Motor Imagery Practice and Cognitive Processes

A scoping review on motor imagery-based rehabilitation: Potential working mechanisms and clinical application for cognitive function and depression

ObjectiveTo map evidence on the characteristics, effectiveness, and potential mechanisms of motor imagery interventions targeting cognitive function and depression in adults with neurological disorders and/or mobility impairments.Data SourcesSix English databases (The Cochrane Library, PubMed, Embase, Scopus, Web of Sciences, and PsycINFO), two Chinese databases (CNKI and WanFang), and a gray literature database were searched from inception to December 2024.Review MethodsThis scoping review followed the Joanna Briggs Institute Scoping Review methodology. Interventional studies that evaluated motor imagery for cognitive function and/or depression in adults with neurological disorders and/or mobility impairments were included.ResultsA total of 24 studies, primarily involving adults with cerebrovascular diseases, multiple sclerosis, and Parkinson's disease, were identified. Motor imagery was typically conducted at home/clinic, occurring 2 to 3 sessions per week for approximately 2 months, with each session lasting 20 to 30 minutes. The 62.5% of studies (n = 10) reported significant improvements in cognitive function, exhibiting moderate-to-large effect sizes (Cohen's d = 0.48-3.41), especially in memory, attention, and executive function, while 53.3% (n = 8) indicated alleviation in depression with moderate-to-large effect sizes (Cohen's d = -0.72- -2.56). Motor imagery interventions could relieve pain perception and promote beneficial neurological changes in brains by facilitating neurotrophic factor expression and activating neural circuits related to motor, emotional, and cognitive functions.ConclusionMotor imagery could feasibly be conducted at home, with promising effects on cognitive function and depression. More high-quality randomized controlled trials and neuroimaging techniques are needed to investigate the effects of motor imagery on neuroplasticity and brain functional reorganization, thereby aiding in the development of mechanism-driven interventions.

Motor Cortex Activation Patterns in Both Hemispheres Induced by Motor Imagery in Patients With Right- and Left-Sided Cerebral Infarction: An fNIRS Study

This study aimed to explore the neuroimaging basis of motor imagery (MI) in stroke rehabilitation, particularly focusing on the brain activation patterns during MI tasks. Additionally, this study may provide insights into clinical rehabilitation strategies. A total of 40 right-handed stroke patients from Zhejiang Rehabilitation Medical Center were assigned to either the right-sided or left-sided cerebral infarction group. They were right-handed and recruited from Zhejiang Rehabilitation Medical Center. A portable near-infrared brain function imaging system was used to detect changes in oxyhemoglobin concentration in the bilateral sensorimotor cortex, premotor cortex, and supplementary motor area during the MI task. Activated channels and intensity changes in brain regions under the MI state were observed and analyzed. In patients with right-sided cerebral infarction, brain activation was left-lateralized during both left- and right-limb MI. Patients with left-sided cerebral infarction exhibited left lateralization during right-limb MI and right lateralization during left-limb MI. Functional near-infrared spectroscopy was utilized to investigate the activation of motor-related brain regions during MI after stroke. These regions of interest were associated with hand motor tasks and were successfully activated during the MI task. Following infarction, the activation of the MI cortex was asymmetric. When imagining movements on the dominant-hand side, MI becomes more vivid and activates bilateral motor cortex areas.

Motor Imagery Practice to Improve Respiratory and Cough Function

Motor imagery practice (MP), or visualizing performing a task without executing it, is an effective intervention for the limbs and tongue. However, MP of expiratory muscle strength training (EMST) and voluntary cough (VC) has not been explored. We examined the feasibility and impact of MP of VC and EMST on pulmonary and cough function in twenty community-dwelling adults. Participants underwent two baseline research evaluations of maximum expiratory and inspiratory pressure (MEP, MIP), forced vital capacity (FVC), voluntary peak expiratory flow rate (PEF), and cough spirometry. After the second research evaluation, participants underwent five weeks of MP of VC or EMST (alternating assignment, 25 repetitions, 70% training load, daily) at home with weekly telehealth sessions. Participants underwent post-treatment research evaluations of MEP, MIP, FVC, PEF, cough spirometry, and the Exercise Therapy Burden Questionnaire (ETBQ). Treatment adherence and telehealth attendance were tracked. Descriptives and Wilcoxon signed rank tests were performed. MP adherence was 95% and telehealth attendance was 91%. Median (IQR) ETBQ scores were 8 (1, 15), indicating minimal burden. Across both MP groups, increases in PEF from a handheld device (+ 13.7, 95% CI: 1.8, 25.6, p = 0.03) and from cough spirometry (+ 0.71, 95% CI: 0.05, 1.4, p = 0.04) were observed. Increases in PEF from cough spirometry (+ 1.00, 95% CI: 0.12, 1.9, p = 0.04) were observed for the MP VC group. Preliminary data demonstrate MP of VC and EMST is feasible and improves voluntary cough in community-dwelling adults. Future research is needed in larger sample sizes and patient populations with pulmonary, cough, and swallowing impairments.

Clinical Aspects of Mental Imagery in Alzheimer's Disease-Related Dementia: A Review of Cognitive, Motor, and Emotional Interventions

The present review describes the use and effectiveness of mental imagery in Alzheimer's disease-related dementia. Six databases were thoroughly searched from January 2010 to December 2024. Different types of studies were retrieved and reviewed for imagery of the motor, cognitive, and emotional states and quality of life of the elderly with dementia. Although the scarce results showed the positive effect of mental imagery to the every-day life of older adults with dementia, more research should be conducted with larger homogenous samples and more valid tools. Future recommendations are provided.

Mental imagery and stress: the mediating role of self-efficacy in competitive martial arts athletes

Introduction

Martial arts are diverse systems of combat practices, each with its unique techniques, philosophies, and histories. Mental imagery is a multisensory experience that integrates various senses to create vivid mental representations, evoking the physical attributes of people, places, or objects not currently within our perception. In sports contexts, studies have indicated that martial arts often use imagery to enhance performance.

Methods

This study aimed to investigate the mediating role of self-efficacy in the relationship between static (visualizing still scenes or concepts) and dynamic (focusing on motion and action) vividness, controllability (manipulating the imagery experience), and the degree of stress, in a group of 110 martial arts athletes (61 males and 49 females), aged between 21 and 23 years old (M = 22.47, SD = 0.75). Participants were competitive athletes of karate, taekwondo and judo, having a minimum of 13 years of training skill in the sport. They completed the Vividness of Visual Imagery Questionnaire, the Vividness of Movement Imagery Questionnaire-2, the Mental Image Transformation Task, The General Self-Efficacy Scale, and Measuring Psychological Stress Test.

Results

A 2 × 3 (gender × sport type) between groups MANOVA showed significant differences in imagery dimensions by sport type. The results of the mediation analysis showed that self-efficacy plays a mediating role between imagery and stress.

Discussion

The study advanced exploration in the field of mental imagery training, providing additional evidence for its importance in improving performance and managing stress in athletes.

Differences in working memory function are associated with motor imagery-induced changes in spinal motor nerve excitability and subsequent motor skill changes

Verification of the effectiveness of motor imagery (MI) has mainly focused on the method of implementing MI, and few studies have assessed individual factors. This study examined the individual differences in MI effects from the viewpoint of the multiple components of working memory. Forty-six healthy subjects (mean age 20.8 years) performed the Stroop Test (central executive within working memory) and reverse chanting (phonological loop within working memory). Then, F-waves were measured at rest for 30 s, the Purdue Pegboard was performed with the non-dominant hand to evaluate finger dexterity (Peg score) before MI, F-waves were measured during 30 s of kinesthetic MI, and the Peg score was evaluated after MI. For statistical analysis, the amplitude F/M ratio and Peg score were used as dependent variables, and the subjects were divided into Good and Poor groups according to cognitive function. The results showed an interaction for the amplitude F/M ratio and Peg score when grouped by reverse inverse chanting. In the subsequent simple main effect analysis, the Peg score was significantly improved after MI in both groups. The amplitude F/M ratio was significantly increased during MI compared to the resting state only in the Poor phonological loop group. Conversely, there was no interaction when the groups were divided by Stroop interference. No relationship was found between individual differences in central executive and changes in hand finger dexterity and spinal motor nerve excitability induced by MI. However, there may be a relationship between individual differences in phonological loops and changes in MI-induced finger dexterity and spinal motor nerve excitability.

Could Motor Imagery Training Provide a Novel Load Management Solution for Athletes? Recommendations for Sport Medicine and Performance Practitioners

CONTEXT

Athletes often face the dual challenge of high training loads with insufficient time to recover. Equally, in any team, sports medicine and performance staff are required to progress training loads in healthy athletes and avoid prolonged reductions in training load in injured athletes. In both cases, the implementation of a well-established psychological technique known as motor imagery (MI) can be used to counteract adverse training adaptations such as excessive fatigue, reduced capacity, diminished performance, and heightened injury susceptibility.

STUDY DESIGN

Narrative overview.

LEVEL OF EVIDENCE

Level 5.

RESULTS

MI has been shown to enhance performance outcomes in a range of contexts including rehabilitation, skill acquisition, return-to-sport protocols, and strength and conditioning. Specific performance outcomes include reduction of strength loss and muscular atrophy, improved training engagement of injured and/or rehabilitating athletes, promotion of recovery, and development of sport-specific skills/game tactics. To achieve improvements in such outcomes, it is recommended that practitioners consider the following factors when implementing MI: individual skill level (ie, more time may be required for novices to obtain benefits), MI ability (ie, athletes with greater capacity to create vivid and controllable mental images of their performance will likely benefit more from MI training), and the perspective employed (ie, an internal perspective may be more beneficial for increasing neurophysiological activity whereas an external perspective may be better for practicing technique-focused movements).

CONCLUSION

We provide practical recommendations grounded in established frameworks on how MI can be used to reduce strength loss and fear of reinjury in athletes with acute injury, improve physical qualities in rehabilitating athletes, reduce physical loads in overtrained athletes, and to develop tactical and technical skills in healthy athletes.

Attention Induced Dual Convolutional-Capsule Network (AIDC-CN): A deep learning framework for motor imagery classification

In recent times, Electroencephalography (EEG)-based motor imagery (MI) decoding has garnered significant attention due to its extensive applicability in healthcare, including areas such as assistive robotics and rehabilitation engineering. Nevertheless, the decoding of EEG signals presents considerable challenges owing to their inherent complexity, non-stationary characteristics, and low signal-to-noise ratio. Notably, deep learning-based classifiers have emerged as a prominent focus for addressing the EEG signal decoding process. This study introduces a novel deep learning classifier named the Attention Induced Dual Convolutional-Capsule Network (AIDC-CN) with the specific aim of accurately categorizing various motor imagination class labels. To enhance the classifier's performance, a dual feature extraction approach leveraging spectrogram and brain connectivity networks has been employed, diversifying the feature set in the classification task. The main highlights of the proposed AIDC-CN classifier includes the introduction of a dual convolution layer to handle the brain connectivity and spectrogram features, addition of a novel self-attention module (SAM) to accentuate the relevant parts of the convolved spectrogram features, introduction of a new cross-attention module (CAM) to refine the outputs obtained from the dual convolution layers and incorporation of a Gaussian Error Linear Unit (GELU) based dynamic routing algorithm to strengthen the coupling among the primary and secondary capsule layers. Performance analysis undertaken on four public data sets depict the superior performance of the proposed model with respect to the state-of-the-art techniques. The code for this model is available at https://github.com/RiteshSurChowdhury/AIDC-CN.

The Effectiveness of Motor Imagery in Balance and Functional Status of Older People with Early-Stage Dementia

BACKGROUND/OBJECTIVES

Dementia involves the loss of cognitive abilities and impairs functional abilities in daily life. In motor imagery (MI) techniques, motor acts are mentally rehearsed without any overt body movements. The purpose of the randomized controlled trial was to examine the effects of MI on the motor function of older adults with dementia.

METHODS

Overall, 160 participants (43 men, 117 women, MMSE M = 23.20, SD = 0.15) from an Athens Day Care Center of the Alzheimer Association were randomized to (a) the MI and exercise group (experimental group) (n = 55), (b) the only exercise group (1st control group) (n = 52) and (c) the neither MI nor exercise group (2nd control group) (n = 53). The exercise session comprised 24 physiotherapy exercise sessions, lasting 45 min each, twice a week for 12 weeks. The exercises were selected from the Otago Exercise Program. Three assessments were performed: (a) one week prior to the program, (b) at one and a half months and (c) after the program. The experimental group performed a 30-minute MI with exercise program content after the end of every physiotherapy exercise session. The Multidirectional Reach Test, Five Times Sit-to-Stand Test (FTSST), Timed Up and Go test (TUG), Functional Gait Assessment (FGA) and Berg Balance Scale (BBS) were used to assess participants' balance and functional status.

RESULTS

In the intention to treat analysis (18 participants dropped out), the 3 × 3 repeated measures ANOVA indicated statistically significant results between the three groups on (a) the TUG (F = 3.06, df (2), p = 0.04), (b) the FTSST (F = 3.00, df (2), p = 0.05), (c) the forward direction test (F = 4.14 df (2), p = 0.02), the lateral right and the lateral left direction tests (F = 3.90, df (2), p = 0.02 and F = 7.87, df (2), p = 0.00, respectively), and (d) the FGA (F = 4.35, df (2), p = 0.01). The Friedman test showed significant statistical significant differences among the three groups for BBS (X2 = 7.62, df = 2, p = 0.22), and an effect size of partial η2 coefficient for F-tests was found. Post hoc comparisons using a Bonferroni test for ANOVA and Wilcoxon test for Friedman indicated that the mean scores for the experimental group and the 1st control were significantly better than the 2rd control group in many dependent variables.

CONCLUSIONS

The study showed a positive effect of MI on balance and the functional status of older adults with early stages of dementia with possible beneficial effects on maintaining independence and reducing physical decline.

Transformation but not generation of motor images is disrupted following stimulation over the left inferior parietal lobe

Motor imagery (MI) involves the generation, maintenance, and transformation of motor images; yet, the neural underpinnings of each stage are not well understood. Here, we investigated the role of the left inferior parietal lobe (IPL) in the stages of MI. Healthy participants (N = 20) engaged in a MI task (making judgments about hands presented on a screen; hand laterality judgment task) over two days. Past literature demonstrates the mental rotation of hands in this task involves implicit MI (i.e., where MI occurs spontaneously in the absence of explicit instructions). During the task, active (Day A; 120% resting motor threshold) or sham (Day B; placebo) neuronavigated transcranial magnetic stimulation (TMS) was applied to the left IPL (location determined from past neuroimaging work) on 50% of trials at 250, 500, or 750ms post-stimulus onset, corresponding to different stages of MI. A/B days were randomized across participants. Linear mixed effects (LME) modelling conducted on reaction time and accuracy revealed that longer reaction times were observed when TMS was delivered at 750ms after trial onset, and more greatly for active vs. sham stimulation. This effect was exacerbated for palm-vs. back-view stimuli and for left vs. right hands. Accuracy overall was decreased for active vs. sham stimulation, and to a greater extent for palm-vs. back-view stimuli. Findings suggest that the left IPL is involved in image transformation. Overall this work informs on the neural underpinnings of the stages of MI.

Boostering motor imagery processing to improve gait in patients with Parkinson disease and freezing of gait: A pilot study

BACKGROUND

Given that patients with Parkinson's Disease (PD) and Freezing of Gait (FoG) may lack the cognitive resources necessary to activate the motor imagery (MI) process, investigating how to boost MI vividness and accuracy could be a valuable therapeutic strategy in MI Practice (MIP).

OBJECTIVE

We aim to evaluate the priming effect of visual, or auditory, or attentional stimuli in enhancing MI ability by using quantitative data on gait and turning performance.

METHODS

Nineteen PD participants with FoG underwent four one-week sessions of MIP, with pre and post clinical assessments. Each session included MI alone or one of three booster MI tasks (Attentional, Action observation, or Auditory) before imagining and executing walking straight and performing a 180° turn. Gait and turning performances were evaluated using six inertial sensors before and after each session.

RESULTS

Our findings showed that both MI and boosted MI induced similar improvement in gait (speed and stride length) and 180° (step number and velocity) and 360° turning (velocity, angle) parameters compared to baseline. When differences among "booster" tasks were analyzed, results showed that Auditory and Attentional boosted MI were superior to MI alone in some gait and turning parameters. At the end of the 4 sessions, MI ability measured by means of Kinesthetic and Visual Imagery Questionnaire and Gait Imagery Questionnaire and FoG symptoms were also improved.

CONCLUSION

Our preliminary results suggest that boosting MI is a feasible strategy for enhancing MI ability and addressing FoG symptoms. Auditory and Attentional conditions appear to enhance the priming effect of MI on gait and turning performance more effectively.

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.

Learning motor actions via imagery-perceptual or motor learning?

It is well accepted that repeatedly imagining oneself acting without any overt behavior can lead to learning. The prominent theory accounting for why imagery practice is effective, motor simulation theory, posits that imagined action and overt action are functionally equivalent, the exception being activation of the end effector. If, as motor simulation theory states, one can compile the goal, plan, motor program and outcome of an action during imagined action similar to overt action, then learning of novel skills via imagery should proceed in a manner equivalent to that of overt action. While the evidence on motor simulation theory is both plentiful and diverse, it does not explicitly account for differences in neural and behavioural findings between imagined and overt action. In this position paper, we briefly review theoretical accounts to date and present a perceptual-cognitive theory that accounts for often observed outcomes of imagery practice. We suggest that learning by way of imagery reflects perceptual-cognitive scaffolding, and that this 'perceptual' learning transfers into 'motor' learning (or not) depending on various factors. Based on this theory, we characterize consistently reported learning effects that occur with imagery practice, against the background of well-known physical practice effects and show that perceptual-cognitive scaffolding is well-suited to explain what is being learnt during imagery practice.

About the Predictive Value of a 3D Multiple Object Tracking Device for Talent Identification in Elite Ice Hockey Players

Purpose: The aim of this study is to verify if a single session on the NeuroTracker has predictive value in talent identification in ice hockey. Methods: Thirty-five male ice hockey players (aged 16-20) from the highest Canadian competition level for that age group participated in the study. A battery of tests (attention, working memory, time reproduction, pattern recognition, temporal equivalence, technical ability, and decision-making) was administered to verify the relation between various cognitive abilities, on-ice performance, and the baseline score on the NeuroTracker, which is claimed to solicit multiple cognitive functions. On-ice performance indicators were game-related statistics: games played, points (mean per game), on-ice goals differential, and draft rank. Results: Results show that the baseline score on the NeuroTracker is not associated with draft ranking, nor is it able to predict which players will perform best based on game-related statistics. However, the NeuroTracker baseline score does correlate with various tests involving working memory and attention. Conclusion: Currently, NeuroTracker is not specific enough to allow talent identification among same-level elite athletes in ice hockey.

Effects of brain-Computer interface combined with mindfulness therapy on rehabilitation of hemiplegic patients with stroke: a randomized controlled trial

Aim

To explore the effects of brain-computer interface training combined with mindfulness therapy on Hemiplegic Patients with Stroke.

Background

The prevention and treatment of stroke still faces great challenges. Maximizing the improvement of patients' ability to perform activities of daily living, limb motor function, and reducing anxiety, depression, and other social and psychological problems to improve patients' overall quality of life is the focus and difficulty of clinical rehabilitation work.

Methods

Patients were recruited from December 2021 to November 2022, and assigned to either the intervention or control group following a simple randomization procedure (computer-generated random numbers). Both groups received conventional rehabilitation treatment, while patients in the intervention group additionally received brain-computer interface training and mindfulness therapy. The continuous treatment duration was 5 days per week for 8 weeks. Limb motor function, activities of daily living, mindfulness attention awareness level, sleep quality, and quality of life of the patients were measured (in T0, T1, and T2). Generalized estimated equation (GEE) were used to evaluate the effects. The trial was registered with the Chinese Clinical Trial Registry (ChiCTR2300070382).

Results

A total of 128 participants were randomized and 64 each were assigned to the intervention and control groups (of these, eight patients were lost to follow-up). At 6 months, compared with the control group, intervention group showed statistically significant improvements in limb motor function, mindful attention awareness, activities of daily living, sleep quality, and quality of life.

Conclusion

Brain-computer interface combined with mindfulness therapy training can improve limb motor function, activities of daily living, mindful attention awareness, sleep quality, and quality of life in hemiplegic patients with stroke.

Impact

This study provides valuable insights into post-stroke care. It may help improve the effect of rehabilitation nursing to improve the comprehensive ability and quality of life of patients after stroke.

Clinical review registration

https://www.chictr.org.cn/, identifier ChiCTR2300070382.

Posthoc Interpretability of Neural Responses by Grouping Subject Motor Imagery Skills Using CNN-Based Connectivity

Motor Imagery (MI) refers to imagining the mental representation of motor movements without overt motor activity, enhancing physical action execution and neural plasticity with potential applications in medical and professional fields like rehabilitation and education. Currently, the most promising approach for implementing the MI paradigm is the Brain-Computer Interface (BCI), which uses Electroencephalogram (EEG) sensors to detect brain activity. However, MI-BCI control depends on a synergy between user skills and EEG signal analysis. Thus, decoding brain neural responses recorded by scalp electrodes poses still challenging due to substantial limitations, such as non-stationarity and poor spatial resolution. Also, an estimated third of people need more skills to accurately perform MI tasks, leading to underperforming MI-BCI systems. As a strategy to deal with BCI-Inefficiency, this study identifies subjects with poor motor performance at the early stages of BCI training by assessing and interpreting the neural responses elicited by MI across the evaluated subject set. Using connectivity features extracted from class activation maps, we propose a Convolutional Neural Network-based framework for learning relevant information from high-dimensional dynamical data to distinguish between MI tasks while preserving the post-hoc interpretability of neural responses. Two approaches deal with inter/intra-subject variability of MI EEG data: (a) Extracting functional connectivity from spatiotemporal class activation maps through a novel kernel-based cross-spectral distribution estimator, (b) Clustering the subjects according to their achieved classifier accuracy, aiming to find common and discriminative patterns of motor skills. According to the validation results obtained on a bi-class database, an average accuracy enhancement of 10% is achieved compared to the baseline EEGNet approach, reducing the number of "poor skill" subjects from 40% to 20%. Overall, the proposed method can be used to help explain brain neural responses even in subjects with deficient MI skills, who have neural responses with high variability and poor EEG-BCI performance.

Motor imagery training to improve language processing: What are the arguments?

Studies showed that motor expertise was found to induce improvement in language processing. Grounded and situated approaches attributed this effect to an underlying automatic simulation of the motor experience elicited by action words, similar to motor imagery (MI), and suggest shared representations of action conceptualization. Interestingly, recent results also suggest that the mental simulation of action by MI training induces motor-system modifications and improves motor performance. Consequently, we hypothesize that, since MI training can induce motor-system modifications, it could be used to reinforce the functional connections between motor and language system, and could thus lead to improved language performance. Here, we explore these potential interactions by reviewing recent fundamental and clinical literature in the action-language and MI domains. We suggested that exploiting the link between action language and MI could open new avenues for complementary language improvement programs. We summarize the current literature to evaluate the rationale behind this novel training and to explore the mechanisms underlying MI and its impact on language performance.

Effects of Baduanjin imagery and exercise on cognitive function in the elderly: A functional near-infrared spectroscopy study

Objective

Cognitive function is essential in ensuring the quality of life of the elderly. This study aimed to investigate the effects of Baduanjin imagery and Baduanjin movement (a traditional Chinese health exercise, TCHE) on cognitive function in the elderly using functional near-infrared spectroscopy (fNIRS).

Methods

72 participants with a mean age of 66.92 years (SD = 4.77) were recruited for this study. The participants were randomly assigned to three groups: the Baduanjin imagery, the Baduanjin exercise, and the Control. Stroop task was used to record the accuracy and reaction times, and a near-infrared spectral brain imaging system was used to monitor the brain's oxy-hemoglobin concentration responses.

Results

(1) For the reaction times of Stroop incongruent tasks, the main effect of the test phase (F = 114.076, p < 0.001) and the interaction effect between test phase and group (F = 10.533, p < 0.001) were all significant. The simple effect analysis further demonstrated that the reaction times of the Baduanjin imagery group and Baduanjin exercise group in the post-test was faster than that in the pre-test (ps < 0.001); (2) Analysis of fNIRS data showed the significant interaction effect (F = 2.554, p = 0.013) between the test phase and group in the left dorsolateral prefrontal cortex. Further analysis showed that, during the post-test incongruent tasks, the oxy-Hb variations were significantly higher in participants of the Baduanjin imagery group (p = 0.005) and Baduanjin exercise group (p = 0.002) than in the control group; For the right inferior frontal gyrus, the interaction between the test phase and group was significant (F = 2.060, p = 0.044). Further analysis showed that, during the post-test incongruent tasks, the oxy-Hb variations were significantly higher in participants of the Baduanjin imagery group than in the control group (p = 0.001).

Conclusion

Baduanjin imagery and exercise positively affect cognitive performance; Baduanjin imagery and exercise activated the left dorsolateral prefrontal cortex; Baduanjin imagery activated the right inferior frontal gyrus, while Baduanjin exercise could not.

Direction decoding of imagined hand movements using subject-specific features from parietal EEG

OBJECTIVE

Research on decoding brain signals for controlling external devices is rapidly emerging, owing to its versatile potential applications including neuro-prosthetic control and neurorehabilitation. Electroencephalogram (EEG)-based non-invasive Brain Computer Interface (BCI) systems decode brain signals to establish an augmented communication and control pathway between the brain and the computer. The development of an efficient BCI system requires accurate decoding of neural activity underlying user's intentions. This study investigates the directional tuning of Electroencephalogram (EEG) characteristics from posterior parietal region, associated with bidirectional hand movement imagination (motor imagery) in left and right directions.

APPROACH

The imagined movement directions of the chosen hand were decoded using a combination of envelope and phase features derived from parietal EEG of both hemispheres. The proposed algorithm uses wavelet for spectral decomposition, and discriminative subject-specific subband levels are identified based on Fisher analysis of envelope and phase features. The selected features from the discriminative subband levels are used for classifying left and right motor imagery directions of the hand using Support Vector Machine Classifier. Furthermore, the performance of the proposed algorithm is evaluated by incorporating a maximum variance-based EEG time bin selection algorithm.

MAIN RESULTS

With the time bin selection approach using subject-specific features, the proposed algorithm yielded an average left vs right motor imagery direction decoding accuracy of 73.33% across 15 healthy subjects. In addition, decoding accuracy offered by the phase features was higher than that of the envelope features, indicating the importance of phase features in MI kinematics decoding.

SIGNIFICANCE

The results reveal the significance of parietal EEG in decoding imagined kinematics and open new possibilities for future BCI research.

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

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

Effect of the Menstrual Cycle on Electroencephalogram Alpha and Beta Bands During Motor Imagery and Action Observation

Female sex steroids (FSS) can affect the motor system, modulating motor cortex excitability as well as performance in dexterity and coordination tasks. However, it has not yet been explored whether FSS affects the cognitive components of motor behavior. Mu is a sensorimotor rhythm observed by electroencephalography (EEG) in alpha (8–12 Hz) and beta (15–30 Hz) frequency bands in practices such as motor imagery (MI) and action observation (AO). This rhythm represents a window for studying the activity of neural circuits involved in motor cognition. Herein we investigated whether the alpha-mu and beta-mu power in the sensorimotor region (C3 and C4, hypothesis-driven approach) and the alpha and beta power over frontal, parietal, and occipital regions (data-driven approach) are modulated differently in the menstrual, follicular, and luteal phases of menstrual cycles in right-handed dominant women. To do so, these women underwent MI and AO in the three menstrual cycle phases. The spectral activity of the cortical regions for the alpha and beta bands were compared between phases of the menstrual cycle and a correlation analysis was also performed in relation to estrogen and progesterone levels. For the hypothesis-based approach, beta-mu event-related desynchronization (ERD) was significantly stronger in the C3 channel in the follicular phase than in the menstrual and luteal phases. For the data-driven approach, beta ERD during MI was higher in the follicular phase than in the menstrual and luteal phases in the frontal region. These findings suggest the effect of FSS on executive movement control. No effect of menstrual cycle phases was observed in cortical areas investigated during OA, but alpha and beta bands correlated positively with the follicular phase plasma estradiol level. Thus, the attenuation of alpha and beta bands referring to mirror neuron activities appears to be associated with inhibition of cortical activity when estradiol levels are lower, improving cognitive processing of motor action.

Using Motor Imagery to Access Alternative Attentional Strategies When Navigating Environmental Boundaries to Prevent Freezing of Gait – A Perspective

Freezing of gait can cause reduced independence and quality of life for many with Parkinson’s disease. Episodes frequently occur at points of transition such as navigating a doorway. Therapeutic interventions, i.e., drugs and exercise, do not always successfully mitigate episodes. There are several different, but not exclusive causes for freezing of gait. People with freezing of gait are able to navigate dynamic situations like stairways by utilizing a different attentional strategy to over-ground walking, but may freeze when passing through a doorway. The question is, is it possible to employ a special attentional strategy to prevent freezing at this point? Motor imagery allows for learning motor skills in absolute safety and has been widely employed in a variety of populations, including other neuro-compromised groups. Motor imagery is not studied in a homologous manner in people with Parkinson’s Disease, leading to conflicting results, but may have the potential to establish a different attentional strategy which allows a subject to mitigate freezing of gait episodes. This paper will identify and discuss the questions that still need to be answered in order to consider this approach i.e., can this population access motor imagery, can motor imagery alter the attentional strategy employed when moving through doorways, what is the best motor imagery approach for people with Parkinson’s Disease and freezing of gait, and what dosage is most effective, while briefly outlining future research considerations.

Exploring the Link between Novel Task Proceduralization and Motor Simulation

Our ability to generate efficient behavior from novel instructions is critical for our adaptation to changing environments. Despite the absence of previous experience, novel instructed content is quickly encoded into an action-based or procedural format, facilitating automatic task processing. In the current work, we investigated the link between proceduralization and motor simulation, specifically, whether the covert activation of the task-relevant responses is used during the assembly of action-based instructions representations. Across three online experiments, we used a concurrent finger-tapping task to block motor simulation during the encoding of novel stimulus-response (S-R) associations. The overlap between the mappings and the motor task at the response level was manipulated. We predicted a greater impairment at mapping implementation in the overlapping condition, where the mappings' relevant response representations were already loaded by the motor demands, and thus, could not be used in the upcoming task simulation. This hypothesis was robustly supported by the three datasets. Nonetheless, the overlapping effect was not modulated by further manipulations of proceduralization-related variables (preparation demands in Exp.2, mapping novelty in Exp.3). Importantly, a fourth control experiment ruled out that our results were driven by alternative accounts as fatigue or negative priming. Overall, we provided strong evidence towards the involvement of motor simulation during anticipatory task reconfiguration. However, this involvement was rather general, and not restricted to novelty scenarios. Finally, these findings can be also integrated into broader models of anticipatory task control, stressing the role of the motor system during preparation.

Mind the gap: State-of-the-art technologies and applications for EEG-based brain-computer interfaces

Brain-computer interfaces (BCIs) provide bidirectional communication between the brain and output devices that translate user intent into function. Among the different brain imaging techniques used to operate BCIs, electroencephalography (EEG) constitutes the preferred method of choice, owing to its relative low cost, ease of use, high temporal resolution, and noninvasiveness. In recent years, significant progress in wearable technologies and computational intelligence has greatly enhanced the performance and capabilities of EEG-based BCIs (eBCIs) and propelled their migration out of the laboratory and into real-world environments. This rapid translation constitutes a paradigm shift in human-machine interaction that will deeply transform different industries in the near future, including healthcare and wellbeing, entertainment, security, education, and marketing. In this contribution, the state-of-the-art in wearable biosensing is reviewed, focusing on the development of novel electrode interfaces for long term and noninvasive EEG monitoring. Commercially available EEG platforms are surveyed, and a comparative analysis is presented based on the benefits and limitations they provide for eBCI development. Emerging applications in neuroscientific research and future trends related to the widespread implementation of eBCIs for medical and nonmedical uses are discussed. Finally, a commentary on the ethical, social, and legal concerns associated with this increasingly ubiquitous technology is provided, as well as general recommendations to address key issues related to mainstream consumer adoption.

Putting Attention on the Spot in Coaching: Shifting to an External Focus of Attention With Imagery Techniques to Improve Basketball Free-Throw Shooting Performance

Attentional focus is an area that has garnered considerable attention in the sport psychology and motor performance literature. This is unsurprising given that attentional focus has been directly linked to performance outcomes and is susceptible to coaching input. While research has amassed supporting benefits of an external focus of attention (EFA) on motor performance using verbal instruction, other studies have challenged the notion that an EFA is more beneficial than an internal focus of attention (IFA) for sport-related performance. Further, it is unclear what type of instructions may serve to direct an athlete to an EFA and, in particular, if coaching can utilize imagery to orient an athlete toward an EFA. In the present exploratory study, we evaluate the effectiveness of instruction to improve free-throw shooting performance with an emphasis on an EFA brought about by implementing techniques borrowed from the imagery literature. This was tested relative to an alternate approach with an IFA induced through an emphasis on technique, devised to more closely resemble input typical of coach-to-athlete instruction. Twenty-five male and female university basketball players completed both conditions in a fully counterbalanced within-subject design. Results confirmed that participants in the EFA imagery condition had greater shooting accuracy than in the IFA technique condition. The study provides initial evidence that EFA coaching can borrow from imagery techniques, though future research should elucidate the underlying mechanisms of the effect.

Embodied Imagination and Metaphor Use in Autism Spectrum Disorder

This paper discusses different frameworks for understanding imagination and metaphor in the context of research on the imaginative skills of children with autism spectrum disorder (ASD). In contrast to a standard linguistic framework, it advances an embodied and enactive account of imagination and metaphor. The paper describes a case study from a systemic therapeutic session with a child with ASD that makes use of metaphors. It concludes by outlining some theoretical insights into the imaginative skills of children with ASD that follow from taking the embodied-enactive perspective and proposes suggestions for interactive interventions to further enhance imaginative skills and metaphor understanding in children with ASD.

Mental Skills Training and Resident Surgical Outcomes: A Systematic Review

OBJECTIVE

Mental skills training (MST) in surgical education varies greatly in quality and outcomes. This systematic review assessed the effectiveness of MST on surgical trainee performance in simulated and operating room (OR) settings.

DESIGN

We searched PubMed/MEDLINE, EMBASE, and PsycINFO for randomized controlled trials using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Peer-reviewed studies published in the English language between January 1, 2000 and March 1, 2020 were considered for inclusion. Articles that did not study surgical residents, assess surgical performance as an outcome, or report findings were excluded. Study characteristics, methodologies, and outcomes were qualitatively analyzed. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to measure the quality of the studies, and the Oxford quality scoring system for risk of bias ratings.

RESULTS

Seven randomized controlled trials met study inclusion criteria; interventions were mental practice, relaxation exercises, action observation, and Mindfulness-Based Stress Reduction. Targeted interventions based on mental practice, relaxation exercises, and MBSR significantly improved surgical performance in four (57%) studies. Risk of bias was low for all included studies, and quality of evidence was moderate for both simulated and OR performance.

CONCLUSIONS

Mental practice, relaxation, and mindfulness training improved simulation and OR performance for surgical residents. There was insufficient evidence to support other MST interventions or the intermediate- and long-term efficacy of MST.