a 6-minute Intervention combining mental imagery practices and breathing exercises, specifically designed to be used while travelling between the fire station and the mission site, would be able to promote maximum strength performance.

METHODS

A series of three Single Case Experimental Designs (SCED) was conducted in single blind design to investigate the effects of repeated challenge-withdrawals between the Intervention and the Baseline on the maximum voluntary isometric contraction (MVIC) strength of the hand-grip.

RESULTS

Data analyses revealed that 62.5% to 100% of the hand-grip strength values during the Intervention periods were greater than or equal to the maximum data point recorded in the Baseline periods. The effect sizes of these highlighted increases of the hand-grip strength performance revealed by the percentage of non-overlapping data (PND) were 75% i.e., moderately effective on average.

CONCLUSIONS

Such a "psyching-up" practice before an upcoming muscular activity can promote muscular strength in firefighters. These results have led French firefighter departments to integrate the teaching of these practices into the initial instruction of firefighters, and remains to be confirmed by a randomised control trial.

The effect of warm-up with transcranial direct current stimulation on performance factors in collegiate golfers

PURPOSE

This study aimed to determine the effects of warm-up using transcranial direct current stimulation (tDCS) on performance factors in collegiate golfers and to provide a scientific basis for the effectiveness and methodology of tDCS. We sought to compare the effects of tDCS as an additional treatment during warm-up. tDCS is generally activated when a small electric current is applied to the motor cortex of the cerebral cortex, which has been reported to be helpful in improving motor function. Therefore, we sought to prove the effectiveness of combined warm-up exercise and tDCS.

METHODS

Twenty-two collegiate male golfers were divided into tDC- (tDCS; n=11) and sham-treated (sham; n=11) groups. To examine performance factors, the following were assessed following tDCS application: carry, clubhead speed (CHS), ball speed (BS) for driver performance, countermovement jump (CMJ) for lower extremity muscle power, global rating of change (GRC) for the subjective change in condition of the participants, and test of attentional interpersonal style (TAIS) for concentration.

RESULTS

This study showed that warm-up with tDCS had positive effects on carry (p=.004), CHS (p=.019), BS (p=.017) of driver performance, CMJ (p=.002), and GRC (p=.005), however, no significant effect on TAIS was found, which suggest that the effects of the warm-up with tDCS were significant for driver performances, CMJ, and GRC.

CONCLUSION

Future studies should independently validate the effectiveness of tDCS and apply it to different situations and timeframes, such as training and competitions, to provide new alternative strategies or performance improvement.

No increase in corticospinal excitability during motor simulation provides a platform to explore the neurophysiology of aphantasia

This scientific commentary refers to 'Explicit and implicit motor simulations are impaired in individuals with aphantasia', by Dupont  et al. (https://doi.org/10.1093/braincomms/fcae072) in Brain Communications.

Explicit and implicit motor simulations are impaired in individuals with aphantasia

Individuals with aphantasia report having difficulties or an inability to generate visual images of objects or events. So far, there is no evidence showing that this condition also impacts the motor system and the generation of motor simulations. We probed the neurophysiological marker of aphantasia during explicit and implicit forms of motor simulation, i.e. motor imagery and action observation, respectively. We tested a group of individuals without any reported imagery deficits (phantasics) as well as a group of individuals self-reporting the inability to mentally simulate images or movements (aphantasics). We instructed the participants to explicitly imagine a maximal pinch movement in the visual and kinaesthetic modalities and to observe a video showing a pinch movement. By means of transcranial magnetic stimulation, we triggered motor-evoked potentials in the target right index finger. As expected, the amplitude of motor-evoked potentials, a marker of corticospinal excitability, increased for phantasics during kinaesthetic motor imagery and action observation relative to rest but not during visual motor imagery. Interestingly, the amplitude of motor-evoked potentials did not increase in any of the conditions for the group of aphantasics. This result provides neurophysiological evidence that individuals living with aphantasia have a real deficit in activating the motor system during motor simulations.

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.

Neural underpinnings of the interplay between actual touch and action imagination in social contexts

While there is established evidence supporting the involvement of the sense of touch in various actions, the neural underpinnings of touch and action interplay in a social context remain poorly understood. To prospectively investigate this phenomenon and offer further insights, we employed a combination of motor and sensory components by asking participants to imagine exerting force with the index finger while experiencing their own touch, the touch of one another individual, the touch of a surface, and no touch. Based on the assumption that the patterns of activation in the motor system are similar when action is imagined or actually performed, we proceeded to apply a single-pulse transcranial magnetic stimulation over the primary motor cortex (M1) while participants engaged in the act of imagination. Touch experience was associated with higher M1 excitability in the presence and in the absence of force production imagination, but only during force production imagination M1 excitability differed among the types of touch: both biological sources, the self-touch and the touch of one other individual, elicited a significant increase in motor system activity when compared to touching a non-living surface or in the absence of touch. A strong correlation between individual touch avoidance questionnaire values and facilitation in the motor system was present while touching another person, indicating a social aspect for touch in action. The present study unveils the motor system correlates when the sensory/motor components of touch are considered in social contexts.

What we imagine learning from watching others: how motor imagery modulates competency perceptions resulting from the repeated observation of a juggling action

Although motor learning can occur from observing others perform a motor skill (action observation; AO), observers' confidence in their own ability to perform the skill can be falsely increased compared to their actual ability. This illusion of motor competence (i.e., 'over-confidence') may arise because the learner does not gain access to sensory feedback about their own performance-a source of information that can help individuals understand their veridical motor capabilities. Unlike AO, motor imagery (MI; the mental rehearsal of a motor skill) is thought to be linked to an understanding of movement consequences and kinaesthetic information. MI may thus provide the learner with movement-related diagnostic information, leading to greater accuracy in assessing ability. The present study was designed to evaluate the effects of MI when paired with AO in assessments of one's own motor capabilities in an online observation task. Two groups rated their confidence in performing a juggling task following repeated observations of the action without MI (OBS group; n = 45) or with MI following observation (OBS+MI; n = 39). As predicted, confidence increased with repeated observation for both groups, yet increased to a greater extent in the OBS relative to the OBS+MI group. The addition of MI appeared to reduce confidence that resulted from repeated AO alone. Data support the hypothesis that AO and MI are separable and that MI allows better access to sensory information than AO. However, further research is required to assess changes in confidence that result from MI alone and motor execution.

Environmental enrichment through virtual reality as multisensory stimulation to mitigate the negative effects of prolonged bed rest

Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted.

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.

The acute effects of motor imagery and cervical transcutaneous electrical stimulation on manual dexterity and neural excitability

Transcutaneous electrical stimulation (TCES) of the spinal cord induces changes in spinal excitability. Motor imagery (MI) elicits plasticity in the motor cortex. It has been suggested that plasticity occurring in both cortical and spinal circuits might underlie the improvements in performance observed when training is combined with stimulation. We investigated the acute effects of cervical TCES and MI delivered in isolation or combined on corticospinal excitability, spinal excitability and manual performance. Participants (N = 17) completed three sessions during which they engaged in 20 min of: 1) MI, listening to an audio recording instructing to complete the purdue pegboard test (PPT) of manual performance; 2) TCES at the spinal level of C5-C6; 3) MI + TCES, listening to the MI script while receiving TCES. Before and after each condition, we measured corticospinal excitability via transcranial magnetic stimulation (TMS) at 100% and 120% motor threshold (MT), spinal excitability via single-pulse TCES and manual performance with the PPT. Manual performance was not improved by MI, TCES or MI + TCES. Corticospinal excitability assessed at 100% MT intensity increased in hand and forearm muscles after MI and MI + TCES, but not after just TCES. Conversely, corticospinal excitability assessed at 120% MT intensity was not affected by any of the conditions. The effects on spinal excitability depended on the recorded muscle: it increased after all conditions in biceps brachii (BB) and flexor carpi radialis (FCR); did not change after any conditions in the abductor pollicis brevis (APB); increased after TCES and MI + TCES, but not after just MI in the extensor carpi radialis (ECR). These findings suggest that MI and TCES increase the excitability of the central nervous system through different but complementary mechanisms, inducing changes in the excitability of spinal and cortical circuits. MI and TCES can be used in combination to modulate spinal/cortical excitability, an approach particularly relevant for people with limited residual dexterity who cannot engage in motor practice.

Post-Activation Performance Enhancement and Motor Imagery Are Efficient to Emphasize the Effects of a Standardized Warm-Up on Sprint-Running Performances

Warm-up routines include various tasks focused on the peripheral contractile properties and nervous motor command. This present study was aimed at investigating the acute effects of different warm-up routines, emphasizing either peripheral (post-activation performance enhancement, PAPE) or central (motor imagery, MI) contributions on sport-specific tasks. Eleven young female athletes took part in this cross-over, randomized, controlled trial. They underwent three experimental sessions composed of a standardized warm-up followed by 10 min of (1) rest (CONTROL), (2) maximal concentric leg press (PAPE), or (3) mental repetitions of sprint tasks (MI). Post-tests consisted of reaction time, arrowhead agility test, 20 m sprint, repeated sprint ability, and NASA-TLX fatigue questionnaire. PAPE and MI significantly enhanced the arrowhead agility test (p < 0.001 and p = 0.012, respectively) and repeated sprint ability (p = 0.002 and p = 0.035, respectively) compared to CONTROL, without any difference between PAPE and MI. The 20 m sprint time was better after PAPE as compared to MI (p = 0.005) and CONTROL (p < 0.001), without any difference between MI and CONTROL. Reaction time and the NASA-TLX questionnaire were not affected by the warm-up modalities (p > 0.05). PAPE was the most efficient to optimize warm-up due to its greater peripheral contribution that would improve muscle contractility. MI specifically improved the imagined tasks mostly by central contribution.

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.

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.

Imagining and reading actions: Towards similar motor representations

While action language and motor imagery both engage the motor system, determining whether these two processes indeed share the same motor representations would contribute to better understanding their underlying mechanisms. We conducted two experiments probing the mutual influence of these two processes. In Exp.1, hand-action verbs were presented subliminally, and participants (n = 36) selected the verb they thought they perceived from two alternatives. When congruent actions were imagined prior to this task, accuracy significantly increased, i.e. participants were better able to "see" the subliminal verbs. In Exp.2, participants (n = 19) imagined hand flexion or extension, while corticospinal excitability was measured via transcranial magnetic stimulation. Corticospinal excitability was modulated by action verbs subliminally presented prior to imagery. Specifically, the typical increase observed during imagery was suppressed after presentation of incongruent action verbs. This mutual influence of action language and motor imagery, both at behavioral and neurophysiological levels, suggests overlapping motor representations.

Can motor imagery balance the acute fatigue induced by neuromuscular electrical stimulation?

PURPOSE

The combination of motor imagery (MI) and neuromuscular electrical stimulation (NMES) can increase the corticospinal excitability suggesting that such association could be efficient in motor performance improvement. However, differential effect has been reported at spinal level after MI and NMES alone. The purpose of this study was to investigate the acute effect on motor performance and spinal excitability following MI, NMES and combining MI and NMES.

METHODS

Ten participants were enrolled in three experimental sessions of MI, NMES and MI + NMES targeting plantar flexor muscles. Each session underwent 60 imagined, evoked (20% MVC) or imagined and evoked contractions simultaneously. Before, immediately after and 10 min after each session, maximal M-wave and H-reflex were evoked by electrical nerve stimulation applied at rest and during maximal voluntary contraction (MVC).

RESULTS

The MVC decreased significantly between PRE-POST (- 12.14 ± 6.12%) and PRE-POST 10 (- 8.1 ± 6.35%) for NMES session, while this decrease was significant only between PRE-POST 10 (- 7.16 ± 11.25%) for the MI + NMES session. No significant modulation of the MVC was observed after MI session. The ratio Hmax/Mmax was reduced immediately after NMES session only.

CONCLUSION

The combination of MI to NMES seems to delay the onset of neuromuscular fatigue compared to NMES alone. This delay onset of neuromuscular fatigue was associated with specific modulation of the spinal excitability. These results suggested that MI could compensate the neuromuscular fatigue induced acutely by NMES until 10 min after the combination of both modalities.

Motor network reorganization after motor imagery training in stroke patients with moderate to severe upper limb impairment

BACKGROUND

Motor imagery training (MIT) has been widely used to improve hemiplegic upper limb function in stroke rehabilitation. The effectiveness of MIT is associated with the functional neuroplasticity of the motor network. Currently, brain activation and connectivity changes related to the motor recovery process after MIT are not well understood.

AIM

We aimed to investigate the neural mechanisms of MIT in stroke rehabilitation through a longitudinal intervention study design with task-based functional magnetic resonance imaging (fMRI) analysis.

METHODS

We recruited 39 stroke patients with moderate to severe upper limb motor impairment and randomly assigned them to either the MIT or control groups. Patients in the MIT group received 4 weeks of MIT therapy plus conventional rehabilitation, while the control group only received conventional rehabilitation. The assessment of Fugl-Meyer Upper Limb Scale (FM-UL) and Barthel Index (BI), and fMRI scanning using a passive hand movement task were conducted on all patients before and after treatment. The changes in brain activation and functional connectivity (FC) were analyzed. Pearson's correlation analysis was conducted to evaluate the association between neural functional changes and motor improvement.

RESULTS

The MIT group achieved higher improvements in FM-UL and BI relative to the control group after the treatment. Passive movement of the affected hand evoked an abnormal bilateral activation pattern in both groups before intervention. A significant Group × Time interaction was found in the contralesional S1 and ipsilesional M1, showing a decrease of activation after intervention specifically in the MIT group, which was negatively correlated with the FM-UL improvement. FC analysis of the ipsilesional M1 displayed the motor network reorganization within the ipsilesional hemisphere, which correlated with the motor score changes.

CONCLUSIONS

MIT could help decrease the compensatory activation at both hemispheres and reshape the FC within the ipsilesional hemisphere along with functional recovery in stroke patients.

The recruitment of indirect waves within primary motor cortex during motor imagery: A directional transcranial magnetic stimulation study

Motor imagery (MI) refers to the mental simulation of an action without overt movement. While numerous transcranial magnetic stimulation (TMS) studies provided evidence for a modulation of corticospinal excitability and intracortical inhibition during MI, the neural signature within the primary motor cortex is not clearly established. In the current study, we used directional TMS to probe the modulation of the excitability of early and late indirect waves (I-waves) generating pathways during MI. Corticospinal responses evoked by TMS with posterior-anterior (PA) and anterior-posterior (AP) current flow within the primary motor cortex evoke preferentially early and late I-waves, respectively. Seventeen participants were instructed to stay at rest or to imagine maximal isometric contractions of the right flexor carpi radialis. We demonstrated that the increase of corticospinal excitability during MI is greater with PA than AP orientation. By using paired-pulse stimulations, we confirmed that short-interval intracortical inhibition (SICI) increased during MI in comparison to rest with PA orientation, whereas we found that it decreased with AP orientation. Overall, these results indicate that the pathways recruited by PA and AP orientations that generate early and late I-waves are differentially modulated by MI.

Effects of motor imagery training on skeletal muscle contractile properties in sports science students

Background

Studies on motor imagery (MI) practice based on different designs and training protocols have reported changes in maximal voluntary contraction (MVC) strength. However, to date, there is a lack of information on the effects of MI training on contractile properties of the trained muscle.

Methods

Forty-five physically active sport science students (21 female) were investigated who trained three times per week over a 4-week period in one of three groups: An MI group conducted MI practice of maximal isometric contraction of the biceps brachii; a physical exercise (PE) group physically practiced maximal isometric contractions of the biceps brachii in a biceps curling machine; and a visual imagery (VI) group performed VI training of a landscape. A MVC test of the arm flexors was performed in a biceps curling machine before and after 4 weeks of training. The muscular properties of the biceps brachii were also tested with tensiomyography measurements (TMG).

Results

Results showed an interaction effect between time and group for MVC (p = 0.027, η ² = 0.17), with a higher MVC value in the PE group (Δ5.9%) compared to the VI group (Δ -1.3%) (p = 0.013). MVC did not change significantly in the MI group (Δ2.1%). Analysis of muscle contractility via TMG did not show any interaction effects neither for maximal radial displacement (p = 0.394, η ² = 0.05), delay time (p = 0.79, η ² = 0.01) nor contraction velocity (p = 0.71, η ² = 0.02).

Conclusion

In spite of MVC-related changes in the PE group due to the interventions, TMG measurements were not sensitive enough to detect concomitant neuronal changes related to contractile properties.

Corticomotor Plasticity Underlying Priming Effects of Motor Imagery on Force Performance

The neurophysiological processes underlying the priming effects of motor imagery (MI) on force performance remain poorly understood. Here, we tested whether the priming effects of embedded MI practice involved short-term changes in corticomotor connectivity. In a within-subjects counterbalanced experimental design, participants (n = 20) underwent a series of experimental sessions consisting of successive maximal isometric contractions of elbow flexor muscles. During inter-trial rest periods, we administered MI, action observation (AO), and a control passive recovery condition. We collected electromyograms (EMG) from both agonists and antagonists of the force task, in addition to electroencephalographic (EEG) brain potentials during force trials. Force output was higher during MI compared to AO and control conditions (both p < 0.01), although fatigability was similar across experimental conditions. We also found a weaker relationship between triceps brachii activation and force output during MI and AO compared to the control condition. Imaginary coherence topographies of alpha (8−12 Hz) oscillations revealed increased connectivity between EEG sensors from central scalp regions and EMG signals from agonists during MI, compared to AO and control. Present results suggest that the priming effects of MI on force performance are mediated by a more efficient cortical drive to motor units yielding reduced agonist/antagonist coactivation.

The role of the primary motor cortex in motor imagery: A theta burst stimulation study

While mentally simulated actions activate similar neural structures to overt movement, the role of the primary motor cortex (PMC) in motor imagery remains disputed. The aim of the study was to use continuous theta burst stimulation (cTBS) to modulate corticospinal activity to investigate the putative role of the PMC in implicit motor imagery in young adults with typical and atypical motor ability. A randomized, double blind, sham-controlled, crossover, offline cTBS protocol was applied to 35 young adults. During three separate sessions, adults with typical and low motor ability (developmental coordination disorder [DCD]), received active cTBS to the PMC and supplementary motor area (SMA), and sham stimulation to either the PMC or SMA. Following stimulation, participants completed measures of motor imagery (i.e., hand rotation task) and visual imagery (i.e., letter number rotation task). Although active cTBS significantly reduced corticospinal excitability in adults with typical motor ability, neither task performance was altered following active cTBS to the PMC or SMA, compared to performance after sham cTBS. These results did not differ across motor status (i.e., typical motor ability and DCD). These findings are not consistent with our hypothesis that the PMC (and SMA) is directly involved in motor imagery. Instead, previous motor cortical activation observed during motor imagery may be an epiphenomenon of other neurophysiological processes and/or activity within brain regions involved in motor imagery. This study highlights the need to consider multi-session theta burst stimulation application and its neural effects when probing the putative role of motor cortices in motor imagery.

Mu-desynchronization, N400 and corticospinal excitability during observation of natural and anatomically unnatural finger movements

The action observation networks (AON) (or the mirror neuron system) are the neural underpinnings of visuomotor integration and play an important role in motor control. Besides, one of the main functions of the human mirror neuron system is recognition of observed actions and the prediction of its outcome through the comparison with the internal mental motor representation. Previous studies focused on the human mirror neurons (MNs) activation during object-oriented movements observation, therefore intransitive movements observation effects on MNs activity remains relatively little-studied. Moreover, the dependence of MNs activation on the biomechanical characteristics of observed movement and their biological plausibility remained highly underexplored. In this study we proposed that naturalness of observed intransitive movement can modulate the MNs activity. Event-related desynchronization (ERD) of sensorimotor electroencephalography (EEG) rhythms, N400 event-related potentials (ERPs) component and corticospinal excitability were investigated in twenty healthy volunteers during observation of simple non-transitive finger flexion that might be either biomechanically natural or unnatural when finger wriggled out toward the dorsal side of palm. We showed that both natural and unnatural movements caused mu/beta-desynchronization, which gradually increased during the flexion phase and returned to baseline while observation of extension. Desynchronization of the mu-rhythm was significantly higher during observation of the natural movements. At the same time, beta-rhythm was not found to be sensitive to the action naturalness. Also, observation of unnatural movements caused an increased amplitude of the N400 component registered in the centro-parietal regions. We suggest that the sensitivity of N400 to intransitive action observation with no explicit semantic context might imply the broader role of N400 sources within AON. Surprisingly, no changes in corticospinal excitability were found. This lack of excitability modulation by action observation could be related with dependence of the M1 activity on the observed movement phase.

Developmental Coordination Disorder: State of the Art and Future Directions from a Neurophysiological Perspective

Developmental coordination disorder (DCD) is a common neurodevelopmental condition characterized by disabling motor impairments being visible from the first years of life. Over recent decades, research in this field has gained important results, showing alterations in several processes involved in the regulation of motor behavior (e.g., planning and monitoring of actions, motor learning, action imitation). However, these studies mostly pursued a behavioral approach, leaving relevant questions open concerning the neural correlates of this condition. In this narrative review, we first survey the literature on motor control and sensorimotor impairments in DCD. Then, we illustrate the contributions to the field that may be achieved using transcranial magnetic stimulation (TMS) of the motor cortex. While still rarely employed in DCD research, this approach offers several opportunities, ranging from the clarification of low-level cortical electrophysiology to the assessment of the motor commands transmitted throughout the corticospinal system. We propose that TMS may help to investigate the neural correlates of motor impairments reported in behavioral studies, thus guiding DCD research toward a brain-oriented acknowledgment of this condition. This effort would help translational research to provide novel diagnostic and therapeutic tools.

Kinesthetic motor-imagery training improves performance on lexical-semantic access

The objective of this study was to evaluate the effect of Motor Imagery (MI) training on language comprehension. In line with literature suggesting an intimate relationship between the language and the motor system, we proposed that a MI-training could improve language comprehension by facilitating lexico-semantic access. In two experiments, participants were assigned to a kinesthetic motor-imagery training (KMI) group, in which they had to imagine making upper-limb movements, or to a static visual imagery training (SVI) group, in which they had to mentally visualize pictures of landscapes. Differential impacts of both training protocols on two different language comprehension tasks (i.e., semantic categorization and sentence-picture matching task) were investigated. Experiment 1 showed that KMI training can induce better performance (shorter reaction times) than SVI training for the two language comprehension tasks, thus suggesting that a KMI-based motor activation can facilitate lexico-semantic access after only one training session. Experiment 2 aimed at replicating these results using a pre/post-training language assessment and a longer training period (four training sessions spread over four days). Although the improvement magnitude between pre- and post-training sessions was greater in the KMI group than in the SVI one on the semantic categorization task, the sentence-picture matching task tended to provide an opposite pattern of results. Overall, this series of experiments highlights for the first time that motor imagery can contribute to the improvement of lexical-semantic processing and could open new avenues on rehabilitation methods for language deficits.

Effectiveness of motor imagery for improving functional performance after total knee arthroplasty: a systematic review with meta-analysis

Background

The aim of this study was to appraise the effects of motor imagery on the functional performance improvement among total knee arthroplasty patients systematically. We hypothesized a relatively greater recovery in the motor imagery group.

Methods

Medline (Ovid), Embase and Cochrane Controlled Register of Trials (CENTRAL) were searched from inception to October 1st, 2021. We included randomized controlled trials evaluating the effects of motor imagery on the functional recovery among total knee arthroplasty patients. Measurements included range of motion, strength intensity, Visual Analogue Scale, Time Up and Go Test, Oxford Knee Score, Western Ontario and McMaster Universities Osteoarthritis Index, all of which were evaluated before and after intervention. Mean differences (MD) or standard mean differences (SMD) and 95% confidence intervals (CI) were calculated. The Cochrane risk of bias tool was used to assess the risk of bias.

Results

Six studies with 168 patients were included for the meta-analysis. The SMD of strength intensity was increased (SMD = 0.90, 95% CI = [0.47]–[1.32], P < 0.001). The SMD of Visual Analogue Scale was reduced (SMD =  − 0.91; 95% CI = [− 1.29]–[− 0.52], P < 0.001). The SMD of Time Up and Go Test was reduced (SMD =  − 0.56, 95% CI = [− 0.94]–[− 0.19], P = 0.003). The MD of Oxford Knee Score was slightly increased (MD = 0.79-point, 95% CI = [− 0.31]–[1.88], P = 0.159). The outcomes of range of motion, Western Ontario and McMaster Universities Osteoarthritis Index were described according to the original data.

Conclusion

Compared with control therapy, motor imagery in the intervention group achieved an effective treatment for strength enhancement, pain reduction and physical activities improvement. More large-scale, prospective researches are needed in the future.

Trial registration: The PROSPERO trial registration number is CRD42021250996.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13018-022-02946-4.

Behavioural indexes of movement imagery ability are associated with the magnitude of corticospinal adaptation following movement imagery training

Movement imagery (MI) is a cognitive process wherein an individual simulates themselves performing a movement in the absence of physical movement. The current paper reports an examination of the relationship between behavioural indexes of MI ability and the magnitude of corticospinal adaptation following MI training. Behavioural indexes of MI ability included data from a questionnaire (MIQ-3), a mental chronometry task, and a hand laterality judgment task. For the measure of corticospinal adaptation, single-pulse transcranial magnetic stimulation (TMS) was administered to elicit thumb movements to determine the representation of thumb movements before and after MI training. MI training involved participants imagining themselves moving their thumb in the opposite direction to the dominant direction of the TMS-evoked movements prior to training. Pre/post-training changes in the direction and velocity of TMS-evoked thumb movements indicated the magnitude of adaptation following MI training. The two main findings were: 1) a positive relationship was found between the MIQ-3 and the pre/post-training changes in the direction of TMS-evoked thumb movements; and 2) a negative relationship between the mental chronometry measure and both measures of corticospinal adaptation following MI training. These results indicate that both ease of imagery and timing of imagery could predict the magnitude of neuroplastic adaptation following MI training. Thus, both these measures may be considered when assessing imagery ability and determining who might benefit from MI interventions.

Enhancement of capability for motor imagery using vestibular imbalance stimulation during brain computer interface

Objective.Motor imagery (MI), based on the theory of mirror neurons and neuroplasticity, can promote motor cortical activation in neurorehabilitation. The strategy of MI based on brain-computer interface (BCI) has been used in rehabilitation training and daily assistance for patients with hemiplegia in recent years. However, it is difficult to maintain the consistency and timeliness of receiving external stimulation to neural activation in most subjects owing to the high variability of electroencephalogram (EEG) representation across trials/subjects. Moreover, in practical application, MI-BCI cannot highly activate the motor cortex and provide stable interaction owing to the weakness of the EEG feature and lack of an effective mode of activation.Approach.In this study, a novel hybrid BCI paradigm based on MI and vestibular stimulation motor imagery (VSMI) was proposed to enhance the capability of feature response for MI. Twelve subjects participated in a group of controlled experiments containing VSMI and MI. Three indicators, namely, activation degree, timeliness, and classification accuracy, were adopted to evaluate the performance of the task.Main results.Vestibular stimulation could significantly strengthen the suppression ofαandβbands of contralateral brain regions during MI, that is, enhance the activation degree of the motor cortex (p< 0.01). Compared with MI, the timeliness of EEG feature-response achieved obvious improvements in VSMI experiments. Moreover, the averaged classification accuracy of VSMI and MI was 80.56% and 69.38%, respectively.Significance.The experimental results indicate that specific vestibular activity contributes to the oscillations of the motor cortex and has a positive effect on spontaneous imagery, which provides a novel MI paradigm and enables the preliminary exploration of sensorimotor integration of MI.

Simultaneous transcranial and transcutaneous spinal direct current stimulation to enhance athletic performance outcome in experienced boxers

Transcranial direct current stimulation (tDCS) is among the rapidly growing experimental approaches to enhance athletic performance. Likewise, novel investigations have recently addressed the effects of transcutaneous spinal Direct Current Stimulation (tsDCS) on motor functions such as reduced reaction time. The impact of tDCS, and tsDCS might be attributed to altered spontaneous neural activity and membrane potentials of cortical and corticomotoneuronal cells, respectively. Given the paucity of empirical research in non-invasive brain stimulation in sports neuroscience, especially in boxing, the present investigation studied the effects of neuromodulation on motor and cognitive functions of professional boxers. The study sample comprised 14 experienced male boxers who received random sequential real or sham direct current stimulation over the primary motor cortex (M1) and paraspinal region (corresponding to the hand area) in two sessions with a 72-h interval. Unlike sham stimulation, real stimulation improved selective attention and reaction time of the experienced boxers [enhanced selective attention (p < 0.0003), diminished right hand (p < 0.0001) and left hand reaction time (p < 0.0006)]. Meanwhile, the intervention left no impact on the participants' cognitive functions (p > 0.05). We demonstrated that simultaneous stimulation of the spinal cord and M1 can improve the performance of experienced boxers through neuromodulation. The present study design may be extended to examine the role of neurostimulation in other sport fields.

The Impact of Context on EEG Motor Imagery Neurofeedback and Related Motor Domains

Neurofeedback (NF) is a versatile non-invasive neuromodulation technique. In combination with motor imagery (MI), NF has considerable potential for enhancing motor performance or supplementing motor rehabilitation. However, not all users achieve reliable NF control. While research has focused on various brain signal properties and the optimisation of signal processing to solve this issue, the impact of context, i.e. the conditions in which NF motor tasks occur, is comparatively unknown. We review current research on the impact of context on MI NF and related motor domains. We identify long-term factors that act at the level of the individual or of the intervention, and short-term factors, with levels before/after and during a session. The reviewed literature indicates that context plays a significant role. We propose considering context factors as well as within-level and across-level interactions when studying MI NF.

Mental individuation of imagined finger movements can be achieved using TMS-based neurofeedback

Neurofeedback (NF) in combination with motor imagery (MI) can be used for training individuals to volitionally modulate sensorimotor activity without producing overt movements. However, until now, NF methods were of limited utility for mentally training specific hand and finger actions. Here we employed a novel transcranial magnetic stimulation (TMS) based protocol to probe and detect MI-induced motor activity patterns in the primary motor cortex (M1) with the aim to reinforce selective facilitation of single finger representations. We showed that TMS-NF training but not MI training with uninformative feedback enabled participants to selectively upregulate corticomotor excitability of one finger, while simultaneously downregulating excitability of other finger representations within the same hand. Successful finger individuation during MI was accompanied by strong desynchronization of sensorimotor brain rhythms, particularly in the beta band, as measured by electroencephalography. Additionally, informative TMS-NF promoted more dissociable EEG activation patterns underlying single finger MI, when compared to MI of the control group where no such feedback was provided. Our findings suggest that selective TMS-NF is a new approach for acquiring the ability of finger individuation even if no overt movements are performed. This might offer new treatment modality for rehabilitation after stroke or spinal cord injury.

Pain, No Gain: Acute Pain Interrupts Motor Imagery Processes and Affects Mental Training-Induced Plasticity

Pain influences both motor behavior and neuroplastic adaptations induced by physical training. Motor imagery (MI) is a promising method to recover motor functions, for instance in clinical populations with limited endurance or concomitant pain. However, the influence of pain on the MI processes is not well established. This study investigated whether acute experimental pain could modulate corticospinal excitability assessed at rest and during MI (Exp. 1) and limit the use-dependent plasticity induced by MI practice (Exp. 2). Participants imagined thumb movements without pain or with painful electrical stimulations applied either on digit V or over the knee. We used transcranial magnetic stimulation to measure corticospinal excitability at rest and during MI (Exp. 1) and to evoke involuntary thumb movements before and after MI practice (Exp. 2). Regardless of its location, pain prevented the increase of corticospinal excitability that is classically observed during MI. In addition, pain blocked use-dependent plasticity following MI practice, as testified by a lack of significant posttraining deviations. These findings suggest that pain interferes with MI processes, preventing the corticospinal excitability facilitation needed to induce use-dependent plasticity. Pain should be carefully considered for rehabilitation programs using MI to restore motor function.

Revisiting the acute effects of resistance exercise on motor imagery ability

Motor imagery (MI) shares psychological and physiological similarities with the physical practice of the same action. Yet, it remains unclear whether fatigue elicited by exercise impairs MI ability. Fourteen participants performed MI of a self-paced walking sequence of 22 m before and after a resistance exercise eliciting muscle fatigue from upper and lower limbs, selectively. We indexed MI ability using psychometric and behavioral methods. Electromyography of the quadriceps was also recorded during physical practice trials of the walking sequence. For both experimental conditions, we recorded improved temporal congruence between MI and physical practice of the walking sequence (9.89 %, 95 % CI [7.03, 12.75], p < 0.01). Vividness decreased immediately after the fatiguing exercise (6.35 %, 95 % CI [5.18, 7.51], p < 0.05), before rapidly returning to pre-fatigue values during recovery trials. The results challenge the hypothesis of an effect of acute fatigue elicited by a resistance exercise on MI ability, i.e. restricted to MI tasks focusing fatigued effectors. The beneficial effects of fatigue conditions on the psychometric and behavioral indexes of MI ability are discussed in the broader context of psychobiological fatigue models linking perceived exertion with the reallocation of attentional resources. The general perception of fatigue, rather than local muscle fatigue, appeared linked to the acute effects of resistance exercise on MI ability.

Motor imagery and action observation following immobilization-induced hypoactivity: a narrative review

BACKGROUND

In sports, the risk of pathology or event that leads to an injury, a cessation of practice or even to an immobilization is high. The subsequent reduction of physical activity, or hypoactivity, induces neural and muscular changes that adversely affect motor skills and functional motor rehabilitation. Because the implementation of physical practice is difficult, if not impossible, during and immediately following injury or immobilization, complementary techniques have been proposed to minimize the deleterious impact of hypoactivity on neuromuscular function.

OBJECTIVE

The current narrative review aimed to discuss the contributions of motor imagery and action observation, which enhance motor (re)learning and induce neural adaptations in both healthy individuals and injured athletes.

METHODS

Online literature research for studies of the effects of motor imagery, action observation and their combination on hypoactivity, extracting relevant publications within the last decade (2009-2020).

RESULTS

From published studies and the authors' knowledge of both motor imagery and action observation, some elements are provided for developing applied protocols during and after the immobilization period. Such interventions consist of associating congruent action observation with kinesthetic motor imagery of different movements, organized in increasing difficulty. The aim is to maintain motor functions and promote motor relearning by activating sensorimotor cortical areas and corticomotor pathways of the injured effector.

CONCLUSION

This narrative review supports the implementation of combined motor imagery and action observation protocols in the context of sports rehabilitation.

Does partial activation of the neuromuscular system induce cross-education training effect? Case of a pilot study on motor imagery and neuromuscular electrical stimulation

INTRODUCTION

Cross education defines the gains observed in the contralateral limb following unilateral strength training of the other limb. The present study questioned the neural mechanisms associated with cross education following training by motor imagery (MI) or submaximal neuromuscular electrical stimulation (NMES), both representing a partial activation of the motor system as compared to conventional strength training.

METHODS

Twenty-seven participants were distributed in three groups: MI, NMES and control. Training groups underwent a training program of ten sessions in two weeks targeting plantar flexor muscles of one limb. In both legs, neuromuscular plasticity was assessed through maximal voluntary isometric contraction (MViC) and triceps surae electrophysiological responses evoked by electrical nerve stimulation (H-reflexes and V-waves).

RESULTS

NMES and MI training improved MViC torque of the trained limb by 11.3% (P < 0.001) and 13.8% (P < 0.001), respectively. MViC of the untrained limb increased by 10.3% (P < 0.003) in the MI group only, accompanied with increases in V-waves on both sides. In the NMES group, V-waves only increased in the trained limb. In the MI group, rest H-reflexes increased in both the trained and the untrained triceps suraes.

CONCLUSION

MI seems to be effective to induce cross education, probably because of the activation of cortical motor regions that impact the corticospinal neural drive of both trained and untrained sides. Conversely, submaximal NMES did not lead to cross education. The present results emphasize that cross education does not necessarily require muscle activity of the trained limb.

Does sonification of action simulation training impact corticospinal excitability and audiomotor plasticity?

Sonification is a sensory augmentation strategy whereby a sound is associated with, and modulated by, movement. Evidence suggests that sonification could be a viable strategy to maximize learning and rehabilitation. Recent studies investigated sonification of action observation, reporting beneficial effects, especially in Parkinson's disease. However, research on simulation training-a training regime based on action observation and motor imagery, in which actions are internally simulated, without physical execution-suggest that action observation alone is suboptimal, compared to the combined use of action observation and motor imagery. In this study, we explored the effects of sonified action observation and motor imagery on corticospinal excitability, as well as to evaluate the extent of practice-dependent plasticity induced by this training. Nineteen participants were recruited to complete a practice session based on combined and congruent action observation and motor imagery (AOMI) and physical imitation of the same action. Prior to the beginning, participants were randomly assigned to one of two groups, one group (nine participants) completed the practice block with sonified AOMI, while the other group (ten participants) completed the practice without extrinsic auditory information and served as control group. To investigate practice-induced plasticity, participants completed two auditory paired associative stimulation (aPAS) protocols, one completed after the practice block, and another one completed alone, without additional interventions, at least 7 days before the practice. After the practice block, both groups significantly increased their corticospinal excitability, but sonification did not exert additional benefits, compared to non-sonified conditions. In addition, aPAS significantly increased corticospinal excitability when completed alone, but when it was primed by a practice block, no modulatory effects on corticospinal excitability were found. It is possible that sonification of combined action observation and motor imagery may not be a useful strategy to improve corticospinal, but further studies are needed to explore its relationship with performance improvements. We also confirm the neuromodulatory effect of aPAS, but its interaction with audiomotor practice remain unclear.

Modulation of intracortical inhibition during physically performed and mentally simulated balance tasks

PURPOSE

Action observation (AO) during motor imagery (MI), so-called AO + MI, has been proposed as a new form of non-physical training, but the neural mechanisms involved remains largely unknown. Therefore, this study aimed to explore whether there were similarities in the modulation of short-interval intracortical inhibition (SICI) during execution and mental simulation of postural tasks, and if there was a difference in modulation of SICI between AO + MI and AO alone.

METHOD

21 young adults (mean ± SD = 24 ± 6.3 years) were asked to either passively observe (AO) or imagine while observing (AO + MI) or physically perform a stable and an unstable standing task, while motor evoked potentials and SICI were assessed in the soleus muscle.

RESULT

SICI results showed a modulation by condition (F2,40 = 6.42, p = 0.009) with less SICI in the execution condition compared to the AO + MI (p = 0.009) and AO (p = 0.002) condition. Moreover, switching from the stable to the unstable stance condition reduced significantly SICI (F1,20 = 8.34, p = 0.009) during both, physically performed (- 38.5%; p = 0.03) and mentally simulated balance (- 10%, p < 0.001, AO + MI and AO taken together).

CONCLUSION

The data demonstrate that SICI is reduced when switching from a stable to a more unstable standing task during both real task execution and mental simulation. Therefore, our results strengthen and further support the existence of similarities between executed and mentally simulated actions by showing that not only corticospinal excitability is similarly modulated but also SICI. This proposes that the activity of the inhibitory cortical network during mental simulation of balance tasks resembles the one during physical postural task execution.

Muscle-specific movement-phase-dependent modulation of corticospinal excitability during upper-limb motor execution and motor imagery combined with virtual action observation

Corticospinal excitability in humans can be facilitated during imagination and/or observation of upper-limb motor tasks. However, it remains unclear to what extent facilitation levels may differ from those elicited during execution of the same tasks. Twelve able-bodied individuals were recruited in this study. Motor evoked potentials (MEPs) in extensor carpi radialis (ECR) and flexor carpi radialis (FCR) muscles were elicited through transcranial magnetic stimulation of the primary motor cortex during: (i) rest; (ii) wrist extension; and (iii) wrist flexion. Responses were compared between: (1) motor imagery combined with virtual action observation (MI + AO; first-person virtual wrist movements shown on a computer display, while participants remained at rest and imagined these movements); and (2) motor execution (ME; participants extended or flexed their wrist). During MI + AO, ECR MEPs were facilitated during the extension phase but not the flexion phase, while FCR MEPs were facilitated during the flexion phase but not extension phase, compared to rest. During the ME condition, same, but greater, modulations were shown as those during MI + AO, while background muscle activities were similar in the rest phase as during extension and flexion phase in the MI + AO condition. Our results demonstrated that kinesthetic MI that included imagination and observation of virtual hands can elicit phase-dependent muscles-specific corticospinal facilitation of wrist muscles, consistent to those during actual hand extension and flexion. Moreover, we showed that MI + AO can contribute considerably to the overall corticospinal facilitation (∼20 % of ME) even without muscle contractions. These findings support utility of computer graphics-based motor imagery, which may have implications for rehabilitation and development of brain-computer interfaces.

Actual and Imagined Movements Reveal a Dual Role of the Insular Cortex for Motor Control

Movements rely on a mixture of feedforward and feedback mechanisms. With experience, the brain builds internal representations of actions in different contexts. Many factors are taken into account in this process among which is the immutable presence of gravity. Any displacement of a massive body in the gravitational field generates forces and torques that must be predicted and compensated by appropriate motor commands. The insular cortex is a key brain area for graviception. However, no attempt has been made to address whether the same internal representation of gravity is shared between feedforward and feedback mechanisms. Here, participants either mentally simulated (only feedforward) or performed (feedforward and feedback) vertical movements of the hand. We found that the posterior part of the insular cortex was engaged when feedback was processed. The anterior insula, however, was activated only in mental simulation of the action. A psychophysical experiment demonstrates participants' ability to integrate the effects of gravity. Our results point toward a dual internal representation of gravity within the insula. We discuss the conceptual link between these two dualities.

Mental rotation performance in young adults with and without developmental coordination disorder

While there have been consistent behavioural reports of atypical hand rotation task (HRT) performance in adults with developmental coordination disorder (DCD), this study aimed to clarify whether this deficit could be attributed to specific difficulties in motor imagery (MI), as opposed to broad deficits in general mental rotation. Participants were 57 young adults aged 18-30 years with (n = 22) and without DCD (n = 35). Participants were compared on the HRT, a measure of MI, and the letter number rotation task (LNRT), a common visual imagery task. Only participants whose behavioural performance on the HRT suggested use of a MI strategy were included in group comparisons. Young adults with DCD were significantly less efficient compared to controls when completing the HRT yet showed comparable performance on the LNRT relative to adults with typical motor ability. Our data are consistent with the view that atypical HRT performance in adults with DCD is likely to be attributed to specific difficulties engaging in MI, as opposed to deficits in general mental rotation. Based on the theory that MI provides insight into the integrity of internal action representations, these findings offer further support for the internal modelling deficit hypothesis of DCD.

Using motor imagery practice for improving motor performance - A review

Motor imagery practice is a current trend, but there is a need for a systematic integration of neuroscientific advances in the field. In this review, we describe the technique of motor imagery practice and its neural representation, considering different fields of application. The current practice of individualized motor imagery practice schemes often lacks systematization and is mostly based on experience. We review literature related to motor imagery practice in order to identify relevant modulators of practice effects like previous experience in motor training and motor imagery practice, the type of motor task to be trained, and strategies to increase sensory feedback during physical practice. Relevant discrepancies are identified between neuroscientific findings and practical consideration of these findings. To bridge these gaps, more effort should be directed at analyzing the brain network activities related to practically relevant motor imagery practice interventions.

Promising Effect of Visually-Assisted Motor Imagery Against Arthrogenic Muscle Inhibition - A Human Experimental Pain Study

Purpose

Clinically, arthrogenic muscle inhibition (AMI) has a negative impact on functional recovery in musculoskeletal disorders. One possible technique to relieve AMI is motor imagery, which is widely used in neurological rehabilitation to enhance motor neuron excitability. The purpose of this study was to verify the efficacy of visually-assisted motor imagery against AMI using a human experimental pain model.

Methods

Ten healthy volunteers were included. Experimental ankle pain was induced by hypertonic saline infusion into unilateral Kager’s fat pad. Isotonic saline was used as control. Subjects were instructed to imagine while watching a movie in which repetitive motion of their own ankle or fingers was shown. H-reflex normalized by the motor response (H/M ratio) on soleus muscle, maximal voluntary contraction (MVC) force of ankle flexion, and contractile activities of the calf muscles during MVC were recorded at baseline, pre-intervention, post-intervention, and 10 minutes after the pain had subsided.

Results

Hypertonic saline produced continuous and constant peri-ankle pain (VAS peak [median]= 6.7 [2.1–8.4] cm) compared to isotonic saline (0 [0–0.8] cm). In response to pain, there were significant decreases in the H/M ratio, MVC and contractile activities (P<0.01), all of which were successfully reversed after the ankle motion imagery. In contrast, no significant changes were observed with the finger motion imagery.

Conclusion

Visually-assisted motor imagery improved the pain-induced AMI. Motor imagery of the painful joint itself would efficiently work for relieving AMI. This investigation possibly shows the potential of a novel and versatile approach against AMI for patients with musculoskeletal pain.

Insights into the combination of neuromuscular electrical stimulation and motor imagery in a training-based approach

Introduction

Training stimuli that partially activate the neuromuscular system, such as motor imagery (MI) or neuromuscular electrical stimulation (NMES), have been previously shown as efficient tools to induce strength gains. Here the efficacy of MI, NMES or NMES + MI trainings has been compared.

Methods

Thirty-seven participants were enrolled in a training program of ten sessions in 2 weeks targeting plantar flexor muscles, distributed in four groups: MI, NMES, NMES + MI and control. Each group underwent forty contractions in each session, NMES + MI group doing 20 contractions of each modality. Before and after, the neuromuscular function was tested through the recording of maximal voluntary contraction (MVC), but also electrophysiological and mechanical responses associated with electrical nerve stimulation. Muscle architecture was assessed by ultrasonography.

Results

MVC increased by 11.3 ± 3.5% in NMES group, by 13.8 ± 5.6% in MI, while unchanged for NMES + MI and control. During MVC, a significant increase in V-wave without associated changes in superimposed H-reflex has been observed for NMES and MI, suggesting that neural adaptations occurred at supraspinal level. Rest spinal excitability was increased in the MI group while decreased in the NMES group. No change in muscle architecture (pennation angle, fascicle length) has been found in any group but muscular peak twitch and soleus maximal M-wave increased in the NMES group only.

Conclusion

Finally, MI and NMES seem to be efficient stimuli to improve strength, although both exhibited different and specific neural plasticity. On its side, NMES + MI combination did not provide the expected gains, suggesting that their effects are not simply cumulative, or even are competitive.

Corticospinal excitability during motor imagery is diminished by continuous repetition-induced fatigue

Application of continuous repetition of motor imagery can improve the performance of exercise tasks. However, there is a lack of more detailed neurophysiological evidence to support the formulation of clear standards for interventions using motor imagery. Moreover, identification of motor imagery intervention time is necessary because it exhibits possible central fatigue. Therefore, the purpose of this study was to elucidate the development of fatigue during continuous repetition of motor imagery through objective and subjective evaluation. The study involved two experiments. In experiment 1, 14 healthy young volunteers were required to imagine grasping and lifting a 1.5-L plastic bottle using the whole hand. Each participant performed the motor imagery task 100 times under each condition with 48 hours interval between two conditions: 500 mL or 1500 mL of water in the bottle during the demonstration phase. Mental fatigue and a decrease in pinch power appeared under the 1500-mL condition. There were changes in concentration ability or corticospinal excitability, as assessed by motor evoked potentials, between each set with continuous repetition of motor imagery also under the 1500-mL condition. Therefore, in experiment 2, 12 healthy volunteers were required to perform the motor imagery task 200 times under the 1500-mL condition. Both concentration ability and corticospinal excitability decreased. This is the first study to show that continuous repetition of motor imagery can decrease corticospinal excitability in addition to producing mental fatigue. This study was approved by the Institutional Ethics Committee at the Nagasaki University Graduate School of Biomedical and Health Sciences (approval No. 18121302) on January 30, 2019.

The motor-related brain activity that supports joint action: A review

Recent years have seen a rapid increase in research investigating the motor-related brain activity that supports joint action. This research has employed a variety of joint action tasks and an array of neuroimaging techniques, including fMRI, fNIRS, EEG, and TMS. In this review, we provide an overview of this research to delineate what is known about the motor-related brain activity that contributes to joint action and to highlight key questions for future research. Taken together, the surveyed research supports three major conclusions. First, the mere presence of a joint action context is sufficient to modulate motor activity elicited by observing others' actions. Second, joint action is supported by dissociable motor activity associated with a person's own actions, their partner's actions, and the joint action, and by between-brain coupling of motor-related oscillatory activity. Third, the structure of a joint action modulates the motor activity involved: Unique motor activity is associated with performing joint actions comprised of complementary actions and with holding the roles of leader and follower within a joint action. We conclude the review by highlighting overarching themes and key questions for future research.