Does Transcranial Direct Current Stimulation Affect the Learning of a Fine Sequential Hand Motor Skill with Motor Imagery?

Improving locomotor performance with motor imagery and tDCS in young adults

The study aimed to assess the feasibility and potential efficacy of a non-motor intervention utilizing motor imagery (MI) and transcranial direct current stimulation (tDCS) to enhance motor function. The research involved a double-blind, randomized, controlled trial with three groups: MIActive, MISham, and Control. Participants engaged in a cognitively demanding obstacle course, with time and prefrontal activation (ΔO2Hb and ΔHHb) measured across three-time points (Baseline, Post-test, 1-week follow-up). Following a pretest, active or sham tDCS was administered during an MI session, while the Control group did not receive this intervention. The MIActive group showed significant improvements in time-to-completion immediately after the intervention and one week later. Additionally, ΔO2Hb levels were lower in the MIActive group than in the other groups. These findings suggest that the combination of MI and tDCS could lead to motor improvements. The study outcomes support the feasibility and initial effectiveness of using MI and tDCS as a non-motor intervention to enhance motor outcomes in short and medium terms. Further research is recommended to explore the impact of this intervention in individuals with existing motor impairments. This study contributes to the growing body of evidence on the potential of non-motor interventions to induce neuroplastic changes that improve motor function. Clinical trial registration: ClinicalTrials.gov, identifier NCT06414213 16/05/2024.

C-SMB 2.0: Integrating over 25 years of motor sequencing research with the Discrete Sequence Production task

An exhaustive review is reported of over 25 years of research with the Discrete Sequence Production (DSP) task as reported in well over 100 articles. In line with the increasing call for theory development, this culminates into proposing the second version of the Cognitive framework of Sequential Motor Behavior (C-SMB 2.0), which brings together known models from cognitive psychology, cognitive neuroscience, and motor learning. This processing framework accounts for the many different behavioral results obtained with the DSP task and unveils important properties of the cognitive system. C-SMB 2.0 assumes that a versatile central processor (CP) develops multimodal, central-symbolic representations of short motor segments by repeatedly storing the elements of these segments in short-term memory (STM). Independently, the repeated processing by modality-specific perceptual and motor processors (PPs and MPs) and by the CP when executing sequences gradually associates successively used representations at each processing level. The high dependency of these representations on active context information allows for the rapid serial activation of the sequence elements as well as for the executive control of tasks as a whole. Speculations are eventually offered as to how the various cognitive processes could plausibly find their neural underpinnings within the intricate networks of the brain.

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.

Time course of learning sequence representations in action imagery practice

Action imagery practice (AIP) is effective to improve motor performance in a variety of tasks, though it is often less effective than action execution practice (AEP). In sequence learning, AIP and AEP result in the acquisition of effector-independent representations. However, it is unresolved whether effector-dependent representations can be acquired in AIP. In the present study, we investigated the acquisition of effector-independent representations and effector-dependent representations in AEP and AIP in an implicit sequence learning task (a visual serial-reaction-time task, involving a twelve-element sequence). Participants performed six sessions, each starting with tests. A practice sequence, a mirror sequence, and a different sequence were tested with the practice and transfer hand. In the first four sessions, after the tests, two groups performed either AIP (N = 50) or AEP (N = 54). Improvement in the different sequence indicated sequence-unspecific learning in both AEP and AIP. Importantly, reaction times of the practice hand became shorter in the practice sequence than in the other sequences, indicating implicit sequence learning in both, AEP and AIP. This effect was stronger in the practice hand than in the transfer hand, indicating effector-dependent sequence representations in both AEP and AIP. However, effector-dependent sequence representations were stronger in AEP than in AIP. No significant differences between groups were observed in the transfer hand, although effector-independent sequence representations were observed in AEP only. In conclusion, AIP promotes not only sequence-unspecific stimulus-response coupling and anticipations of the subsequent stimuli, but also anticipations of the subsequent responses.

Anodal tDCS does not enhance the learning of the sequential finger-tapping task by motor imagery practice in healthy older adults

Background

Motor imagery practice (MIP) and anodal transcranial direct current stimulation (a-tDCS) are innovative methods with independent positive influence on motor sequence learning (MSL) in older adults.

Objective

The present study investigated the effect of MIP combined with a-tDCS over the primary motor cortex (M1) on the learning of a finger tapping sequence of the non-dominant hand in healthy older adults.

Methods

Thirty participants participated in this double-blind sham-controlled study. They performed three MIP sessions, one session per day over three consecutive days and a retention test 1 week after the last training session. During training / MIP, participants had to mentally rehearse an 8-element finger tapping sequence with their left hand, concomitantly to either real (a-tDCS group) or sham stimulation (sham-tDCS group). Before and after MIP, as well as during the retention test, participants had to physically perform the same sequence as fast and accurately as possible.

Results

Our main results showed that both groups (i) improved their performance during the first two training sessions, reflecting acquisition/on-line performance gains, (ii) stabilized their performance from one training day to another, reflecting off-line consolidation; as well as after 7 days without practice, reflecting retention, (iii) for all stages of MSL, there was no significant difference between the sham-tDCS and a-tDCS groups.

Conclusion

This study highlights the usefulness of MIP in motor sequence learning for older adults. However, 1.5 mA a-tDCS did not enhance the beneficial effects of MIP, which adds to the inconsistency of results found in tDCS studies. Future work is needed to further explore the best conditions of use of tDCS to improve motor sequence learning with MIP.

Frontal brain areas are more involved during motor imagery than during motor execution/preparation of a response sequence

Results of several neuroimaging studies support the functional equivalence model, which states that motor imagery (MI) and motor execution (ME) involve the same processes, except for the final execution component. In contrast, the motor-cognitive model implies that MI additionally involves frontal executive control processes. However, according to some authors MI may actually be more comparable to motor preparation (MP). In the current electroencephalographic study, a version of the discrete sequence production paradigm was employed in which human participants initially had to prepare a sequence of five finger movements that subsequently had to be executed, imagined, or withheld. MI, ME, and MP were compared by computing event-related (de)-synchronization in the theta, alpha/mu, and beta bands. Results revealed a major increase in frontal theta power during MI as compared to ME and MP. At the end of the examined intervals, a posterior reduction in alpha power was present during ME and MP, but not during MI. Finally, above sensorimotor areas a decrease in beta power was observed that was most pronounced in the case of ME. The increase of frontal theta activity during MI may reflect increased effort, while the absence of a reduction in posterior alpha power suggests no major involvement of visuospatial attention and/or visual imagery. The present findings favor the motor-cognitive model, as it predicts extra involvement of frontal executive processes during MI.