Association of Personality Traits With the Efficacy of Stress Management Interventions for Medical Students Taking Objective Structured Clinical Examinations

PURPOSE

Personality traits are associated with psychophysiological stress, but few studies focus on medical students. This study aimed to better understand the association of personality traits with the efficacy of stress management interventions for medical students.

METHOD

A randomized controlled trial was conducted with fourth-year students who took the objective structured clinical examination at Bernard University Lyon 1 in December 2021. Students were randomized in cardiac biofeedback, mindfulness, and control groups. Each intervention was implemented for 6 minutes before the examination. Physiological stress levels were collected during the intervention. Psychological stress levels were rated by students at baseline and after the intervention. Personality traits were assessed via the Big-Five Inventory. Interactions between personality traits and the efficacy of the interventions were analyzed using multivariable linear regression models.

RESULTS

Four hundred eighty-one students participated. Higher baseline psychological stress levels were associated with higher neuroticism and agreeableness (β = 10.27, 95% confidence interval (CI) [7.40, 13.13], P < .001 and β = 3.42, 95% CI [0.98, 5.85], P = .006, respectively) and lower openness (β = -4.95, 95% CI [-7.40, -2.49], P < .001). As compared to the control intervention, both stress management interventions led to lower levels of psychological (P < .001 for both) and physiological stress levels (biofeedback: P < .001 and mindfulness: P = .009). Biofeedback efficacy varied by extraversion score for psychological (β = -5.66, 95% CI [-10.83, -0.50], P = .03) and physiological stress reduction (β = -0.002, 95% CI [-0.003, -0.00004], P = .045). Mindfulness efficacy varied by agreeableness score for psychological stress reduction (β = -7.87, 95% CI [-13.05, -2.68], P = .003).

CONCLUSIONS

Students with a high score in extraversion may benefit more from biofeedback interventions, while students with high scores in agreeableness may benefit more from mindfulness interventions.

Effects of morning and evening physical exercise on subjective and objective sleep quality: an ecological study

To optimise the relationship between exercise and sleep quality, the intensity of exercise and its proximity to sleep are key factors to manage. Although low-to-moderate exercises promote sleep quality, late-evening vigorous exercise instead of morning should still be avoided. It potentially impacts the objective and subjective markers of sleep quality. In the present study, we investigated the effects of vigorous morning and evening exercise on objective and subjective sleep features in an ecological context. A total of 13 recreational runners (mean [SD] age 27.7 [7.2] years, four females) performed a 45-60 min run (70% maximal aerobic velocity) either in the MORNING (30 min to 2 h after waking-up) or in the EVENING (2 h to 30 min before sleep). The two exercise conditions were separated by a REST day. After each condition, sleep was objectively assessed using an electroencephalographic headband and subjectively using the Spiegel Sleep Inventory. Compared with REST, both MORNING and EVENING exercise increased the time spent in non-rapid eye movement (NREM, +24.9 min and +22.7 min; p = 0.01, η2  = 0.11, respectively). Longer NREM duration was mainly due to sleep stage 2 extension after both MORNING (+20.8 min) and EVENING (+22.8 min) exercise relative to REST (p = 0.02, η2  = 0.12). No other effect of exercise on either objective or subjective sleep could be observed. Exercise, independently of the time at which it takes place, leads to extended NREM sleep without other effects on sleep quality. Considering the crucial role of exercise in achieving good health, sleep hygiene guidelines should be updated to promote exercise at any time of the day.

Brain plasticity underlying sleep-dependent motor consolidation after motor imagery

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

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

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

Exploring the impact of interactive movement-based anatomy learning in real classroom setting among kinesiology students

Descriptive and functional anatomy is one of the most important sciences for kinesiology students. Anatomy learning requires spatial and motor imagery abilities. Learning anatomy is complex when teaching methods and instructional tools do not appropriately develop spatial and motor imagery abilities. Recent technological developments such as three-dimensional (3D) digital tools allow to overcome those difficulties, especially when 3D tools require strong interactions with the learners. Besides interactive digital tools, embodied learning or learning in motion is an effective method for a wide variety of sciences including anatomy. The aim of this study was to explore the impact of combining movement execution with 3D animation visualization on anatomy learning in a real classroom teaching context. To do so, the results of two groups of kinesiology students during three official assessments were compared. The experimental group (n = 60) learned functional anatomy by combining movement execution with traditional knowledge acquisition (e.g., 3D animations visualization, problem-based learning exercises). The control group (n = 61) had the same material but did not execute the movements during problem-solving exercises. Although no differences were found between both groups on early and mid-semester examinations, significant difference appeared at the end of the semester with an advantage for the experimental group. This exploratory study suggests that embodied learning is beneficial in improving functional anatomy learning. Therefore, it would be interesting to integrate such type of pedagogical approach within the kinesiology curriculum.

The Role of Motor Inhibition During Covert Speech Production

Covert speech is accompanied by a subjective multisensory experience with auditory and kinaesthetic components. An influential hypothesis states that these sensory percepts result from a simulation of the corresponding motor action that relies on the same internal models recruited for the control of overt speech. This simulationist view raises the question of how it is possible to imagine speech without executing it. In this perspective, we discuss the possible role(s) played by motor inhibition during covert speech production. We suggest that considering covert speech as an inhibited form of overt speech maps naturally to the purported progressive internalization of overt speech during childhood. We further argue that the role of motor inhibition may differ widely across different forms of covert speech (e.g., condensed vs. expanded covert speech) and that considering this variety helps reconciling seemingly contradictory findings from the neuroimaging literature.

Combining proactive transcranial stimulation and cardiac biofeedback to substantially manage harmful stress effects

BACKGROUND

Previous studies have identified the dorsolateral prefrontal cortex (dlPFC) as a core region in cognitive emotional regulation. Transcranial direct current stimulations of the dlPFC (tDCS) and heart-rate variability biofeedback (BFB) are known to regulate emotional processes. However, the effect of these interventions applied either alone or concomitantly during an anticipatory stress remains unexplored.

OBJECTIVE

The study investigated the effect of anodal tDCS and BFB, alone or combined, on psychophysiological stress responses and cognitive functioning.

METHODS

Following a stress anticipation induction, 80 participants were randomized into four groups and subjected to a 15-min intervention: neutral video viewing (ctrl), left dlPFC anodal tDCS (tdcs), heart-rate variability biofeedback (bfb), or a combined treatment (bfb + tdcs). Participants were then immediately confronted with the stressor, which was followed by an assessment of executive functions. Psychophysiological stress responses were assessed throughout the experiment (heart rate, heart-rate variability, salivary cortisol).

RESULTS

The tdcs did not modulate stress responses. Compared with both ctrl and tdcs interventions, bfb reduced physiological stress and improved executive functions after the stressor. The main finding revealed that bfb + tdcs was the most effective intervention, yielding greater reduction in psychological and physiological stress responses than bfb.

CONCLUSIONS

Combining preventive tDCS with BFB is a relevant interventional approach to reduce psychophysiological stress responses, hence offering a new and non-invasive treatment of stress-related disorders. Biofeedback may be particularly useful for preparing for an important stressful event when performance is decisive.

Motor imagery practice benefits during arm immobilization

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

Implementing biofeedback as a proactive coping strategy: Psychological and physiological effects on anticipatory stress

Anticipating a stressful situation involves psychophysiological reactions before the occurrence of the overt stress event. The current challenge in the stress domain is to characterize anticipatory stress reactions and how to effectively modulate them. The present study aimed to characterize the anticipation period and evaluate the benefits of a heart-rate variability biofeedback (BFB) intervention designed to manage anticipatory stress. Healthy participants were exposed to an anticipation stress period (15 min) during which they either practised BFB (stress + bfb, n = 15) or watched a neutral video (stress + video, n = 14). Anticipatory stress was effectively induced by the Trier Social Anticipatory Stress (TSAS) protocol, specifically designed for this study. Control participants, without anticipation stress, practised BFB for an equivalent time (ctrl + bfb, n = 15). Subsequently, all participants performed a set of cognitive tasks assessing executive functions. Heart-rate variability (cardiac coherence, standard deviation of the R-R intervals, root mean square of successive difference measure) and the evolution of the perceived psychological state were measured during the anticipation period. Self-reported judgements of how the intervention influenced stress and performance were further assessed. The main result showed that BFB is a relevant proactive stress-coping method. Compared with the stress + video group, participants who practised BFB attained higher cardiac coherence scores. Post-intervention self-reported measures revealed that BFB contributed to reduce psychological stress and increase perceived levels of performance. Together, these findings provide practical guidelines for examining the stress anticipation period by means of the TSAS protocol.

Effect of Physical Fatigue Elicited by Continuous and Intermittent Exercise on Motor Imagery Ability

Purpose: The ability to perform motor imagery (MI) might be impaired by the physical fatigue elicited during training. Interestingly, there is also theoretical support for a more limited influence of fatigue in the existing literature. Method: We evaluated MI ability before and after two exercise protocols: (i) a continuous exercise of 20 min performed on a cycle ergometer at 80% of the secondary ventilatory threshold (Continuous exercise), and (ii) an intermittent exercise of 20 min involving sprints at maximal intensity performed with regular intervals (Intermittent exercise). MI ability evaluations were performed using validated behavioral (mental chronometry) and psychometric (subjective reports) methods. MI ability evaluations included mental rehearsal of a motor sequence which involved the main effectors of the exercise protocols (walking), and mental rehearsal of a motor task which did not involve the main somatic effectors of the exercise protocols (pointing movements with the upper limbs). Results: Mental chronometry showed that MI ability was degraded only after Intermittent exercise, while self-report measures of MI vividness revealed that MI ability was primarily impaired during MI of the walking task. Conclusions: Present results suggest that Intermittent exercise engaging anaerobic processes of energy expenditure, but not Continuous exercise engaging aerobic processes of energy expenditure, impaired MI ability. Findings are discussed in relation to the internal models theory of motor simulation, specifically changes in current state of the motor system under the fatigued state-affecting motor predictions. Present findings may contribute to successful applications of MI training in sports and rehabilitation.

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

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

Motor Imagery Training During Arm Immobilization Prevents Corticomotor Idling: An EEG Resting-State Analysis

Limb disuse causes overt, measurable alterations in motor functions. Motor imagery (MI) practice has been used as a behavioral strategy to prevent motor impairments due to limb disuse or immobilization. Yet, how MI operates at the neural level in the context of short-term limb immobilization remains understudied. We hypothesized that MI treatment applied during 12 h of arm immobilization prevents immobilization-related changes in resting-state electroencephalographic (rsEEG) power and functional connectivity. Fourteen participants first underwent rsEEG after 12 h of normal motor activity (without immobilization). Then, rsEEG recording was performed after 12 h of arm immobilization either with MI treatment or without, each condition separated by 1 week, according to a randomized within-subjects design. MI treatment consisted in performing varied visual and kinaesthetic MI exercises (5 sessions of 15 min every two hours). The results showed that in the delta, theta, alpha and beta frequency bands, interhemispheric difference in sensors power over the motor cortex (i.e. C3 vs. C4) was reduced after arm immobilization, while it did not change when MI treatment was delivered during the immobilization period. Moreover, functional connectivity across the sensors-network in the delta (1-4 Hz) and alpha (8-12 Hz) frequency bands decreased after immobilization while it was restored by MI treatment. To conclude, MI counteracts functional neural changes within and between motor regions in the context of limb immobilization. Practical applications for motor rehabilitation strategies, particularly in stroke patients, are also discussed.

Breathing with the mind: Effects of motor imagery on breath-hold performance

We aimed at studying the effect of Motor Imagery (MI), i.e., the mental representation of a movement without executing it, on breath-holding performance. Classical guidelines for efficient MI interventions advocate for a congruent MI practice with regards to the requirements of the physical performance, specifically in terms of physiological arousal. We specifically aimed at studying whether an incongruent form of MI practice might enhance the breath-hold performance. In a counterbalanced design including three experimental sessions, participants engaged in maximal breath-hold trials while concomitantly performing i) MI of breathing, ii) MI of breath-hold, and iii) an "ecological" breath-hold trial, i.e., without specific instructions of MI practice. In addition to breath-hold durations, we measured the cardiac activity and blood oxygen saturation. Performance was improved during MI of breathing (73.06 s ± 24.53) compared to both MI of breath-hold (70.57 s ± 18.15) and the control condition (67.67 s ± 19.27) (p < 0.05). The mechanisms underlying breath-hold performance improvements during MI of breathing remain uncertain. MI of breathing might participate to decrease the threat perception associated with breath-holding, presumably due to psychological and physiological effects associated with the internal simulation of a breathing body state.

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.

Benefits of Motor Imagery for Human Space Flight: A Brief Review of Current Knowledge and Future Applications

Motor imagery (MI) is arguably one of the most remarkable capacities of the human mind. There is now strong experimental evidence that MI contributes to substantial improvements in motor learning and performance. The therapeutic benefits of MI in promoting motor recovery among patients with motor impairments have also been reported. Despite promising theoretical and experimental findings, the utility of MI in adapting to unusual conditions, such as weightlessness during space flight, has received far less attention. In this review, we consider how, why, where, and when MI might be used by astronauts, and further evaluate the optimum MI content. Practically, we suggest that MI might be performed before, during, and after exposure to microgravity, respectively, to prepare for the rapid changes in gravitational forces after launch and to reduce the adverse effects of weightlessness exposition. Moreover, MI has potential role in facilitating re-adaptation when returning to Earth after long exposure to microgravity. Suggestions for further research include a focus on the multi-sensory aspects of MI, the requirement to use temporal characteristics as a measurement tool, and to account for the knowledge-base or metacognitive processes underlying optimal MI implementation.

Sleep does not facilitate insight in older adults

Sleep has been shown to foster the process of insight generation in young adults during problem solving activities. Aging is characterized by substantial changes in sleep architecture altering memory consolidation. Whether sleep might promote the occurrence of insight in older adults as well has not yet been tested experimentally. To address this issue, we tested healthy young and old volunteers on an insight problem solving task, involving both explicit and implicit features, before and after a night of sleep or a comparable wakefulness period. Data showed that insight emerged significantly less frequently after a night of sleep in older adults compared to young. Moreover, there was no difference in the magnitude of insight occurrence following sleep and daytime -consolidation in aged participants. We further found that acquisition of implicit knowledge in the task before sleep potentiated the gain of insight in young participants, but this effect was not observed in aged participants. Overall, present findings demonstrate that a period of sleep does not significantly promote insight in problem solving in older adults.

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

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

When music tempo affects the temporal congruence between physical practice and motor imagery

When people listen to music, they hear beat and a metrical structure in the rhythm; these perceived patterns enable coordination with the music. A clear correspondence between the tempo of actual movement (e.g., walking) and that of music has been demonstrated, but whether similar coordination occurs during motor imagery is unknown. Twenty participants walked naturally for 8m, either physically or mentally, while listening to slow and fast music, or not listening to anything at all (control condition). Executed and imagined walking times were recorded to assess the temporal congruence between physical practice (PP) and motor imagery (MI). Results showed a difference when comparing slow and fast time conditions, but each of these durations did not differ from soundless condition times, hence showing that body movement may not necessarily change in order to synchronize with music. However, the main finding revealed that the ability to achieve temporal congruence between PP and MI times was altered when listening to either slow or fast music. These data suggest that when physical movement is modulated with respect to the musical tempo, the MI efficacy of the corresponding movement may be affected by the rhythm of the music. Practical applications in sport are discussed as athletes frequently listen to music before competing while they mentally practice their movements to be performed.

Experts bodies, experts minds: How physical and mental training shape the brain

Skill learning is the improvement in perceptual, cognitive, or motor performance following practice. Expert performance levels can be achieved with well-organized knowledge, using sophisticated and specific mental representations and cognitive processing, applying automatic sequences quickly and efficiently, being able to deal with large amounts of information, and many other challenging task demands and situations that otherwise paralyze the performance of novices. The neural reorganizations that occur with expertise reflect the optimization of the neurocognitive resources to deal with the complex computational load needed to achieve peak performance. As such, capitalizing on neuronal plasticity, brain modifications take place over time-practice and during the consolidation process. One major challenge is to investigate the neural substrates and cognitive mechanisms engaged in expertise, and to define “expertise” from its neural and cognitive underpinnings. Recent insights showed that many brain structures are recruited during task performance, but only activity in regions related to domain-specific knowledge distinguishes experts from novices. The present review focuses on three expertise domains placed across a motor to mental gradient of skill learning: sequential motor skill, mental simulation of the movement (motor imagery), and meditation as a paradigmatic example of “pure” mental training. We first describe results on each specific domain from the initial skill acquisition to expert performance, including recent results on the corresponding underlying neural mechanisms. We then discuss differences and similarities between these domains with the aim to identify the highlights of the neurocognitive processes underpinning expertise, and conclude with suggestions for future research.

Selective delayed gains following motor imagery of complex movements

Recent studies suggest that a night of sleep may play a similar functional role following motor imagery (MI) practice. Here we examined whether offline gains following MI of a finger tapping sequence depends on the degree of complexity of the motor sequence, and whether this improvement differentially affects the individual transitions of the motor-sequence pattern being learned. The data revealed greater delayed performance gains in motor skill procedures that were most difficult, with larger sleep-dependent overnight improvement for movements involving bimanual coordination. The analyses of single transitions between sequence elements further revealed greatest overnight improvement in speed for the slowest (i.e., most difficult) transitions at the re-test. These findings suggest that sleep-related performance gains for imagined movements depend on motor skill complexity, and that difficult transition movements are most effectively enhanced after a night of sleep.

Mental rotation: effects of gender, training and sleep consolidation

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

Selective influence of circadian modulation and task characteristics on motor imagery time

In this study, we examined the effect of circadian modulation on motor imagery (MI) time while also considering the effects of task complexity and duration. The ability to imagine in real time was influenced by circadian modulation in a simple walking condition, with longer MI times in the morning and evening sessions. By contrast, there was no effect of circadian rhythm in the complex, short or long walking conditions. We concluded that motor imagery time is modulated during the course of the day, but the effect of task difficulty is stronger than circadian modulation in altering the temporal congruence between physical practice and MI performance. Practical applications in motor learning and rehabilitation are discussed.

Role of the primary motor cortex in the early boost in performance following mental imagery training

Recently, it has been suggested that the primary motor cortex (M1) plays a critical role in implementing the fast and transient post-training phase of motor skill consolidation, known to yield an early boost in performance. Whether a comparable early boost in performance occurs following motor imagery (MIM) training is still unknown. To address this issue, two groups of subjects learned a finger tapping sequence either by MIM or physical practice (PP). In both groups, performance increased significantly in the post-training phase when compared with the pre-training phase and further increased after a 30 min resting period, indicating that both MIM and PP trainings were equally efficient and induced an early boost in motor performance. This conclusion was corroborated by the results of an additional control group. In a second experiment, we then investigated the causal role of M1 in implementing the early boost process resulting from MIM training. To do so, we inhibited M1 by applying a continuous theta-burst stimulation (cTBS) in healthy volunteers just after they learnt, by MIM, the same finger-tapping task as in Experiment #1. As a control, cTBS was applied over the vertex of subjects who underwent the same experiment. We found that cTBS applied over M1 selectively abolished the early boost process subsequent to MIM training. Altogether, the present study provides evidence that MIM practice induces an early boost in performance and demonstrates that M1 is causally involved in this process. These findings further divulge some degree of behavioral and neuronal similitude between MIM and PP.

Sleep contribution to motor memory consolidation: a motor imagery study

STUDY OBJECTIVES

Sleep is known to enhance performance following physical practice (PP) of a new sequence of movements. Apart from a pilot study, it is still unknown whether a similar sleep-dependent consolidation effect can be observed following motor imagery (MI) and whether this mnemonic process is related to MI speed.

DESIGN

Counterbalanced within-subject design.

SETTING

The laboratory.

PARTICIPANTS

Thirty-two participants.

INTERVENTIONS

PP, real-time MI, fast MI, and NoSleep (control) groups.

MEASUREMENTS AND RESULTS

Subjects practiced an explicitly known sequence of finger movements, and were assigned to PP, real-time MI, or fast MI, in which they intentionally imagined the sequence at a faster pace. A NoSleep group subjected to real-time MI, but without any intervening sleep, was also tested. Performance was evaluated before practice, as well as prior to, and after a night of sleep or a similar time interval during the daytime. Compared with the NoSleep group, the results revealed offline gains in performance after sleep in the PP, real-time MI, and fast MI groups. There was no correlation between a measure of underestimation of the time to imagine the motor sequence and the actual speed gains after sleep, neither between the ease/difficulty to form mental images and performance gains.

CONCLUSIONS

These results provide evidence that sleep contributes to the consolidation of motor sequence learning acquired through MI and further suggests that offline delayed gains are not related to the MI content per se. They extend our previous findings and strongly confirm that performance enhancement following MI is sleep dependent.

Functional structure of spontaneous sleep slow oscillation activity in humans

Background

During non-rapid eye movement (NREM) sleep synchronous neural oscillations between neural silence (down state) and neural activity (up state) occur. Sleep Slow Oscillations (SSOs) events are their EEG correlates. Each event has an origin site and propagates sweeping the scalp. While recent findings suggest a SSO key role in memory consolidation processes, the structure and the propagation of individual SSO events, as well as their modulation by sleep stages and cortical areas have not been well characterized so far.

Methodology/Principal Findings

We detected SSO events in EEG recordings and we defined and measured a set of features corresponding to both wave shapes and event propagations. We found that a typical SSO shape has a transition to down state, which is steeper than the following transition from down to up state. We show that during SWS SSOs are larger and more locally synchronized, but less likely to propagate across the cortex, compared to NREM stage 2. Also, the detection number of SSOs as well as their amplitudes and slopes, are greatest in the frontal regions. Although derived from a small sample, this characterization provides a preliminary reference about SSO activity in healthy subjects for 32-channel sleep recordings.

Conclusions/Significance

This work gives a quantitative picture of spontaneous SSO activity during NREM sleep: we unveil how SSO features are modulated by sleep stage, site of origin and detection location of the waves. Our measures on SSOs shape indicate that, as in animal models, onsets of silent states are more synchronized than those of neural firing. The differences between sleep stages could be related to the reduction of arousal system activity and to the breakdown of functional connectivity. The frontal SSO prevalence could be related to a greater homeostatic need of the heteromodal association cortices.