Low-frequency sounds combined with motor imagery elicits a transient disruption of force performance: A path to neuromotor reprogramming?

The effectiveness of motor imagery (MI) training on sports performance is now well-documented. Recently, it has been proposed that a single session of MI combined with low frequency sound (LFS) might enhance muscle activation. However, the neural mechanisms underlying this effect remain unknown. We set up a test-retest intervention over the course of 2 consecutive days to evaluate the effect of (i) MI training (MI, n = 20), (ii) MI combined with LFS (MI + LFS, n = 20), and (iii) a control condition (CTRL, n = 20) on force torque produced across repeated maximal voluntary contractions of the quadriceps before (Pretest), after (Posttest) and at +12 h (Retention) post-intervention. We collected the integrated electromyograms of the quadriceps muscles, as well as brain electrical potentials during each experimental intervention. In the CTRL group, total force torque decreased from Pretest to Retention and from Posttest to Retention. By contrast, there was an increase between Posttest and Retention in both MI + LFS and MI groups (both ηP2 = 0.03, p < 0.05). Regression analyses further revealed a negative relationship between force performance and EEG activity in the MI + LFS group only. The data support a transient interference of LFS on cortical activity underlying the priming effects of MI practice on force performance. Findings are discussed in relation to the potential for motor reprogramming through MI combined with LFS.

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.

Enhancing endurance performance with combined imagined and actual physical practice.

PURPOSE: The perception of effort exerts influence in determining task failure during endurance performance. Training interventions blending physical and cognitive tasks yielded promising results in enhancing performance. Motor imagery can decrease the perception of effort. Whether combining motor imagery and physical training improves endurance remains to be understood, and this was the aim of this study. METHODS: Participants (24 ± 3 year) were assigned to a motor imagery (n = 16) or a control (n = 17) group. Both groups engaged in physical exercises targeting the knee extensors (i.e., wall squat, 12 training sessions, 14-days), with participants from the motor imagery group also performing motor imagery. Each participant visited the laboratory Pre and Post-training, during which we assessed endurance performance through a sustained submaximal isometric knee extension contraction until task failure, at either 20% or 40% of the maximal voluntary contraction peak torque. Perceptions of effort and muscle pain were measured during the exercise. RESULTS: We reported no changes in endurance performance for the control group. Endurance performance in the motor imagery group exhibited significant improvements when the intensity of the sustained isometric exercise closely matched that used in training. These enhancements were less pronounced when considering the higher exercise intensity. No reduction in perception of effort was observed in both groups. There was a noticeable decrease in muscle pain perception within the motor imagery group Post training. CONCLUSION: Combining motor imagery and physical training may offer a promising avenue for enhancing endurance performance and managing pain in various contexts.

Imagery and motor learning: a special issue on the neurocognitive mechanisms of imagery and imagery practice of motor actions.

Human beings are able to imagine actions with the aim to change movement coordination and to learn particular movements. Meta-analyses to date have shown that when individuals systematically engage in imagery of a motor action without overt behavior this can improve motor performance and facilitate motor learning. Despite a considerable body of research in neuroscience, psychology, and sport science, however, there is at present no consensus on the neurocognitive mechanisms of imagery, and the mechanisms that lead to learning via imagined action are still being debated. In particular, the differences between imagined and overt action, and respective learning effects, remain to be fully explained. The present collection of manuscripts is a result of compiling both theoretical advances in the field of motor control and motor learning and those in imagery research to better understand imagery and learning. It is structured alongside five position papers from leading experts in the field, each of which is followed by a series of short commentaries written by experts from various disciplines. This collection demonstrates (a) that conceptualizations of imagery are manifold, vary highly and depend on the perspective chosen, (b) that existing approaches to the neurocognitive mechanisms of imagery and imagery practice of motor actions draw on distinct motor control and learning perspectives, (c) that perspectives from the wider fields of motor control and learning stimulate new approaches to explain imagery and imagery practice, (d) and that future research is needed to investigate and compare different perspectives and conceptualizations of the neurocognitive mechanisms of imagery and imagery practice of motor actions.

Towards efficient motor imagery interventions after lower-limb amputation.

BACKGROUND: The therapeutic benefits of motor imagery (MI) are now well-established in different populations of persons suffering from central nervous system impairments. However, research on similar efficacy of MI interventions after amputation remains scarce, and experimental studies were primarily designed to explore the effects of MI after upper-limb amputations. OBJECTIVES: The present comparative study therefore aimed to assess the effects of MI on locomotion recovery following unilateral lower-limb amputation. METHODS: Nineteen participants were assigned either to a MI group (n = 9) or a control group (n = 10). In addition to the course of physical therapy, they respectively performed 10 min per day of locomotor MI training or neutral cognitive exercises, five days per week. Participants' locomotion functions were assessed through two functional tasks: 10 m walking and the Timed Up and Go Test. Force of the amputated limb and functional level score reflecting the required assistance for walking were also measured. Evaluations were scheduled at the arrival at the rehabilitation center (right after amputation), after prosthesis fitting (three weeks later), and at the end of the rehabilitation program. A retention test was also programed after 6 weeks. RESULTS: While there was no additional effect of MI on pain management, data revealed an early positive impact of MI for the 10 m walking task during the pre-prosthetic phase, and greater performance during the Timed Up and Go Test during the prosthetic phase. Also, a lower proportion of participants still needed a walking aid after MI training. Finally, the force of the amputated limb was greater at the end of rehabilitation for the MI group. CONCLUSION: Taken together, these data support the integration of MI within the course of physical therapy in persons suffering from lower-limb amputations.

Anodal transcranial direct current stimulation does not enhance the effects of motor imagery training of a sequential finger-tapping task in young adults.

When applied over the primary motor cortex (M1), anodal transcranial direct current stimulation (a-tDCS) could enhance the effects of a single motor imagery training (MIt) session on the learning of a sequential finger-tapping task (SFTT). This study aimed to investigate the effect of a-tDCS on the learning of an SFTT during multiple MIt sessions. Two groups of 16 healthy young adults participated in three consecutive MIt sessions over 3 days, followed by a retention test 1 week later. They received active or sham a-tDCS during a MIt session in which they mentally rehearsed an eight-item complex finger sequence with their left hand. Before and after each session, and during the retention test, they physically repeated the sequence as quickly and accurately as possible. Both groups (i) improved their performance during the first two sessions, showing online learning; (ii) stabilised the level they reached during all training sessions, reflecting offline consolidation; and (iii) maintained their performance level one week later, showing retention. However, no significant difference was found between the groups, regardless of the MSL stage. These results emphasise the importance of performing several MIt sessions to maximise performance gains, but they do not support the additional effects of a-tDCS.

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

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

Effects of relaxing breathing paired with cardiac biofeedback on performance and relaxation during critical simulated situations: a prospective randomized controlled trial.

BACKGROUND: Active participation in high-fidelity simulation remains stressful for residents. Increased stress levels elicited during such simulation impacts performance. We tested whether relaxing breathing, paired or not with cardiac biofeedback, could lead to enhanced performance of residents during simulation. METHODS: This randomized pilot study involved the fifth-year anesthesiology and critical care residents who participated in high-fidelity at Lyon medical simulation center in 2019. Residents were randomized into three parallel interventions: relaxing breathing, relaxing breathing paired with cardiac biofeedback, and control. Each intervention was applied for five minutes immediately after the scenario briefing. The primary endpoint was the overall performance during the simulation rated by two blinded independent investigators. The secondary endpoints included component scores of overall performance and changes in psychological states. RESULTS: Thirty-four residents were included. Compared to the control group, residents in the relaxing breathing (+ 7%, 98.3% CI: 0.3 to 13.7, P = 0.013) and relaxing breathing paired with cardiac biofeedback (+ 8%, 98.3% CI: 0.82 to 14.81, P = 0.009) groups had a higher overall performance score. Following the interventions, compared to the control group, stress level was lower when participants had performed relaxing breathing alone (P = 0.029) or paired with biofeedback (P = 0.035). The internal relaxation level was higher in both the relaxing breathing alone (P = 0.016) and paired with biofeedback groups (P = 0.035). CONCLUSIONS: Performing five minutes of relaxing breathing before the scenario resulted in better overall simulation performance. These preliminary findings suggest that short breathing interventions are effective in improving performance during simulation. TRIAL REGISTRATION: The study protocol was retrospectively registered on clinicaltrials.gov ( NCT04141124 , 28/10/2019).

Tensorpac: An open-source Python toolbox for tensor-based phase-amplitude coupling measurement in electrophysiological brain signals.

Despite being the focus of a thriving field of research, the biological mechanisms that underlie information integration in the brain are not yet fully understood. A theory that has gained a lot of traction in recent years suggests that multi-scale integration is regulated by a hierarchy of mutually interacting neural oscillations. In particular, there is accumulating evidence that phase-amplitude coupling (PAC), a specific form of cross-frequency interaction, plays a key role in numerous cognitive processes. Current research in the field is not only hampered by the absence of a gold standard for PAC analysis, but also by the computational costs of running exhaustive computations on large and high-dimensional electrophysiological brain signals. In addition, various signal properties and analyses parameters can lead to spurious PAC. Here, we present Tensorpac, an open-source Python toolbox dedicated to PAC analysis of neurophysiological data. The advantages of Tensorpac include (1) higher computational efficiency thanks to software design that combines tensor computations and parallel computing, (2) the implementation of all most widely used PAC methods in one package, (3) the statistical analysis of PAC measures, and (4) extended PAC visualization capabilities. Tensorpac is distributed under a BSD-3-Clause license and can be launched on any operating system (Linux, OSX and Windows). It can be installed directly via pip or downloaded from Github (https://github.com/EtienneCmb/tensorpac). By making Tensorpac available, we aim to enhance the reproducibility and quality of PAC research, and provide open tools that will accelerate future method development in neuroscience.

Acquisition and consolidation of implicit motor learning with physical and mental practice across multiple days of anodal tDCS.

BACKGROUND: Acquisition and consolidation of a new motor skill occurs gradually over long time span. Motor imagery (MI) and brain stimulation have been showed as beneficial approaches that boost motor learning, but little is known about the extent of their combined effects. OBJECTIVE: Here, we aimed to investigate, for the first time, whether delivering multiple sessions of transcranial direct current stimulation (tDCS) over primary motor cortex during physical and MI practice might improve implicit motor sequence learning in a young population. METHODS: Participants practiced a serial reaction time task (SRTT) either physically or through MI, and concomitantly received either an anodal (excitatory) or sham stimulation over the primary motor cortex during three successive days. The effect of anodal tDCS on the general motor skill and sequence specific learning were assessed on both acquisition (within-day) and consolidation (between-day) processes. We further compared the magnitude of motor learning reached after a single and three daily sessions of tDCS. RESULTS: The main finding showed that anodal tDCS boosted MI practice, but not physical practice, during the first acquisition session. A second major result showed that compared to sham stimulation, multiple daily session of anodal tDCS, for both types of practice, resulted in greater implicit motor sequence learning rather than a single session of stimulation. CONCLUSIONS: The present study is of particular importance in the context of rehabilitation, where we postulate that scheduling mental training when patients are not able to perform physical movement might beneficiate from concomitant and consecutive brain stimulation sessions over M1 to promote functional recovery.

Foam Rolling and Joint Distraction with Elastic Band Training Performed for 5-7 Weeks Respectively Improve Lower Limb Flexibility.

Both foam rolling and joint distraction training with elastic bands are very popular interventions designed to improve muscular function, motor performance, and joint range of motion, as well as to reduce feeling of fatigue and delayed onset of muscle soreness. The heterogeneity of methods used among studies however prevents from drawing firm conclusions about the optimal content of pre/post interventions. The present study aims at answering the following questions: i) Do foam rolling and joint distraction with elastic band training improve joint range of motion in national rugby players? ii) Do short and long rolling durations have similar effects on range of motion? In a first experiment, we compared ankle, knee, and hip flexibility scores in 30 national rugby players after a 7-week foam rolling training program involving either a short (20s) or long (40s) rolling duration. Data revealed that foam rolling substantially improved all range of motion scores, regardless the rolling duration (performance gains ranged from 9 to 18° in the foam rolling groups, i.e. 8 to 20% increase, but remained under 2° in the control group). In a second experiment, we investigated the effect of a 5-week joint distraction with elastic band training program on hamstring and adductor range of motion in 23 national rugby players. Data showed that elastic band training significantly improved sit-and-reach (29.16% increase, p = 0.01) as well as side split (2.31% increase, p < 0.001) stretching performances. Taken together, present findings confirm that both foam rolling and joint distraction exercises with elastic bands are likely to enhance joint range of motion and specific mobility patterns during sport performance, and further serve prophylaxis. Such effects therefore constitute a promising avenue for clinical, home therapy, and personal flexibility training.

Optimal Combination of Anodal Transcranial Direct Current Stimulations and Motor Imagery Interventions.

Motor imagery contributes to enhance the (re)learning of motor skills through remapping of cortical networks. Combining motor imagery with anodal transcranial direct-current stimulation (a-tDCS) over the primary motor cortex has further been shown to promote its beneficial effects on postural control. Whether motor imagery should be performed concomitantly to a-tDCS (over depolarized membrane) or consecutively (over changing neurotransmitters activity) remains to be elucidated. In the present study, we measured the performance in a postural control task before and after three experimental conditions. Participants received a-tDCS before (tDCSBefore), during (tDCSDuring), or both before and during motor imagery training (tDCSBefore + During). Performance was improved after tDCSDuring, but not after both the tDCSBefore and tDCSBefore + During conditions. These results support that homeostatic plasticity is likely to operate following a-tDCS through decreasing cortical excitability and that motor imagery should be performed during anodal stimulation for optimum gains.

The influence of gate start position on physical performance and anxiety perception in expert BMX athletes.

The critical importance of the start phase in bicycle motocross (BMX) racing is increasingly acknowledged. Past experiments underlined that the internal lane of the starting gate provides a strong positional advantage. However, how lane position affects start performance and cognitive and somatic state anxiety remains unexplored. We examined the start performance and anxiety responses of youth national-level BMX riders in both experimental and ecological contexts. We used contextualization motor imagery routines to evaluate start performance and state anxiety from the internal and external lanes. Cycle ergometer measures revealed a better start performance from the external lane, but we did not record any lane effect on actual gate start times. Both somatic and cognitive anxiety scores were higher before racing from the internal compared to the external lane. Finally, state anxiety (i.e., somatic anxiety, worry and concentration disruptions) negatively predicted the start performance. Present findings provide original insights on psychological factors involved in BMX start performance, and might contribute to fruitful coping interventions and training programmes in sports overlapping the framework of "handicap races" taking the specific form of positional advantages/disadvantages at the start (e.g., ski/snowboard cross, athletics, swimming, motorsports, etc.).

From intentions to actions: Neural oscillations encode motor processes through phase, amplitude and phase-amplitude coupling.

Goal-directed motor behavior is associated with changes in patterns of rhythmic neuronal activity across widely distributed brain areas. In particular, movement initiation and execution are mediated by patterns of synchronization and desynchronization that occur concurrently across distinct frequency bands and across multiple motor cortical areas. To date, motor-related local oscillatory modulations have been predominantly examined by quantifying increases or suppressions in spectral power. However, beyond signal power, spectral properties such as phase and phase-amplitude coupling (PAC) have also been shown to carry information with regards to the oscillatory dynamics underlying motor processes. Yet, the distinct functional roles of phase, amplitude and PAC across the planning and execution of goal-directed motor behavior remain largely elusive. Here, we address this question with unprecedented resolution thanks to multi-site intracerebral EEG recordings in human subjects while they performed a delayed motor task. To compare the roles of phase, amplitude and PAC, we monitored intracranial brain signals from 748 sites across six medically intractable epilepsy patients at movement execution, and during the delay period where motor intention is present but execution is withheld. In particular, we used a machine-learning framework to identify the key contributions of various neuronal responses. We found a high degree of overlap between brain network patterns observed during planning and those present during execution. Prominent amplitude increases in the delta (2-4Hz) and high gamma (60-200Hz) bands were observed during both planning and execution. In contrast, motor alpha (8-13Hz) and beta (13-30Hz) power were suppressed during execution, but enhanced during the delay period. Interestingly, single-trial classification revealed that low-frequency phase information, rather than spectral power change, was the most discriminant feature in dissociating action from intention. Additionally, despite providing weaker decoding, PAC features led to statistically significant classification of motor states, particularly in anterior cingulate cortex and premotor brain areas. These results advance our understanding of the distinct and partly overlapping involvement of phase, amplitude and the coupling between them, in the neuronal mechanisms underlying motor intentions and executions.

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.

Neuroplasticity of imagined wrist actions after spinal cord injury: a pilot study.

Motor imagery (MI - i.e., the mental representation of an action without physically executing it) stimulates brain motor networks and promotes motor learning after spinal cord injury (SCI). An interesting issue is whether the brain networks controlling MI are being reorganized with reference to spared motor functions. In this pilot study, we tested using magnetoencephalography (MEG) whether changes in cortical recruitment during MI were related to the motor changes elicited by rehabilitation. Over a 1-year period of inclusion, C6 SCI participants (n = 4) met stringent criteria for inclusion in a rehabilitation program focused on the tenodesis prehension (i.e., a compensatory prehension enabling seizing of objects in spite of hand and forearm muscles paralysis). After an extended baseline period of 5 weeks including repeated MEG and chronometric assessments of motor performance, MI training was embedded to the classical course of physiotherapy for five additional weeks. Posttest MEG and motor performance data were collected. A group of matched healthy control participants underwent a similar procedure. The MI intervention resulted in changes in the variability of the wrist extensions, i.e., a key movement of the tenodesis grasp (p < .05). Interestingly, the extent of cortical recruitment, quantified by the number of MEG activation sources recorded within Brodmann areas 1-8 during MI of the wrist extension, significantly predicted actual movement variability changes across sessions (p < .001). However, no such relationship was present for movement times. Repeated measurements afforded a reliable statistical power (range .70-.97). This pilot study does not provide straightforward evidence of MI efficacy, which would require a randomized controlled trial. Nonetheless, the data showed that the relationship between action and imagery of spared actions may be preserved after SCI.

Impact of neurologic deficits on motor imagery: a systematic review of clinical evaluations.

Motor imagery (MI, the mental representation of an action without engaging in its actual execution) is a therapeutically relevant technique to promote motor recovery after neurologic disorders. MI shares common neural and psychological bases with physical practice. Interestingly, both acute and progressive neurologic disorders impact brain motor networks, hence potentially eliciting changes in MI capacities. How experimental neuroscientists and medical practitioners should assess and take into account these changes in order to design fruitful interventions is largely unresolved. Understanding how the psychometric, behavioral and neurophysiological correlates of MI are impacted by neurologic disorders is required. To address this brain-behavior issue, we conducted a systematic review of MI data in stroke, Parkinson's disease, spinal cord injury, and amputee participants. MI evaluation methods are presented. Redundant MI profiles, primarily based on psychometric and behavioral evaluations, emerged in each clinical population. When present, changes in the psychometric and behavioral correlates of MI were highly congruent with the corresponding motor impairments. Neurophysiological recordings yielded specific changes in cerebral activations during MI, which mirrored structural and functional reorganizations due to neuroplasticity. In this view, MI capacities may not be deteriorated per se by neurologic diseases resulting in chronic motor incapacities, but adjusted to the current state of the motor system. Literature-driven orientations for future clinical research are provided.

Physiological changes in response to apnea impact the timing of motor representations: a preliminary study.

BACKGROUND: Reduced physiological arousal in response to breath-holding affects internal clock processes, leading swimmers to underestimate the time spent under apnea. We investigated whether reduced physiological arousal during static apnea was likely to affect the temporal organization of motor imagery (MI). METHODS: Fourteen inter-regional to national breath-holding athletes mentally and physically performed two 15 m swimming tasks of identical durations. They performed the two sequences in a counterbalanced order, the first while breathing normally using a scuba, the second under apnea. We assessed MI duration immediately after completion of the corresponding task. Athletes performed MI with and without holding breath. RESULTS: MI durations (26.1 s ± 8.22) were significantly shorter than actual durations (29.7 s ± 7.6) without holding breath. Apnea increased MI durations by 10% (± 5%). Heart rate decrease in response to breath-holding correlated with MI durations increase (p < .01). Under apnea, participants achieved temporal congruence between MI and PP only when performing MI of the apnea swimming task. Self-report data indicated greater ease when MI was performed in a physiological arousal state congruent with that of the corresponding motor task. CONCLUSIONS: Physiological arousal affected the durations of MI through its effects on internal clock processes and by impacting the congruency in physiological body states between overt and covert motor performance. Present findings have potential implications with regards to the possibility of preventing underestimation of durations spent under a state of reduced physiological arousal.

Motor inhibition during motor imagery: a MEG study with a quadriplegic patient.

The neurophysiological substrates underlying motor imagery are now well established. However, the neural processes of motor inhibition while mentally rehearsing an action are poorly understood. This concern has received limited experimental investigations leading to divergent conclusions. Whether motor command suppression is mediated by specific brain structures or by intracortical facilitation/inhibition is a matter of debate. Interestingly, although motor commands are inhibited during motor imagery (MI) in healthy participants, spinal cord injury may result in weakened motor inhibition. Using magentoencephalography, we observed that mental and actual execution of a goal-directed pointing task elicited similar primary motor cortex activation in a C6-C7 quadriplegic patient, thus confirming the hypothesis of weakened motor inhibition during MI. In an age-matched healthy control participant, however, primary motor area activation during MI was significantly reduced compared to physical practice. Brain activation during actual movement resulted in enhanced recruitment of premotor areas in the patient. In the healthy participant, we found functional relationships between the primary motor area and peri-rolandic sites including the primary sensory area and the supplementary motor area during MI. This neural network was not activated when the quadriplegic patient performed MI. We assume that the primary sensory area and the supplementary motor area may be part of a functional network underlying motor inhibition during MI. These data provide insights into brain function changes due to neuroplasticity after spinal cord injury and evidence cortical substrates underlying weakened motor inhibition during MI after deafferentation and deefferentation.

Implicit and explicit motor imagery ability after SCI: Moving the elbow makes the difference.

Cervical spinal cord injury (SCI) causes dramatic sensorimotor deficits that restrict both activity and participation. Restoring activity and participation requires extensive upper limb rehabilitation focusing elbow and wrist movements, which can include motor imagery. Yet, it remains unclear whether MI ability is impaired or spared after SCI. We investigated implicit and explicit MI ability in individuals with C6 or C7 SCI (SCIC6 and SCIC7 groups), as well as in age- and gender-matched controls without SCI. Inspired by previous studies, implicit MI evaluations involved hand laterality judgments, hand orientation judgments (HOJT) and hand-object interaction judgments. Explicit MI evaluations involved mental chronometry assessments of physically possible or impossible movements due to the paralysis of upper limb muscles in both groups of participants with SCI. HOJT was the paradigm in which implicit MI ability profiles differed the most between groups, particularly in the SCIC6 group who had impaired elbow movements in the horizontal plane. MI ability profiles were similar between groups for explicit MI evaluations, but reflected task familiarity with higher durations in the case of unfamiliar movements in controls or attempt to perform movements which were no longer possible in persons with SCI. Present results, obtained from a homogeneous population of individuals with SCI, suggest that people with long-term SCI rely on embodied cognitive motor strategies, similar to controls. Differences found in behavioral response pattern during implicit MI mirrored the actual motor deficit, particularly during tasks that involved internal representations of affected body parts.