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.

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.

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.

Optimal stimulation parameters for spinal and corticospinal excitabilities during contraction, motor imagery and rest: A pilot study.

OBJECTIVES: It is commonly accepted that motor imagery (MI), i.e. the mental simulation of a movement, leads to an increased size of cortical motor evoked potentials (MEPs), although the magnitude of this effect differs between studies. Its impact on the spinal level is even more variable in the literature. Such discrepancies may be explained by many different experimental approaches. Therefore, the question of the optimal stimulation parameters to assess both spinal and corticospinal excitabilities remains open. METHODS: H-reflexes and MEPs of the triceps surae were evoked in 11 healthy subjects during MI, weak voluntary contraction (CON) and rest (REST). In each condition, the full recruitment curve from the response threshold to maximal potential was investigated. RESULTS: At stimulation intensities close to the maximal response, MEP amplitude was increased by CON compared to REST on the triceps surae. No effect of the different conditions was found on the H-reflex recruitment curve, except a small variation beyond maximal H-reflex in the soleus muscle. CONCLUSION: Based on our results, we recommend to assess corticospinal excitability between 70% and 100% of maximal MEP intensity instead of the classical use of a percentage of the motor threshold and to elicit H-reflexes on the ascending part of the recruitment curve.

Corticospinal Modulations during Motor Imagery of Concentric, Eccentric, and Isometric Actions.

PURPOSE: It is not known yet whether the neurophysiological specificity of eccentric, concentric, and isometric contractions can also be observed when these are mentally simulated. Therefore, our aim was to assess corticospinal excitability during motor imagery (MI) of different contraction types and to test whether a passive movement during MI could have additional effects. METHODS: Twelve young participants imagined contractions of the wrist flexors, firstly with the arm motionless (static mode) and second, with a congruent passive movement (wrist extension during eccentric MI and wrist flexion during concentric MI). Motor-evoked potentials (MEP) and H-reflexes were elicited in flexor carpi radialis (FCR) at rest and during the three types of MI. As a secondary outcome, the MEP of one antagonist (extensor carpi radialis), elicited concomitantly with FCR MEP recording, were also analyzed. RESULTS: In static mode, FCR MEP were facilitated during isometric (P = 0.046) and concentric (P = 0.039) MI, but not during eccentric MI (P = 0.902). With passive congruent movements, FCR MEP were enhanced during all imagined contraction types, including eccentric (P = 0.047). FCR H-reflexes increased only during eccentric MI accompanied with wrist extension (P = 0.003). Extensor carpi radialis MEP were modulated only when a passive congruent movement was provided (P = 0.040). CONCLUSIONS: Like actual contractions, eccentric MI exhibits specific neural correlates, compared with isometric and concentric MI, which should be considered when using this modality for training. The present results showed that adding passive movements congruent to the eccentric MI task would enhance its impact over corticospinal structures.

Neuromuscular adaptations to wide-pulse high-frequency neuromuscular electrical stimulation training.

PURPOSE: No studies have evaluated the potential benefits of wide-pulse high-frequency (WPHF) neuromuscular electrical stimulation (NMES) despite it being an interesting alternative to conventional NMES. Hence, this study evaluated neuromuscular adaptations induced by 3 weeks of WPHF NMES. METHODS: Ten young healthy individuals (training group) completed nine sessions of WPHF NMES training spread over 3 weeks, whereas seven individuals (control group) only performed the first and last sessions. Plantar flexor neuromuscular function (maximal voluntary contraction (MVC) force, voluntary activation level, H reflex, V wave, contractile properties) was evaluated before the first and last training sessions. Each training session consisted of ten 20-s WPHF NMES contractions (pulse duration: 1 ms, stimulation frequency: 100 Hz) interspaced by 40 s of recovery and delivered at an intensity set to initially evoke ~ 5% of MVC force. The averaged mean evoked forces produced during the ten WPHF NMES-evoked contractions of a given session as well as the sum of the ten contractions force time integral (total FTI) were computed. RESULTS: Total FTI (+ 118 ± 98%) and averaged mean evoked forces (+ 96 ± 91%) increased following the 3-week intervention (p < 0.05); no changes were observed in the control group. The intervention did not induce any change (p > 0.05) in parameters used to characterize plantar flexor neuromuscular function. CONCLUSION: Three weeks of WPHF NMES increased electrically evoked forces but induced no other changes in plantar flexor neuromuscular properties. Before introducing WPHF NMES clinically, optimal training program characteristics (such as frequency, duration and intensity) remain to be identified.

Spinal plasticity with motor imagery practice.

KEY POINTS: While a consensus has now been reached on the effect of motor imagery (MI) - the mental simulation of an action - on motor cortical areas, less is known about its impact on spinal structures. The current study, using H-reflex conditioning paradigms, examined the effect of a 20 min MI practice on several spinal mechanisms of the plantar flexor muscles. We observed modulations of spinal presynaptic circuitry while imagining, which was even more pronounced following an acute session of MI practice. We suggested that the small cortical output generated during MI may reach specific spinal circuits and that repeating MI may increase the sensitivity of the spinal cord to its effects. The short-term plasticity induced by MI practice may include spinal network modulation in addition to cortical reorganization. ABSTRACT: Kinesthetic motor imagery (MI) is the mental simulation of a movement with its sensory consequences but without its concomitant execution. While the effect of MI practice on cortical areas is well known, its influence on spinal circuitry remains unclear. Here, we assessed plastic changes in spinal structures following an acute MI practice. Thirteen young healthy participants accomplished two experimental sessions: a 20 min MI training consisting of four blocks of 25 imagined maximal isometric plantar flexions, and a 20 min rest (control session). The level of spinal presynaptic inhibition was assessed by conditioning the triceps surae spinal H-reflex with two methods: (i) the stimulation of the common peroneal nerve that induced D1 presynaptic inhibition (HPSI response), and (ii) the stimulation of the femoral nerve that induced heteronymous Ia facilitation (HFAC response). We then compared the effects of MI on unconditioned (HTEST ) and conditioned (HPSI and HFAC ) responses before, immediately after and 10 min after the 20 min session. After resting for 20 min, no changes were observed on the recorded parameters. After MI practice, the amplitude of rest HTEST was unchanged, while HPSI and HFAC significantly increased, showing a reduction of presynaptic inhibition with no impact on the afferent-motoneuronal synapse. The current results revealed the acute effect of MI practice on baseline spinal presynaptic inhibition, increasing the sensitivity of the spinal circuitry to MI. These findings will help in understanding the mechanisms of neural plasticity following chronic practice.

Non-physical approaches to counteract age-related functional deterioration: Applications for rehabilitation and neural mechanisms.

Normal and pathological ageing are associated with several motor impairments that reduce quality of life and represent a general challenge for public healthcare systems. Consequently, over the past decades, many scientists and physiotherapists dedicated their research to the development and improvement of safe and costless methods to counteract the progressive decline of motor functions with age. The urgency of finding new and easy to implement methods is even more paramount in case of acute pathologies (e.g. stroke or hip surgery). The frailty of older population makes it difficult or even impossible to use traditional physical therapy at an early stage after the occurrence of a pathology. To that purpose, non-physical approaches such as cognitive training (e.g. memory, attention training) and mental techniques (e.g. motor imagery) have grown in popularity for the elderly. Such methods, involving individual and/or group exercises, have shown particular effects on increasing or maintaining cognitive functions, as well as physical performances. Improving the motor function (especially in older age) requires an improvement of motor execution, i.e. the pathway from the brain motor areas to the muscle but also higher cognitive control. The present work reviews different non-physical interventions that can be used as a complementary approach by asymptomatic or frail older adults, and the effects thereof on functional performance. The use of cognitive training or motor imagery protocols is recommended when physical practice is limited or not possible. Finally, insights into the underlying neurophysiological mechanisms are proposed.

Neural mechanisms of strength increase after one-week motor imagery training.

The neural mechanisms explaining strength increase following mental training by motor imagery (MI) are not clearly understood. While gains are mostly attributed to cortical reorganization, the sub-cortical adaptations have never been investigated. The present study investigated the effects of MI training on muscle force capacity and the related spinal and supraspinal mechanisms. Eighteen young healthy participants (mean age: 22.5 ± 2.6) took part in the experiment. They were distributed into two groups: a control group (n = 9) and an MI training group (n = 9). The MI group performed seven consecutive sessions (one per day) of imagined maximal isometric plantar flexion (4 blocks of 25 trials per session). The control group did not engage in any physical or mental training. Both groups were tested for the isometric maximal plantar flexion torque (MVC) and the rate of torque development (RTD) before and after the training session. In addition, soleus and medial gastrocnemius spinal and supraspinal adaptations were assessed through the recording of H-reflexes and V-waves, with electrical stimulations of the posterior tibial nerve evoked at rest and during MVC, respectively. After one week, only the MI training group increased both plantar flexion MVC and RTD. The enhancement of muscle torque capacity was accompanied by significant increase of electromyographic activity and V-wave during MVC and of H-reflex at rest. The increased cortical descending neural drive and the excitability of spinal networks at rest could explain the greater RTD and MVC after one week of MI training.

Assessment of Homonymous Recurrent Inhibition during Voluntary Contraction by Conditioning Nerve Stimulation.

In humans, the amount of spinal homonymous recurrent inhibition during voluntary contraction is usually assessed by using a peripheral nerve stimulation paradigm. This method consists of conditioning the maximal M-wave (SM stimulus) with prior reflex stimulation (S1), with 10 ms inter-stimulus interval (ISI). The decrease observed between unconditioned (S1 only) and conditioned (S1+SM) reflex size is then attributed to recurrent inhibition. However, during a voluntary contraction, a superimposed SM stimulation leads to a maximal M-wave followed by a voluntary (V) wave at similar latency than the H-reflex. This wave can therefore interfere with the conditioned H-reflex when two different stimulation intensities are used (S1 and SM), leading to misinterpretation of the data. The aim of the present study was to assess if conditioning V-wave response instead of H-reflex, by applying SM for both stimuli (test and conditioning), can be used as an index of recurrent inhibition. Conditioned and unconditioned responses of soleus and medial gastrocnemius muscles were recorded in twelve subjects at 25% and at 50% of maximal voluntary contraction at the usual ISI of 10 ms and an optimal inter-stimulus of 15 ms determined upon M- and V-wave latencies. Conditioned H-reflex (obtained with S1+SM paradigm) was significantly lower than the unconditioned by ~30% on average, meaning that the amount of inhibition was 70%. This amount of recurrent inhibition was significantly lower at higher force level with both methods. Regardless of the level of force or the conditioning ISI, results obtained with V-wave conditioning (SM+SM) were similar at both force levels, linearly correlated and proportional to those obtained with H conditioning. Then, V-wave conditioning appears to be a reliable index of homonymous recurrent inhibition during voluntary contraction.

New evidence of corticospinal network modulation induced by motor imagery.

Motor imagery (MI) is the mental simulation of movement, without the corresponding muscle contraction. Whereas the activation of cortical motor areas during MI is established, the involvement of spinal structures is still under debate. We used original and complementary techniques to probe the influence of MI on spinal structures. Amplitude of motor-evoked potentials (MEPs), cervico-medullary-evoked potentials (CMEPs), and Hoffmann (H)-reflexes of the flexor carpi radialis (FCR) muscle and of the triceps surae muscles was measured in young, healthy subjects at rest and during MI. Participants were asked to imagine maximal voluntary contraction of the wrist and ankle, while the targeted limb was fixed (static condition). We confirmed previous studies with an increase of FCR MEPs during MI compared with rest. Interestingly, CMEPs, but not H-reflexes, also increased during MI, revealing a possible activation of subcortical structures. Then, to investigate the effect of MI on the spinal network, we used two techniques: 1) passive lengthening of the targeted muscle via an isokinetic dynamometer and 2) conditioning of H-reflexes with stimulation of the antagonistic nerve. Both techniques activate spinal inhibitory presynaptic circuitry, reducing the H-reflex amplitude at rest. In contrast, no reduction of H-reflex amplitude was observed during MI. These findings suggest that MI has modulatory effects on the spinal neuronal network. Specifically, the activation of low-threshold spinal structures during specific conditions (lengthening and H-reflex conditioning) highlights the possible generation of subliminal cortical output during MI.

Motor imagery and cortico-spinal excitability: A review.

Motor imagery (MI) has received a lot of interest during the last decades as its chronic or acute use has demonstrated several effects on improving sport performances or skills. The development of neuroimagery techniques also helped further our understanding of the neural correlates underlying MI. While some authors showed that MI, motor execution and action observation activated similar motor cortical regions, transcranial magnetic stimulation (TMS) studies brought great insights on the role of the primary motor cortex and on the activation of the cortico-spinal pathway during MI. After defining MI and describing the TMS technique, a short report of MI activities only at cortical level is provided. Then, a main focus on the specificities of cortico-spinal modulations during MI, investigated by TMS, is provided. Finally, a brief overview of sub-cortical mechanisms gives importance to the activation of peripheral neural structures during MI.

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation.

Percutaneous electrical nerve stimulation is a non-invasive method commonly used to evaluate neuromuscular function from brain to muscle (supra-spinal, spinal and peripheral levels). The present protocol describes how this method can be used to stimulate the posterior tibial nerve that activates plantar flexor muscles. Percutaneous electrical nerve stimulation consists of inducing an electrical stimulus to a motor nerve to evoke a muscular response. Direct (M-wave) and/or indirect (H-reflex) electrophysiological responses can be recorded at rest using surface electromyography. Mechanical (twitch torque) responses can be quantified with a force/torque ergometer. M-wave and twitch torque reflect neuromuscular transmission and excitation-contraction coupling, whereas H-reflex provides an index of spinal excitability. EMG activity and mechanical (superimposed twitch) responses can also be recorded during maximal voluntary contractions to evaluate voluntary activation level. Percutaneous nerve stimulation provides an assessment of neuromuscular function in humans, and is highly beneficial especially for studies evaluating neuromuscular plasticity following acute (fatigue) or chronic (training/detraining) exercise.