Daytime naps improve motor imagery learning

Examining the prevalence of sleep disturbances in patients seeking physical therapy services

OBJECTIVE

The purpose of this study was to assess the prevalence of sleep disturbances in adults seeking physical therapy services.

METHODS

Participants were issued an electronic survey to provide demographic information and the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Sleep Hygiene Index (SHI), Insomnia Severity Index (ISI), STOP-BANG (obstructive sleep apnea (OSA) risk), and restless leg syndrome (RLS) risk. Percentages were calculated to describe prevalence of sleep disturbances, and Spearman's correlations were used to identify associations between pain and sleep questionnaires.

RESULTS

Eighty-eight participants (47.9 ± 15.8 years, 68 females) completed the survey. Seventy-eight percent (n = 69) scored >5 on the PSQI; 32% (n = 28) scored ≥10 on the ESS; 52% (n = 46) scored ≥16 on the SHI; 51% (n = 45) scored ≥10 on the ISI; 28% (n = 25) had intermediate or high risk of OSA; and 40% (n = 35) indicated possible RLS. Pain level was significantly associated with PSQI (r(86) = 0.277, p = .009) and ISI (r(86) = 0.268, p = .012).

CONCLUSIONS

There was a higher prevalence of sleep disturbances in adults seeking physical therapy services than in the general population. Increased pain severity was associated with poorer sleep quality and increased insomnia symptoms. This study highlights the need to screen patients for sleep disturbances.

Brain plasticity underlying sleep-dependent motor consolidation after motor imagery

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

Sleep-related motor skill consolidation and generalizability after physical practice, motor imagery, and action observation

Sleep benefits the consolidation of motor skills learned by physical practice, mainly through periodic thalamocortical sleep spindle activity. However, motor skills can be learned without overt movement through motor imagery or action observation. Here, we investigated whether sleep spindle activity also supports the consolidation of non-physically learned movements. Forty-five electroencephalographic sleep recordings were collected during a daytime nap after motor sequence learning by physical practice, motor imagery, or action observation. Our findings reveal that a temporal cluster-based organization of sleep spindles underlies motor memory consolidation in all groups, albeit with distinct behavioral outcomes. A daytime nap offers an early sleep window promoting the retention of motor skills learned by physical practice and motor imagery, and its generalizability toward the inter-manual transfer of skill after action observation. Findings may further have practical impacts with the development of non-physical rehabilitation interventions for patients having to remaster skills following peripherical or brain injury.

Learning to Cycle: Is Velocity a Control Parameter for Children's Cycle Patterns on the Balance Bike?

The balance bike (BB) has been pointed out as being the most efficient learning bicycle due to its inherent stimulation of balance. However, the process of acquiring the control of balance on the BB has not been explored. This study aimed to: (i) categorize the cycle patterns of children on the BB, (ii) compare the cycle patterns in different stages of learning (before and after six sessions of a BB practice program), and (iii) verify whether velocity is a control parameter leading to transitions between different cycle patterns on a BB. The data were collected during the Learning to Cycle program from 12 children aged 6.06 ± 1.25 years. The velocity was measured using an inertial sensor. Seven different movement patterns were captured and categorized through video analysis. After practice, there was an increase in the mean number of different patterns and in the global mean and maximum velocity. These were interpreted as an improvement of the motor competence in the use of the BB. The results obtained support the hypothesis that velocity is a control parameter which leads to the emergence of diverse patterns of behavior. As the speed increased, the amount of foot contact with the ground became less frequent and the locomotor modes that imply that longer flight phases began to emerge.

The effect of interictal epileptic discharges and following spindles on motor sequence learning in epilepsy patients

PURPOSE

Interictal epileptic discharges (IEDs) are known to affect cognitive function in patients with epilepsy, but the mechanism has not been elucidated. Sleep spindles appearing in synchronization with IEDs were recently demonstrated to impair memory consolidation in rat, but this has not been investigated in humans. On the other hand, the increase of sleep spindles at night after learning is positively correlated with amplified learning effects during sleep for motor sequence learning. In this study, we examined the effects of IEDs and IED-coupled spindles on motor sequence learning in patients with epilepsy, and clarified their pathological significance.

MATERIALS AND METHODS

Patients undergoing long-term video-electroencephalography (LT-VEEG) at our hospital from June 2019 to November 2021 and age-matched healthy subjects were recruited. Motor sequence learning consisting of a finger-tapping task was performed before bedtime and the next morning, and the improvement rate of performance was defined as the sleep-dependent learning effect. We searched for factors associated with the changes in learning effect observed between the periods of when antiseizure medications (ASMs) were withdrawn for LT-VEEG and when they were returned to usual doses after LT-VEEG.

RESULTS

Excluding six patients who had epileptic seizures at night after learning, nine patients and 11 healthy subjects were included in the study. In the patient group, there was no significant learning effect when ASMs were withdrawn. The changes in learning effect of the patient group during ASM withdrawal were not correlated with changes in sleep duration or IED density; however, they were significantly negatively correlated with changes in IED-coupled spindle density.

CONCLUSION

We found that the increase of IED-coupled spindles correlated with the decrease of sleep-dependent learning effects of procedural memory. Pathological IED-coupled sleep spindles could hinder memory consolidation, that is dependent on physiological sleep spindles, resulting in cognitive dysfunction in patients with epilepsy.

Potential Benefits of Daytime Naps on Consecutive Days for Motor Adaptation Learning

Daytime napping offers benefits for motor memory learning and is used as a habitual countermeasure to improve daytime functioning. A single nap has been shown to ameliorate motor memory learning, although the effect of consecutive napping on motor memory consolidation remains unclear. This study aimed to explore the effect of daytime napping over multiple days on motor memory learning. Twenty university students were divided into a napping group and no-nap (awake) group. The napping group performed motor adaption tasks before and after napping for three consecutive days, whereas the no-nap group performed the task on a similar time schedule as the napping group. A subsequent retest was conducted one week after the end of the intervention. Significant differences were observed only for speed at 30 degrees to complete the retention task, which was significantly faster in the napping group than in the awake group. No significant consolidation effects over the three consecutive nap intervention periods were confirmed. Due to the limitations of the different experimental environments of the napping and the control group, the current results warrant further investigation to assess whether consecutive napping may benefit motor memory learning, which is specific to speed.

Systematic review and meta-analyses on the effects of afternoon napping on cognition

Naps are increasingly considered a means to boost cognitive performance. We quantified the cognitive effects of napping in 60 samples from 54 studies. 52 samples evaluated memory. We first evaluated effect sizes for all tests together, before separately assessing their effects on memory, vigilance, speed of processing and executive function. We next examined whether nap effects were moderated by study features of age, nap length, nap start time, habituality and prior sleep restriction. Naps showed significant benefits for the total aggregate of cognitive tests (Cohen's d = 0.379, CI₉₅ = 0.296-0.462). Significant domain specific effects were present for declarative (Cohen's d = 0.376, CI₉₅ = 0.269-0.482) and procedural memory (Cohen's d = 0.494, CI₉₅ = 0.301-0.686), vigilance (Cohen's d = 0.610, CI₉₅ = 0.291-0.929) and speed of processing (Cohen's d = 0.211, CI₉₅ = 0.052-0.369). There were no significant moderation effects of any of the study features. Nap effects were of comparable magnitude across subgroups of each of the 5 moderators (Q values = 0.009 to 8.572, p values > 0.116). Afternoon naps have a small to medium benefit over multiple cognitive tests. These effects transcend age, nap duration and tentatively, habituality and prior nocturnal sleep.

Effects of a brief afternoon nap on declarative and procedural memory

The relationship between sleep and memory consolidation has not been fully revealed. The current study aimed to investigate how a brief afternoon nap contributed to the consolidation of declarative and procedural memory by exploring the relationship between sleep characteristics (i.e., the durations of sleep stages and slow oscillation, slow-wave activity, and spindle activity extracted from sleep) and task performance and the relationship between delta, theta, alpha, and beta bands extracted from wake during task performance and task performance. Twenty-three healthy young adults underwent a paired associates learning task and a sequential finger-tapping task with easy and difficult levels and were tested for memory performance before and after the intervention (i.e., an about 30-min nap or stay awake). Electroencephalogram (EEG) signals were continously recorded during the whole experiment. Results revealed that a short afternoon nap improved movement speed for the procedural memory task, regardless of the task difficulty, but unaffected the performance on the declarative memory task. Besides, the improvement in movement speed for the easy procedural memory task was positively correlated with slow-wave activity (SWA) during non-rapid-eye-movement (NREM) sleep but negatively correlated with slow oscillation and spindle activity during sleep stage 2 and NREM sleep, and the improvement in the difficult procedural memory task correlated positively with SWA during NREM sleep. Moreover, performance on the easy declarative and procedural memory tasks was negatively correlated with the relative power of alpha or theta; whereas the alpha band was positively correlated with the difficult declarative memory performance. These findings suggested that a brief afternoon nap with NREM sleep would benefit procedural memory consolidation but not declarative memory; such contribution of napping to memory consolidation would be either explained by the sleep characteristics or physiological arousal during performing tasks; task difficulty would moderate the relationship between the declarative memory performance and EEGs during task performance.

Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis

BACKGROUND

Napping in the workplace is under debate, with interesting results on work efficiency and well-being of workers. In this systematic review and meta-analysis, we aimed to assess the benefits of a short daytime nap on cognitive performance.

METHODS

PubMed, Cochrane Library, ScienceDirect and PsycInfo databases were searched until 19 August 2021. Cognitive performance in working-aged adults, both before and following a daytime nap or under control conditions (no nap), was analysed by time and by type of cognitive function (alertness, executive function and memory).

RESULTS

We included 11 studies (all in laboratory conditions including one with a subgroup in working conditions) for a total of 381 participants. Mean duration of nap was 55.4 ± 29.4 min. Overall cognitive performance did not differ at baseline (t0) between groups (effect size -0.03, 95% CI -0.14 to 0.07), and improved in the nap group following the nap (t1) (0.18, 0.09 to 0.27), especially for alertness (0.29, 0.10 to 0.48). Sensitivity analyses gave similar results comparing only randomized controlled trials, and after exclusion of outliers. Whatever the model used, performance mainly improved until 120 min after nap, with conflicting results during the sleep inertia period. Early naps in the afternoon (before 1.00 p.m.) gave better cognitive performance (0.24, -0.07 to 0.34). The benefits of napping were independent of sex and age. Duration of nap and time between nap and t1 did not influence cognitive performance.

CONCLUSIONS

Despite the fact that our meta-analyses included almost exclusively laboratory studies, daytime napping in the afternoon improved cognitive performance with beneficial effects of early nap. More studies in real work condition are warranted before implementing daytime napping at work as a preventive measure to improve work efficiency.

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.

Motor imagery practice benefits during arm immobilization

Motor imagery (MI) is known to engage motor networks and is increasingly used as a relevant strategy in functional rehabilitation following immobilization, whereas its effects when applied during immobilization remain underexplored. Here, we hypothesized that MI practice during 11 h of arm-immobilization prevents immobilization-related changes at the sensorimotor and cortical representations of hand, as well as on sleep features. Fourteen participants were tested after a normal day (without immobilization), followed by two 11-h periods of immobilization, either with concomitant MI treatment or control tasks, one week apart. At the end of each condition, participants were tested on a hand laterality judgment task, then underwent transcranial magnetic stimulation to measure cortical excitability of the primary motor cortices (M1), followed by a night of sleep during which polysomnography data was recorded. We show that MI treatment applied during arm immobilization had beneficial effects on (1) the sensorimotor representation of hands, (2) the cortical excitability over M1 contralateral to arm-immobilization, and (3) sleep spindles over both M1s during the post-immobilization night. Furthermore, (4) the time spent in REM sleep was significantly longer, following the MI treatment. Altogether, these results support that implementing MI during immobilization may limit deleterious effects of limb disuse, at several levels of sensorimotor functioning.

Role of Napping for Learning across the Lifespan

Purpose of review

Napping is a common behavior across age groups. While studies have shown a benefit of overnight sleep on memory consolidation, given differences in nap frequency, composition, and intent, it is important to consider whether naps serve a memory function across development and aging.

Recent findings

We review studies of the role of naps in declarative, emotional, and motor procedural memory consolidation across age groups. Recent findings in both developmental and aging populations find that naps benefit learning of many tasks but may require additional learning or sleep bouts compared to young adult populations. These studies have also identified variations in nap physiology based on the purpose of the nap, timing of the nap, or age.

Summary

These studies lend to our understanding of the function of sleep, and the potential for naps as an intervention for those with reduced nighttime sleep or learning impairments.

Acquisition and consolidation processes following motor imagery practice

It well-known that mental training improves skill performance. Here, we evaluated skill acquisition and consolidation after physical or motor imagery practice, by means of an arm pointing task requiring speed-accuracy trade-off. In the main experiment, we showed a significant enhancement of skill after both practices (72 training trials), with a better acquisition after physical practice. Interestingly, we found a positive impact of the passage of time (+ 6 h post training) on skill consolidation for the motor imagery training only, without any effect of sleep (+ 24 h post training) for none of the interventions. In a control experiment, we matched the gain in skill learning after physical training (new group) with that obtained after motor imagery training (main experiment) to evaluate skill consolidation after the same amount of learning. Skill performance in this control group deteriorated with the passage of time and sleep. In another control experiment, we increased the number of imagined trials (n = 100, new group) to compare the acquisition and consolidation processes of this group with that observed in the motor imagery group of the main experiment. We did not find significant differences between the two groups. These findings suggest that physical and motor imagery practice drive skill learning through different acquisition and consolidation processes.

Acute Effects of Mental Recovery Strategies After a Mentally Fatiguing Task

Both daily demands as well as training and competition characteristics in sports can result in a psychobiological state of mental fatigue leading to feelings of tiredness, lack of energy, an increased perception of effort, and performance decrements. Moreover, optimal performance will only be achievable if the balance between recovery and stress states is re-established. Consequently, recovery strategies are needed aiming at mental aspects of recovery. The aim of the study was to examine acute effects of potential mental recovery strategies (MR) on subjective-psychological and on cognitive performance outcomes after a mentally fatiguing task. A laboratory-based randomized cross-over study with twenty-four students (22.8 ± 3.6 years) was applied. Participants were run through a powernap intervention (PN), a systematic breathing intervention (SB), a systematic breathing plus mental imagery intervention (SB+), and a control condition (CC) with one trial a week over four consecutive weeks. Mental fatigue was induced by completion of the 60-min version of the AX-continuous performance test (AX-CPT). The Short Recovery and Stress Scale (SRSS) and Visual Analog Scales (VAS) were assessed to measure effects on perceptual outcomes. Cognitive performance was measured with a reaction time test of the Vienna Test System (VTS). During all three recovery interventions and CC portable polysomnography was applied. Results showed a significant increase from pre-AX-CPT to pre-MR on fatigue states and recovery-stress states indicating that the induction of mental fatigue was effective. Moreover, results underlined that analysis yielded no significant differences between recovery interventions and the control condition but they revealed significant time effects for VAS, SRSS items, and cognitive performance. However, it could be derived that the application of a rest break with 20 min of mental recovery strategies appears to enhance recovery on a mainly mental and emotional level and to reduce perceived mental fatigue.

The Relationship between Mindfulness and Sleep Quality is Mediated by Emotion Regulation

Background: Sleep is critical to a person’s overall physical and mental health. The current study investigated the relationship between mindfulness and sleep quality, to determine if this relationship is influenced by emotion regulation and perceived stress. Method: Three hundred sixty-seven undergraduate students responded to five self-report measures, (1) The Cognitive and Affective Mindfulness Scale (CAMS-R), (2) The Impact of Event Scale (IES-R), (3) The Five Facet Mindfulness Questionnaire (FFMQ), (4) The Emotion Regulation Questionnaire (ERQ), and (5) The Pittsburgh Sleep Quality Index (PSQI). Results: Results revealed (1) sleep quality was predicted by the presence of hyperarousal, acting with awareness, and the CAMS-R, (2) the Impact of Event Scale was moderately positively correlated with a person’s global score on the Pittsburgh Sleep Quality Index, and (3) the relationship between mindfulness and sleep quality was mediated by hyperarousal. Conclusions: Together, our findings suggest that higher levels of intrusive thoughts, avoidance, and hyperarousal are correlated with lower overall sleep quality, and the use of mindfulness techniques such as acting with awareness and being non-reacting to negative thoughts or hyperarousal may help predict an individual’s sleep quality.

Acquisition and consolidation of sequential footstep movements with physical and motor imagery practice

Sleep-dependent performance enhancement has been consistently reported after explicit sequential finger learning, even using motor imagery practice (MIP), but whether similar sleep benefits occur after explicit sequential gross motor learning with the lower limbs has been addressed less often. Here, we investigated both acquisition and consolidation processes in an innovative sequential footstep task performed either physically or mentally. Forty-eight healthy young participants were tested before and after physical practice (PP) or MIP on the footstep task, following either a night of sleep (PPsleep and MIPsleep groups) or an equivalent daytime period (PPday and MIPday groups). Results showed that all groups improved motor performance following the acquisition session, albeit the magnitude of enhancement in the MIP groups remained lower relative to the PP groups. Importantly, only the MIPsleep group further improved performance after a night of sleep, while the other groups stabilized their performance after consolidation. Together, these findings demonstrate a sleep-dependent gain in performance after MIP in a sequential motor task with the lower limbs but not after PP. Overall, the present study is of particular importance in the context of motor learning and functional rehabilitation.

Neuroscientism, the neuroscience of learning

Purpose

Although the field of neuroscience has evolved dramatically, little research has attempted to conceptualize the impact of neuroscience on the field of human resource development (HRD). The purpose of this study is an integrative review of the influential relationship between neuroscience and workplace learning including applicable implications for HRD research and practice.

Design/methodology/approach

By reviewing 93 studies on neuroscience and brain-based learning published between 1995 and 2017, the authors synthesized their findings.

Findings

This study discusses the basic concepts of neuroscience such as the structure and functions of the brain, neuroscientific findings about memory and cognition, the effect of neural transmitters on memory and cognition and the neuroscience of learning. This study also illustrates brain-based learning styles affecting learning and describes various neuroscientific learning principles and models that can be applied to practical planning and the delivery of workplace learning and HRD activities.

Originality/value

This study concludes with brain-based learning principles called neuroscientism compared with traditional learning theories. It also includes several brain-based learning cases from workplace settings and implications for future research and further HRD practices.

Can Daytime Napping Assist the Process of Skills Acquisition After Stroke?

Acquisition and reacquisition of skills is a main pillar of functional recovery after stroke. Nighttime sleep has a positive influence on motor learning in healthy individuals, whereas the effect of daytime sleep on neuro-rehabilitative training and relearning of the trained skills is often neglected. The aim of this study was to investigate the relationship between daytime sleep (napping) and the ability to learn a new visuomotor task in chronic stroke patients. The main hypothesis was that sleep enhances motor memory consolidation after training resulting in better motor performance after a period of daytime sleep. Thirty stroke survivors completed the study. They were randomized to one of three different conditions (i) wakeful resting, (ii) short nap (10-20 min), or (iii) long nap (50-80 min). All individuals trained the task with the contralesional, stroke-impaired hand, behavioral evaluation was performed after the break time (wake, nap), and 24 h later. Patients demonstrated a significant task-related behavioral improvement throughout the training. In contrast to the main hypothesis, there was no evidence for sleep-dependent motor consolidation early after the initial, diurnal break, or after an additional full night of sleep. In a secondary analysis, the performance changes of stroke survivors were compared with those of a group of healthy older adults who performed the identical task within the same experimental setup with their non-dominant hand. Performance levels were comparable between both cohorts at all time points. Stroke-related difficulties in motor control did not impact on the degree of performance improvement through training and daytime sleep did not impact on the behavioral gains in the two groups. In summary, the current study indicates that one-time daytime sleep after motor training does not influence behavioral gains.

Acute Sleep Restriction Has Differential Effects on Components of Attention

Inadequate nightly sleep duration can impair daytime functioning, including interfering with attentional and other cognitive processes. Current models posit that attention is a complex function regulated by several separate, but interacting, neural systems responsible for vigilance, orienting, and executive control. However, it is not clear to what extent each of these underlying component processes is affected by sleep loss. The purpose of this study was to evaluate the effects of acute sleep restriction on these attentional components using the Dalhousie Computerized Attention Battery (DalCAB). DalCAB tasks were administered to healthy women (aged 19-25 years) on two consecutive mornings: once after a night with 9 h time in bed (TIB), and once again after either another night with 9 h TIB (control condition, n = 19) or after a night with 3 h TIB (sleep restriction condition, n = 20). Self-ratings of sleepiness and mood were also obtained following each sleep condition. Participants showed increases in self-reported sleepiness and fatigue after the second night only in the sleep restriction group. Sleep restriction primarily affected processing speed on tasks measuring vigilance; however, performance deficits were also observed on some measures of executive function (e.g., go/no-go task, flanker task, working memory). Tasks assessing orienting of attention were largely unaffected. These results indicate that acute sleep restriction has differential effects on distinct components of attention, which should be considered in modeling the impacts of sleep loss on the underlying attentional networks.

Sleep Health Promotion: Practical Information for Physical Therapists

Sleep disturbances occur in one third of the US population, and the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control has deemed insufficient sleep to be a public health problem. Knowledge about sleep and skills to screen sleep disorders and to promote sleep health have been recommended for physical therapists. Furthermore, in survey studies, physical therapists overwhelmingly agree that sleep is important for health and poor sleep impairs function. Sleep is critical for the proper functioning of the body, including immune function, tissue healing, pain modulation, cardiovascular health, cognitive function, and learning and memory. Sleep disruptions occur across the life span and in individuals with various conditions that are typically treated by physical therapists. Therefore, the purpose of this perspective paper is to (1) discuss the relevance of sleep to physical therapist practice, (2) recommend tools to screen for the 3 most common sleep disorders, and (3) provide suggestions for how therapists can integrate sleep health in prevention, health promotion, and wellness interventions.

Interactive effects of visuomotor perturbation and an afternoon nap on performance and the flow experience

The present study was designed (1) to clarify the relationship between the flow experience and improvements in visuomotor skills, (2) to examine the effects of rotating the axis of a computer mouse on visuomotor skills, and (3) to investigate the effects of sleep for improving visuomotor skills. Participants (N = 18) responded to Perturbation and nap (PER+Nap), No-perturbation and nap (NoPER+Nap) and Perturbation and rest (PER+Rest) conditions. In the PER+Nap condition, participants conducted a visuomotor tracking task using a computer mouse, which was accompanied by perturbation caused by rotating the axis of their mouse. After the task, they took a 90 min nap. In NoPER+Nap condition, they conducted the same visuomotor task without any perturbation and took a nap. In the PER+Rest condition, participants conducted the task with the perturbation and took a 90 min break spent reading magazines instead of taking a nap. Results indicated (1) the flow experience did not occur when participants’ skills and the degree of the visuomotor challenge were matching, (2) improvements of visuomotor skills occurred regardless of the perturbation, (3) improvements of visuomotor skills occurred unrelated to the flow experience, or to mood states, and (4) improvements of visuomotor performance occurred regardless of sleep. These findings suggest that improvements of visuomotor skills occur regardless of mood status and occur independently of perturbations by axis rotation. The study also suggests that the acquisition of skills is related to merely the time elapsed since learning, rather than to sleep.

Neural plasticity during motor learning with motor imagery practice: Review and perspectives

In the last decade, many studies confirmed the benefits of mental practice with motor imagery. In this review we first aimed to compile data issued from fundamental and clinical investigations and to provide the key-components for the optimization of motor imagery strategy. We focused on transcranial magnetic stimulation studies, supported by brain imaging research, that sustain the current hypothesis of a functional link between cortical reorganization and behavioral improvement. As perspectives, we suggest a model of neural adaptation following mental practice, in which synapse conductivity and inhibitory mechanisms at the spinal level may also play an important role.

Online and Offline Performance Gains Following Motor Imagery Practice: A Comprehensive Review of Behavioral and Neuroimaging Studies

There is now compelling evidence that motor imagery (MI) promotes motor learning. While MI has been shown to influence the early stages of the learning process, recent data revealed that sleep also contributes to the consolidation of the memory trace. How such "online" and "offline" processes take place and how they interact to impact the neural underpinnings of movements has received little attention. The aim of the present review is twofold: (i) providing an overview of recent applied and fundamental studies investigating the effects of MI practice (MIP) on motor learning; and (ii) detangling applied and fundamental findings in support of a sleep contribution to motor consolidation after MIP. We conclude with an integrative approach of online and offline learning resulting from intense MIP in healthy participants, and underline research avenues in the motor learning/clinical domains.

Daytime sleep has no effect on the time course of motor sequence and visuomotor adaptation learning

Sleep has previously been claimed to be essential for the continued learning processes of declarative information as well as procedural learning. This study was conducted to examine the importance of sleep, especially the effects of midday naps, on motor sequence and visuomotor adaptation learning. Thirty-five (27 females) healthy, young adults aged between 18 and 30years of age participated in the current study. Addressing potential differences in explicit sequence and motor adaptation learning participants were asked to learn both, a nine-element explicit sequence and a motor adaptation task, in a crossover fashion on two consecutive days. Both tasks were performed with their non-dominant left hand. Prior to learning, each participant was randomized to one of three interventions; (1) power nap: 10-20min sleep, (2) long nap: 50-80min sleep or (3) a 45-min wake-condition. Performance of the motor learning task took place prior to and after a midday rest period, as well as after a night of sleep. Both sleep conditions were dominated by Stage N2 sleep with embedded sleep spindles, which have been described to be associated with enhancement of motor performance. Significant performance changes were observed in both tasks across all interventions (sleep and wake) confirming that learning took place. In the present setup, the magnitude of motor learning was not sleep-dependent in young adults - no differences between the intervention groups (short nap, long nap, no nap) could be found. The effect of the following night of sleep was not influenced by the previous midday rest or sleep period. This finding may be related to the selectiveness of the human brain enhancing especially memory being thought of as important in the future. Previous findings on motor learning enhancing effects of sleep, especially of daytime sleep, are challenged.

Anodal transcranial direct current stimulation enhances the effects of motor imagery training in a finger tapping task

Motor imagery (MI) training and anodal transcranial direct current stimulation (tDCS) applied over the primary motor cortex can independently improve hand motor function. The main objective of this double-blind, sham-controlled study was to examine whether anodal tDCS over the primary motor cortex could enhance the effects of MI training on the learning of a finger tapping sequence. Thirty-six right-handed young human adults were assigned to one of three groups: (i) who performed MI training combined with anodal tDCS applied over the primary motor cortex; (ii) who performed MI training combined with sham tDCS; and (iii) who received tDCS while reading a book. The MI training consisted of mentally rehearsing an eight-item complex finger sequence for 13 min. Before (Pre-test), immediately after (Post-test 1), and at 90 min after (Post-test 2) MI training, the participants physically repeated the sequence as fast and as accurately as possible. An anova showed that the number of sequences correctly performed significantly increased between Pre-test and Post-test 1 and remained stable at Post-test 2 in the three groups (P < 0.001). Furthermore, the percentage increase in performance between Pre-test and Post-test 1 and Post-test 2 was significantly greater in the group that performed MI training combined with anodal tDCS compared with the other two groups (P < 0.05). As a potential physiological explanation, the synaptic strength within the primary motor cortex could have been reinforced by the association of MI training and tDCS compared with MI training alone and tDCS alone.

How to become an expert: A new perspective on the role of sleep in the mastery of procedural skills

How do you get to Carnegie Hall? Practice, sleep, practice. With enough practice - and sleep - we adopt new strategies that eventually become automatic, and subsequently require only the refinement of the existing skill to become an "expert". It is not known whether sleep is involved in the mastery and refinement of new skills that lead to expertise, nor is it known whether this may be primarily dependent on rapid eye movement (REM), non-REM stage 2 (NREM2) or slow wave sleep (SWS). Here, we employed behavioural and scalp-recorded electroencephalography (EEG) techniques to investigate the post-learning changes in the architecture (e.g., REM, NREM2 and SWS duration) and the electrophysiological features (e.g., rapid eye movements, sleep spindles and slow wave activity) that characterize these sleep states as individuals progress from night to night, from "Novice" to "Experts" on a cognitive procedural task (e.g., the Tower of Hanoi task). Here, we demonstrate that speed of movements improves over the course of training irrespective of whether sleep or wake intervenes training sessions, whereas accuracy improves gradually, but only significantly over a night of sleep immediately prior to mastery of the task. On the night that subjects are first exposed to the task, the density of fast spindles increased significantly during both NREM2 and SWS accompanied by increased NREM2 sigma power and SWS delta power, whereas, on the night that subjects become experts on the task, they show increased REM sleep duration and spindles became larger in terms of amplitude and duration during SWS. Re-exposure to the task one-week after it had already been mastered resulted in increased NREM sleep duration, and again, increased spindle density of fast spindles during SWS and NREM2 and increased NREM2 sigma power and SWS delta power. Importantly, increased spindle density was correlated with overnight improvement in speed and accuracy. Taken together, these results help to elucidate how REM and NREM sleep are uniquely involved in memory consolidation over the course of the mastery of a new cognitively complex skill, and help to resolve controversies regarding sequential nature of memory processing during sleep in humans, for which consistent evidence is currently lacking.

Rapid-Eye-Movement-Sleep (REM) Associated Enhancement of Working Memory Performance after a Daytime Nap

The main objective was to study the impact of a daytime sleep opportunity on working memory and the mechanism behind such impact. This study adopted an experimental design in a sleep research laboratory. Eighty healthy college students (Age:17-23, 36 males) were randomized to either have a polysomnography-monitored daytime sleep opportunity (Nap-group, n=40) or stay awake (Wake-group, n=40) between the two assessment sessions. All participants completed a sleep diary and wore an actigraph-watch for 5 days before and one day after the assessment sessions. They completed the state-measurement of sleepiness and affect, in addition to a psychomotor vigilance test and a working memory task before and after the nap/wake sessions. The two groups did not differ in their sleep characteristics prior to and after the lab visit. The Nap-group had higher accuracy on the working memory task, fewer lapses on the psychomotor vigilance test and lower state-sleepiness than the Wake-group. Within the Nap-group, working memory accuracy was positively correlated with duration of rapid eye movement sleep (REM) and total sleep time during the nap. Our findings suggested that "sleep gain" during a daytime sleep opportunity had significant positive impact on working memory performance, without affecting subsequent nighttime sleep in young adult, and such impact was associated with the duration of REM. While REM abnormality has long been noted in pathological conditions (e.g. depression), which are also presented with cognitive dysfunctions (e.g. working memory deficits), this was the first evidence showing working memory enhancement associated with REM in daytime napping in college students, who likely had habitual short sleep duration but were otherwise generally healthy.

The napping behaviour of Australian university students

The purpose of this study was to evaluate the self-reported sleep and napping behaviour of Australian university students and the relationship between napping and daytime functioning. A sample of 280 university first-year psychology students (median age  = 19.00 years) completed a 6-item napping behaviour questionnaire, a 12-item Daytime Feelings and Functioning Scale, the Pittsburg Sleep Quality Index and the Epworth Sleepiness Scale. Results indicated that 53.6% of students reported napping with 34% napping at least 1-2 times per week, and 17% napping three or more occasions per week. Long naps, those over 30 minutes, were taken by 77% of the napping students. Sixty-one percent of students reported they took long naps during the post-lunch dip period, from 2-4 pm. Students who nap at least once per week reported significantly more problems organizing their thoughts, gaining motivation, concentrating, and finishing tasks than students who did not nap. Students who napped also felt significantly more sleepy and depressed when compared to students who did not nap. The results also indicated that nap frequency increased with daytime sleepiness. The majority of students (51%) reported sleeping 6-7 hours per night or less. Overall, the results from this study suggest that among this population of Australian first-year university students habitual napping is common and may be used in an attempt to compensate for the detrimental effects of excessive sleepiness.

Brain plasticity and motor practice in cognitive aging

For more than two decades, there have been extensive studies of experience-based neural plasticity exploring effective applications of brain plasticity for cognitive and motor development. Research suggests that human brains continuously undergo structural reorganization and functional changes in response to stimulations or training. From a developmental point of view, the assumption of lifespan brain plasticity has been extended to older adults in terms of the benefits of cognitive training and physical therapy. To summarize recent developments, first, we introduce the concept of neural plasticity from a developmental perspective. Secondly, we note that motor learning often refers to deliberate practice and the resulting performance enhancement and adaptability. We discuss the close interplay between neural plasticity, motor learning and cognitive aging. Thirdly, we review research on motor skill acquisition in older adults with, and without, impairments relative to aging-related cognitive decline. Finally, to enhance future research and application, we highlight the implications of neural plasticity in skills learning and cognitive rehabilitation for the aging population.

Sleep enhances learning of a functional motor task in young adults

BACKGROUND

Sleep has been demonstrated to enhance simple motor skill learning "offline" in young adults. "Offline learning" refers to either the stabilization or the enhancement of a memory through the passage of time without additional practice. It remains unclear whether a functional motor task will benefit from sleep to produce offline motor skill enhancement. Physical therapists often teach clients functional motor skills; therefore, it is important to understand how sleep affects learning of these skills.

OBJECTIVE

The purpose of this study was to determine whether sleep enhances the learning of a functional motor task.

DESIGN

A prospective, cross-sectional, repeated-measures design was used.

METHODS

Young participants who were healthy (N=24) were randomly assigned to either a sleep group or a no-sleep group. The sleep group practiced a novel walking task in the evening and underwent retention testing the following morning, and the no-sleep group practiced the task in the morning and underwent retention testing in the evening. Outcome measures included time around the walking path and spatiotemporal gait parameters.

RESULTS

Only participants who slept after practicing the novel walking task demonstrated a significant offline improvement in performance. Compared with the no-sleep group, participants in the sleep group demonstrated a significant decrease in the time around the walking path, an increase in tandem velocity, an increase in tandem step length, and a decline in tandem step time.

LIMITATIONS

Time-of-day effect and inability to ensure a certain amount of sleep quantity and quality of participants were limitations of the study.

CONCLUSIONS

This study is the first to provide evidence that sleep facilitates learning clinically relevant functional motor tasks. Sleep is an important factor that physical therapists should consider when teaching clients motor skills.

Overnight Sleep Enhances Hippocampus-Dependent Aspects of Spatial Memory

STUDY OBJECTIVES

Several studies have now demonstrated that spatial information is processed during sleep, and that posttraining sleep is beneficial for human navigation. However, it remains unclear whether the effects of sleep are primarily due to consolidation of cognitive maps, or alternatively, whether sleep might also affect nonhippocampal aspects of navigation (e.g., speed of motion) involved in moving through a virtual environment.

DESIGN

Participants were trained on a virtual maze navigation task (VMT) and then given a memory test following either a day of wakefulness or a night of sleep. Subjects reported to the laboratory for training at either 10:00am or 10:00pm, depending on randomly assigned condition, and were tested 11 h later. Overnight subjects slept in the laboratory with polysomnography.

SETTING

A hospital-based academic sleep laboratory.

PATIENTS OR PARTICIPANTS

Thirty healthy college student volunteers.

INTERVENTIONS

N/A.

MEASUREMENTS AND RESULTS

Point-by-point position data were collected from the VMT. Analysis of the movement data revealed a sleep-dependent improvement in maze completion time (P < 0.001) due to improved spatial understanding of the maze layout, which led to a shortening of path from start to finish (P = 0.01) rather than faster exploration speed through the maze (P = 0.7).

CONCLUSIONS

We found that overnight sleep benefitted performance, not because subjects moved faster through the maze, but because they were more accurate in navigating to the goal. These findings suggest that sleep enhances participants' knowledge of the spatial layout of the maze, contributing to the consolidation of hippocampus-dependent spatial information.

CITATION

Nguyen ND; Tucker MA; Stickgold R; Wamsley EJ. Overnight sleep enhances hippocampus-dependent aspects of spatial memory. SLEEP 2013;36(7):1051-1057.

Mental rotation: effects of gender, training and sleep consolidation

A wide range of experimental studies have provided evidence that a night of sleep contributes to memory consolidation. Mental rotation (MR) skill is characterized by fundamental aspect of both cognitive and motor abilities which can be improved within practice sessions, but little is known about the effect of consolidation after MR practice. In the present study, we investigated the effect of MR training and the following corresponding day- and sleep-related time consolidations in taking into account the well-established gender difference in MR. Forty participants (20 women) practiced a computerized version of the Vandenberg and Kuse MR task. Performance was evaluated before MR training, as well as prior to, and after a night of sleep or a similar daytime interval. Data showed that while men outperformed women during the pre-training test, brief MR practice was sufficient for women to achieve equivalent performance. Only participants subjected to a night of sleep were found to enhance MR performance during the retest, independently of gender. These results provide first evidence that a night of sleep facilitates MR performance compared with spending a similar daytime interval, regardless gender of the participants. Since MR is known to involve motor processes, the present data might contribute to schedule relevant mental practice interventions for fruitful applications in rehabilitation and motor learning processes.

Antidepressant suppression of non-REM sleep spindles and REM sleep impairs hippocampus-dependent learning while augmenting striatum-dependent learning

Rapid eye movement (REM) sleep enhances hippocampus-dependent associative memory, but REM deprivation has little impact on striatum-dependent procedural learning. Antidepressant medications are known to inhibit REM sleep, but it is not well understood if antidepressant treatments impact learning and memory. We explored antidepressant REM suppression effects on learning by training animals daily on a spatial task under familiar and novel conditions, followed by training on a procedural memory task. Daily treatment with the antidepressant and norepinephrine reuptake inhibitor desipramine (DMI) strongly suppressed REM sleep in rats for several hours, as has been described in humans. We also found that DMI treatment reduced the spindle-rich transition-to-REM sleep state (TR), which has not been previously reported. DMI REM suppression gradually weakened performance on a once familiar hippocampus-dependent maze (reconsolidation error). DMI also impaired learning of the novel maze (consolidation error). Unexpectedly, learning of novel reward positions and memory of familiar positions were equally and oppositely correlated with amounts of TR sleep. Conversely, DMI treatment enhanced performance on a separate striatum-dependent, procedural T-maze task that was positively correlated with the amounts of slow-wave sleep (SWS). Our results suggest that learning strategy switches in patients taking REM sleep-suppressing antidepressants might serve to offset sleep-dependent hippocampal impairments to partially preserve performance. State-performance correlations support a model wherein reconsolidation of hippocampus-dependent familiar memories occurs during REM sleep, novel information is incorporated and consolidated during TR, and dorsal striatum-dependent procedural learning is augmented during SWS.