Articles de revues sur le sujet « Motor imagery abilities »

This study extended motor imagery theories by establishing specificity and verification of expected brain activation patterns during imagery. Eighteen female participants screened with the Movement Imagery Questionnaire-3 (MIQ-3) as having good imagery abilities were scanned to determine the neural networks active during an arm rotation task. Four experimental conditions (i.e., KINESTHETIC, INTERNAL Perspective, EXTERNAL Perspective, and REST) were randomly presented (counterbalanced for condition) during three brain scans. Behaviorally, moderate interscale correlations were found between the MIQ-3 and Vividness of Movement Imagery Questionnaire-2, indicating relatedness between the questionnaires. Partially confirming our hypotheses, common and distinct brain activity provides initial biological validation for imagery abilities delineated in the MIQ-3: kinesthetic imagery activated motor-related areas, internal visual imagery activated inferior parietal lobule, and external visual imagery activated temporal, but no occipital areas. Lastly, inconsistent neuroanatomical intraindividual differences per condition were found. These findings relative to recent biological evidence of imagery abilities are highlighted.

Aim: The purpose of the present study is to examine the motor imagery profiles of children with hemiplegic cerebral palsy. Material and Method: 52 Hemiplegic (29 males, 23 females) individuals with 11.35 ± 3.48 years of mean age were included in the research. Participants’ implicit motor imagery abilities were analyzed with the laterality task. In addition, weekday and weekend screen times were questioned. Results: No statistically significant difference was determined in motor imagery abilities in terms of gender and affected extremity (p>0.05). Additionally, a significant correlation was found between screen time and Laterality task affected side accuracy and Laterality task not affected side accuracy percentages in both females and males (p<0.05). A significant correlation was found between age and motor imagery skills of males and left hemiplegic individuals. Conclusion: Excessive screen times negatively affect motor imagery abilities in Hemiplegic Cerebral Palsy. It was observed that motor imagery skills were associated with age, but not with gender and affected sides.

Aim: To determine the effectiveness of motor imagery training to improve the lower extremity function and gait in subjects with sub-acute stroke. Methods: Forty four patients with subacute stroke with gait impairment were randomly assigned to one of two groups: motor imagery training group or muscle relaxation group. At the beginning and after six weeks of therapy, the ability to use motor imagery and lower limb performance were assessed. Results: There were substantial differences of scores between both groups, with the motor imagery group progressing more than the muscle relaxation group. Conclusion: Motor imagery may have a beneficial and effective task-specific effect on gait function in sub-acute stroke patients. Keywords: motor imagery; gait rehabilitation; sub-acute stroke patients

Aim: To determine the effectiveness of motor imagery training to improve the lower extremity function and gait in subjects with sub-acute stroke. Methods: Forty four patients with subacute stroke with gait impairment were randomly assigned to one of two groups: motor imagery training group or muscle relaxation group. At the beginning and after six weeks of therapy, the ability to use motor imagery and lower limb performance were assessed. Results: There were substantial differences of scores between both groups, with the motor imagery group progressing more than the muscle relaxation group. Conclusion: Motor imagery may have a beneficial and effective task-specific effect on gait function in sub-acute stroke patients. Keywords: motor imagery; gait rehabilitation; sub-acute stroke patients

Not much is known about how well stroke patients are able to perform motor imagery (MI) and which MI abilities are preserved after stroke. We therefore applied three different MI tasks (one mental chronometry task, one mental rotation task, and one EEG-based neurofeedback task) to a sample of postacute stroke patients (n=20) and age-matched healthy controls (n=20) for addressing the following questions: First, which of the MI tasks indicate impairment in stroke patients and are impairments restricted to the paretic side? Second, is there a relationship between MI impairment and sensory loss or paresis severity? And third, do the results of the different MI tasks converge? Significant differences between the stroke and control groups were found in all three MI tasks. However, only the mental chronometry task and EEG analysis revealed paresis side-specific effects. Moreover, sensitivity loss contributed to a performance drop in the mental rotation task. The findings indicate that although MI abilities may be impaired after stroke, most patients retain their ability for MI EEG-based neurofeedback. Interestingly, performance in the different MI measures did not strongly correlate, neither in stroke patients nor in healthy controls. We conclude that one MI measure is not sufficient to fully assess an individual’s MI abilities.

People with Parkinson’s disease (PD) experience kinesthetic deficits, which affect motor and nonmotor functions, including mental imagery. Imagery training is a recommended, yet underresearched, approach in PD rehabilitation. Dynamic Neuro-Cognitive Imagery (DNI™) is a codified method for imagery training. Twenty subjects with idiopathic PD (Hoehn and Yahr stages I–III) were randomly allocated into DNI training (experimental;n=10) or in-home learning and exercise program (control;n=10). Both groups completed at least 16 hours of training within two weeks. DNI training focused on anatomical embodiment and kinesthetic awareness. Imagery abilities, disease severity, and motor and nonmotor functions were assessed pre- and postintervention. The DNI participants improved (p<.05) in mental imagery abilities, disease severity, and motor and spatial cognitive functions. Participants also reported improvements in balance, walking, mood, and coordination, and they were more physically active. Both groups strongly agreed they enjoyed their program and were more mentally active. DNI training is a promising rehabilitation method for improving imagery ability, disease severity, and motor and nonmotor functions in people with PD. This training might serve as a complementary PD therapeutic approach. Future studies should explore the effect of DNI on motor learning and control strategies.

Functional equivalence hypothesis and motor-cognitive model both posit that motor imagery performance involves inhibition of overt physical movement and thus engages control processes. As motor inhibition in internal motor imagery has been fairly well studied in adults, the present study aimed to investigate the correlation between internal motor imagery and motor inhibition in children. A total of 73 children (7-year-olds: 23, 9-year-olds: 27, and 11-year-olds: 23) participated the study. Motor inhibition was assessed with a stop-signal task, and motor imagery abilities were measured with a hand laterality judgment task and an alphanumeric rotation task, respectively. Overall, for all age groups, response time in both motor imagery tasks increased with rotation angles. Moreover, all children’s response times in both tasks decreased with age, their accuracy increased with age, and their motor inhibition efficiency increased with age. We found a significant difference between 7-year-olds and 9-year-olds in the hand laterality judgment task, suggesting that the involvement of motor inhibition in internal motor imagery might change with age. Our results reveal the underlying processes of internal motor imagery development, and furthermore, provide practical implications for movement rehabilitation of children.

Brain Computer Interface (BCI) is a fast growing area of research to enable communication between our brains and computers. EEG based motor imagery BCI involves the user imagining movement, the subsequent recording and signal processing on the electroencephalogram signals from the brain, and the translation of those signals into specific commands. Ultimately, motor imagery BCI has the potential to be applied to helping those with special abilities recover motor control. This paper presents an evaluation of performance for EEG based motor imagery BCI with a classification accuracy of 80.2%, making use of features extracted using the Fast Fourier Transform and the Discrete Wavelet Transform, and classification is done using an Artificial Neural Network. It goes on to conclude how the performance is affected by the particular feature sets and neural network parameters.

Prism adaptation (PA) is a useful method to investigate short-term sensorimotor plasticity. Following active exposure to prisms, individuals show consistent after-effects, probing that they have adapted to the perturbation. Whether after-effects are transferable to another task or remain specific to the task performed under exposure, represents a crucial interest to understand the adaptive processes at work. Motor imagery (MI, i.e., the mental representation of an action without any concomitant execution) offers an original opportunity to investigate the role of cognitive aspects of motor command preparation disregarding actual sensory and motor information related to its execution. The aim of the study was to test whether prism adaptation through MI led to transferable after-effects. Forty-four healthy volunteers were exposed to a rightward prismatic deviation while performing actual (Active group) versus imagined (MI group) pointing movements, or while being inactive (inactive group). Upon prisms removal, in the MI group, only participants with the highest MI abilities (MI+ group) showed consistent after-effects on pointing and, crucially, a significant transfer to throwing. This was not observed in participants with lower MI abilities and in the inactive group. However, a direct comparison of pointing after-effects and transfer to throwing between MI+ and the control inactive group did not show any significant difference. Although this interpretation requires caution, these findings suggest that exposure to intersensory conflict might be responsible for sensory realignment during prism adaptation which could be transferred to another task. This study paves the way for further investigations into MI’s potential to develop robust sensorimotor adaptation.

Objective: Autonomy in patients with Alzheimer's disease (AD) in daily life depends on the preservation of neurocognitive and motor abilities, which decline over time. So far, very few studies have investigated motor representations and their contribution to perception and cognition in AD. Methods: In the present study, we compared the performance of AD patients to age-matched healthy participants in perceptual and cognitive tasks involving motor imagery. Experiment 1 tested explicit motor and visual imagery through an imagined movement task. Experiment 2 tested body-centred implicit motor imagery through a mental rotation of visual hand task. Finally, Experiment 3 tested object-centred implicit motor imagery through a reachability judgment task. Results: The results showed that, compared to age-matched controls, conscious imagination of a body movement or the movement of a visual stimulus was much longer in AD patients, with no specific difficulty in the motor condition (Experiment 1). Furthermore, response time in AD patients was strongly affected by the angle of rotation of the visual stimuli in the mental rotation of hand task (Experiment 2). Likewise, response time in AD patients increased substantially in the reachability judgment task, but predominantly for stimuli located at the boundary of peripersonal space (Experiment 3). Conclusion: As a whole, the data suggested a decline in AD of implicit, but not explicit, motor imagery capacities affecting processing time, but not performance accuracy, in motor-related perceptual and cognitive tasks.

Dysfunctions in body processing have been documented in adults with brain damage, while limited information is available for children. This study aimed to investigate body processing in children and adolescents with traumatic brain injury (TBI) (N = 33), compared to peers with typical development. Two well-known computerized body-representation paradigms, namely Visual Body Recognition and Visuo-spatial Imagery, were administered. Through the first paradigm, the body inversion and composite illusion effects were tested with a matching to sample task as measures of configural and holistic processing of others’ bodies, respectively. The second paradigm investigated with a laterality judgement task the ability to perform first-person and object-based mental spatial transformations of own body and external objects, respectively. Body stimuli did not convey any emotional contents or symbolic meanings. Patients with TBI had difficulties with mental transformations of both body and object stimuli, displaying deficits in motor and visual imagery abilities, not limited to body processing. Therefore, cognitive rehabilitation of body processing in TBI might benefit from the inclusion of both general training on visuo-spatial abilities and specific exercises aimed at boosting visual body perception and motor imagery.

Motor imagery represents the ability to simulate anticipated movements mentally prior to their actual execution and has been proposed as a tool to assess both individuals’ perception of task difficulty as well as their perception of their own abilities. People with multiple sclerosis (pwMS) often present with motor and cognitive dysfunction, which may negatively affect motor imagery. In this cross-sectional study, we explored differences in motor imagery of walking performance between pwMS (n = 20, age = 57.1 (SD = 8.6) years, 55% female) and age- and sex-matched healthy controls (n = 20, age = 58.1 (SD = 7.0) years, 60% female). Participants underwent mental chronometry assessments, a subset of motor imagery, which evaluated the difference between imagined and actual walking times across four walking tasks of increasing difficulty (i.e., large/narrow-width walkway with/without obstacles). Raw and absolute mental chronometry (A-MC) measures were recorded in single- (ST) and dual-task (DT) conditions. In ST conditions, pwMS had higher A-MC scores across all walking conditions (p ≤ 0.031, η2 ≥ 0.119), indicating lower motor imagery ability compared to healthy controls. During DT, all participants tended to underestimate their walking ability (3.38 ± 6.72 to 5.63 ± 9.17 s). However, after physical practice, pwMS were less able to adjust their imagined walking performance compared to healthy controls. In pwMS, A-MC scores were correlated with measures of balance confidence (ρ = −0.629, p < 0.01) and the self-reported expanded disability status scale (ρ = 0.747, p < 0.01). While the current study revealed that pwMS have lower motor imagery of walking performance compared to healthy individuals, further work is necessary to examine how the disassociation between mental chronometry and actual performance relates to quality of life and well-being.

Children with developmental coordination disorder (DCD) experiences difficulty in performing coordinated movement task as there is a defect in the internal of movements. The of DCD has been examined in several studies which reveal several viable hypotheses including reduced processing speed, problems in executive functioning, poor cross-model integration and low perceptual-motor coupling. Researchers well documented that the predictive control of movements is impaired in children with Developmental Coordination Disorder (DCD), it was examined that impaired control of movements was due to a deficit in the internal of movements. Motor imagery training has been used to test this internal deficit. Motor imagery training is useful for children with DCD as it focuses on internal of movements. The current study aims to examine the effectiveness of Motor imagery training focused on mental imagery task to enhance the movement coordination abilities of children with DCD. By random sampling, 20 children with DCD were randomly divided into two groups, Group A received MI training, and Group B received COOP- Cognitive orientation to daily occupational performance. Both groups received intervention for nine sessions of 45 minutes. The results provided by the current study will help to describe treatment protocol for children with DCD with evidence. Both children and therapist will be benefited from the study.

Early brain damage leading to cerebral palsy is associated to core motor impairments and also affects cognitive and social abilities. In particular, previous studies have documented specific alterations of perceptual body processing and motor cognition that are associated to unilateral motor deficits in hemiplegic patients. However, little is known about spastic diplegia (SpD), which is characterized by motorial deficits involving both sides of the body and is often associated to visuospatial, attentional, and social perception impairments. Here, we compared the performance of a sample of 30 children and adolescents with SpD (aged 7-18 years) and of a group of age-matched controls with typical development (TD) at two different tasks tapping on body representations. In the first task, we tested visual and motor imagery abilities as assessed, respectively, by the object-based mental rotation of letters and by the first-person transformations for whole-body stimuli. In the second task, we administered an inversion effect/composite illusion task to evaluate the use of configural/holistic processing of others’ body. Additionally, we assessed social perception abilities in the SpD sample using the NEPSY-II battery. In line with previously reported visuospatial deficits, a general mental imagery impairment was found in SpD patients when they were engaged in both object-centered and first-person mental transformations. Nevertheless, a specific deficit in operating an own-body transformation emerged. As concerns body perception, while more basic configural processing (i.e., inversion effect) was spared, no evidence for holistic (i.e., composite illusion) body processing was found in the SpD group. NEPSY-II assessment revealed that SpD children were impaired in both the theory of mind and affect recognition subtests. Overall, these findings suggested that early brain lesions and biased embodied experience could affect higher-level motor cognition and perceptual body processing, thus pointing to a strict link between motor deficits, body schema alterations, and person processing difficulties.

Brain–computer interfaces (BCIs) can help people with limited motor abilities to interact with their environment without external assistance. A major challenge in electroencephalogram (EEG)-based BCI development and research is the cross-subject classification of motor imagery data. Due to the highly individualized nature of EEG signals, it has been difficult to develop a cross-subject classification method that achieves sufficiently high accuracy when predicting the subject’s intention. In this study, we propose a multi-branch 2D convolutional neural network (CNN) that utilizes different hyperparameter values for each branch and is more flexible to data from different subjects. Our model, EEGNet Fusion, achieves 84.1% and 83.8% accuracy when tested on the 103-subject eegmmidb dataset for executed and imagined motor actions, respectively. The model achieved statistically significantly higher results compared with three state-of-the-art CNN classifiers: EEGNet, ShallowConvNet, and DeepConvNet. However, the computational cost of the proposed model is up to four times higher than the model with the lowest computational cost used for comparison.

Brain–computer interface (BCI) remains an emerging tool that seeks to improve the patient interaction with the therapeutic mechanisms and to generate neuroplasticity progressively through neuromotor abilities. Motor imagery (MI) analysis is the most used paradigm based on the motor cortex’s electrical activity to detect movement intention. It has been shown that motor imagery mental practice with movement-associated stimuli may offer an effective strategy to facilitate motor recovery in brain injury patients. In this sense, this study aims to present the BCI associated with visual and haptic stimuli to facilitate MI generation and control the T-FLEX ankle exoskeleton. To achieve this, five post-stroke patients (55–63 years) were subjected to three different strategies using T-FLEX: stationary therapy (ST) without motor imagination, motor imagination with visual stimulation (MIV), and motor imagination with visual-haptic inducement (MIVH). The quantitative characterization of both BCI stimuli strategies was made through the motor imagery accuracy rate, the electroencephalographic (EEG) analysis during the MI active periods, the statistical analysis, and a subjective patient’s perception. The preliminary results demonstrated the viability of the BCI-controlled ankle exoskeleton system with the beta rebound, in terms of patient’s performance during MI active periods and satisfaction outcomes. Accuracy differences employing haptic stimulus were detected with an average of 68% compared with the 50.7% over only visual stimulus. However, the power spectral density (PSD) did not present changes in prominent activation of the MI band but presented significant variations in terms of laterality. In this way, visual and haptic stimuli improved the subject’s MI accuracy but did not generate differential brain activity over the affected hemisphere. Hence, long-term sessions with a more extensive sample and a more robust algorithm should be carried out to evaluate the impact of the proposed system on neuronal and motor evolution after stroke.

Background Motor imagery (MI) ability should be evaluated in selected individuals with spinal cord injury (SCI) who can benefit from MI training in their rehabilitation program. Electrodermal activity seems to be a reliable indicator for assessing MI ability. However, individuals with SCI have a variety of autonomic dysfunctions. Objective This study aimed to investigate electrodermal responses (EDRs) elicited by MI. Design A cost-utility analysis of EDR above and below the lesion level in individuals with complete or incomplete SCI (n=30) versus a control group of individuals who were healthy (n=10) was used. Method The EDR was recorded above and below the lesion level during MI of a drinking action. Duration, latency, and amplitude of EDR were the outcome measures. Results Hand and foot EDR in the control group occurred with the same pattern and similar latencies, suggesting a common efferent sympathetic pathway to sweat glands of the hand and foot mediating a sympathetic skin response. Individuals with SCI elicited responses above the lesion level. The EDR amplitude was correlated to the lesion level and autonomic dysreflexia history. No foot response was recorded in individuals with complete cervical and thoracic motor lesions. Foot response with a lower amplitude and higher latency occurred in participants with incomplete motor lesion, suggesting a link between the descending motor pathway and sympathetic function. Limitations The small sample of individuals with incomplete SCI limits the generalization of the results obtained at the foot site. Conclusions Electrodermal response above the lesion level may be a reliable index for assessing MI ability in individuals with SCI. It is a noninvasive, user-friendly method for clinicians to consider before enrolling individuals in MI training.

The aim of this study was to demonstrate the effects of motor imagery training on balance and gait abilities in older adults and to investigate the possible application of the training as an effective intervention against fall prevention. Subjects (n = 34) aged 65 years and over who had experienced falls were randomly allocated to three groups: (1) motor imagery training group (MITG, n = 11), (2) task-oriented training group (TOTG, n = 11), and (3) control group (CG, n = 12). Each group performed an exercise three times a week for 6 weeks. The dependent variables included Path Length of center of pressure (COP)-based static balance, Berg Balance Scale (BBS) score, Timed Up and Go Test (TUG) score, which assesses a person’s mobility based on changes in both static and dynamic balance, Falls Efficacy Scale (FES) score, which evaluates changes in fear of falls, and gait parameters (velocity, cadence, step length, stride length, and H-H base support) to evaluate gait. After the intervention, Path Length, BBS, TUG, velocity, cadence, step length, and stride length showed significant increases in MITG and TOTG compared to CG (p < 0.05). Post hoc test results showed a significantly greater increase in BBS, TUG, and FES in MITG compared with TOTG and CG (p < 0.05). Our results suggest that motor imagery training combined with functional training has positive effects on balance, gait, and fall efficacy for fall prevention in the elderly.

Abstract: Visual imagery (VI) involves self-visualization of action, whereas kinesthetic imagery (KI) implies somesthetic sensations elicited by action. Motor imagery (MI) has been shown to enhance motor performance but inconsistent results were obtained depending on the respective impacts of VI and KI. It is hypothesized here that the type of MI may interact with individual characteristics such as field dependence-independence. As subjects' movements can be mainly checked out through exteroceptive or proprioceptive information, task requirements were also expected to influence MI. Witkin's Group Embedded Figures Test was implemented with two groups (n1 = 10 gymnasts, n2 = 10 tennis players). Athletes were asked to imagine a complex motor skill by alternate use of VI and KI. Skin resistance was selected as a peripheral indicator of MI and recorded continuously. Autonomic responses were compared by computing the VI/KI ratio. Results taking both the field-dependence test and MI type into account were not as clear as expected. As hypothesized, gymnasts were more field-independent than tennis players. VI/KI ratio analysis showed that a similar pattern was observed in the gymnasts group (ratio close to 1.0), whatever the type of imagery. This suggests that gymnasts are equally able to perform VI and KI. Fifty percent of the tennis players group showed a ratio higher than 1.0, suggesting that VI was more effective than KI. Conversely, the remaining 50% showed a below-1.0 ratio, suggesting more effective KI. Thus, some tennis players may make better use of VI than KI, and conversely some may make better use of KI than VI. These results indicate that MI training may be relatively independent of task requirements and be based mainly upon individual characteristics such as MI abilities. Finally, results indicate systematic overestimation in self-estimation of movement duration during MI, which was greater during KI than during VI, suggesting that athletes have greater trouble in feeling than in visualizing movement.

The present studies analysed drawing as a system rather than a unitary ability. The aim was to investigate whether and which language factors influence drawing performance and drawing development. In two studies of 2- to 11-year-old children drawing as a system of components was investigated. Tests were designed to measure motor output, imagery, memory, perception, and verbal abilities. The analysis of relationships between drawing measures and putative components of a drawing system revealed that all of the proposed components independently affected drawing development. Results of analyses of the data from younger and older children separately suggest that different components of a system are crucial for drawing development at different phases of development.

Introduction Motor imagery training delivered at home via telerehabilitation is a novel rehabilitation concept. The aim was to investigate the effects of telerehabilitation-based motor imaging training (Tele-MIT) on gait, balance and cognitive and psychosocial outcomes in people with multiple sclerosis (pwMS). Methods This randomized, controlled pilot trial included pwMS and healthy individuals. pwMS were randomly divided into two groups, intervention and control. The intervention group received Tele-MIT twice a week for 8 weeks. The control group was a wait-list group without any additional specific treatment. Healthy participants served as a baseline comparison. The Dynamic Gait Index, used to assess dynamic balance during walking, was the primary outcome. Secondary outcomes included assessments of walking speed, endurance and perceived ability, balance performance assessed by a computerized posturography device, balance confidence, cognitive functions, fatigue, anxiety, depression and quality of life. Results Baseline comparisons with healthy individuals revealed that motor imagery abilities were preserved in pwMS ( p > 0.05). The intervention group exhibited significant improvements in dynamic balance during walking ( p = 0.002), walking speed ( p = 0.007), perceived walking ability ( p = 0.008), balance confidence ( p = 0.002), most cognitive functions ( p = 0.001–0.008), fatigue ( p = 0.001), anxiety ( p = 0.001), depression ( p = 0.005) and quality of life ( p = 0.002). No significant changes were observed in the control group in any of the outcome measures ( p > 0.05). Discussion Tele-MIT is a novel method that proved feasible and effective in improving dynamic balance during walking, walking speed and perceived walking ability, balance confidence, cognitive functions, fatigue, anxiety, depression and quality of life in pwMS.

There is a growing interest in action observation treatment (AOT), i.e., a rehabilitative procedure combining action observation, motor imagery, and action execution to promote the recovery, maintenance, and acquisition of motor abilities. AOT studies employed basic upper limb gestures as stimuli, but—in principle—the AOT approach can be effectively extended to more complex actions like occupational gestures. Here, we present a repertoire of virtual-reality (VR) stimuli depicting occupational therapy exercises intended for AOT, potentially suitable for occupational safety and injury prevention. We animated a humanoid avatar by fitting the kinematics recorded by a healthy subject performing the exercises. All the stimuli are available via a custom-made graphical user interface, which allows the user to adjust several visualization parameters like the viewpoint, the number of repetitions, and the observed movement’s speed. Beyond providing clinicians with a set of VR stimuli promoting via AOT the recovery of goal-oriented, occupational gestures, such a repertoire could extend the use of AOT to the field of occupational safety and injury prevention.

While the importance of physical abilities is noncontested to perform in elite sport, more focus has recently been turned toward cognitive processes involved in sport performance. Practicing any sport requires a high demand of cognitive functioning including, but not limited to, decision-making, processing speed, working memory, perceptual processing, motor functioning, and attention. Noninvasive transcranial electrical stimulation (tES) has recently attracted considerable scientific interest due to its ability to modulate brain functioning. Neuromodulation apparently improves cognitive functions engaged in sports performance. This opinion manuscript aimed to reveal that tES is likely an adjunct ergogenic resource for improving cognitive processes, counteracting mental fatigue, and managing anxiety in elite athletes. Nevertheless, the first evidence is insufficient to guarantee its real effectiveness and benefits. All tES techniques could be add-ons to make performance-related cognitive functions more efficient and obtain better results. Modulating inhibitory control through tES over the frontal cortex might largely contribute to the improvement of mental performance. Nevertheless, studies in elite athletes are required to assess the long-term effects of tES application as an ergogenic aid in conjunction with other training methods (e.g., neurofeedback, mental imagery) where cognitive abilities are trainable.

Introduction Motor imagery (MI) is the mental rehearsal of a motor task. Between real and imagined movements, a functional equivalence has been described regarding timing and brain activation. The primary study aim was to investigate the feasibility of MI training focusing on the autonomic function in healthy young people. Further aims were to evaluate participants’ MI abilities and compare preliminary effects of activating and relaxing MI on autonomic function and against controls. Methods A single-blinded randomised controlled pilot trial was performed. Participants were randomised to the activating MI (1), relaxing MI (2), or control (3) group. Following a MI familiarisation, they practiced home-based kinaesthetic MI for 17 minutes, 5 times/week for 2 weeks. Participants were called once for support. The primary outcome was the feasibility of a full-scale randomised controlled trial using predefined criteria. Secondary outcomes were participants’ MI ability using the Movement Imagery Questionnaire-Revised, mental chronometry tests, hand laterality judgement and semi-structured interviews, autonomic function. Results A total of 35 participants completed the study. The feasibility of a larger study was confirmed, despite 35% attrition related to the COVID-19 pandemic. Excellent MI capabilities were seen in participants, and significant correlations between MI ability measures. Interview results showed that participants accepted or liked both interventions. Seven major themes and insider recommendations for MI interventions emerged. No significant differences and negligible to medium effects were observed in MI ability or autonomic function between baseline and post-intervention measures or between groups. Conclusions Results showed that neither activating nor relaxing MI seems to change autonomic function in healthy individuals. Further adequately powered studies are required to answer open questions remaining from this study. Future studies should investigate effects of different MI types over a longer period, to rule out habituation and assess autonomic function at several time points and simultaneously with MI.

Objective. To investigate the effect of mental practice on the learning of a sequential task for the lower limb in a patient with a hemiparesis resulting from a stroke. Design. A single-case study. Setting. Research laboratory of a university-affiliated rehabilitation center. Patient. A right-handed 38-year-old man who had suffered a left hemorrhagic subcortical stroke 4 months prior. Intervention. The patient practiced a serial response time task with the lower limb in 3 distinct training phases over a period of 5 weeks: 2 weeks of physical practice, 1 week of combined physical and mental practice, and then 2 weeks of mental practice alone. Main Outcome Measures. Performance on the task measured through errors and response times. Imagery abilities measured through questionnaires. Results . The patient’s average response time improved significantly during the 1st 5 days of physical practice (26%) but then failed to show further improvement during the following week of physical practice. The combination of mental and physical practice during the 3rd week yielded additional improvement (10.3%), whereas the following 2 weeks of mental practice resulted in a marginal increase in performance (2.2%). Conclusion. The findings show that mental practice, when combined with physical practice, can improve the performance of a sequential motor skill in people who had a stroke, and suggest that mental practice could play a role in the retention of newly acquired abilities.

Background: Normal aging is associated with balance and working memory decline. From a neurobiological standpoint, changes in cerebellar functional plasticity may mediate the decline in balance and working memory for older adults. Mounting evidence suggests that physical activity is beneficial for decreasing aging effects. Previous studies have focused on land-based physical activity and research concerning the aquatic environment is scarce. This study investigated the effectiveness of Ai-Chi on balance abilities and cerebral activation during a high working memory load task among community-dwelling older people. Methods: A total of 19 people aged 65–86 years were allocated to receive Ai-Chi practice (n = 6), structured on-land Ai-Chi practice (n = 7) or guided-imagery of Ai-Chi practice (n = 6) for a bi-weekly, 30-min exercise session for 12 weeks. Balance was measured by the Tinetti balance sub-test and working memory was measured by the N-back test during functional-MRI scan. Results: The Ai-Chi practice group presented a significant change in balance between pre and post intervention (balance t = −4.8, p < 0.01). In the whole-brain analysis, during high working memory load task, the Ai-Chi practice group presented a decrease in left cerebellar activation. Region of interest analyses yielded similar results by which pre-cerebellar activation was higher than post-intervention (t = 2.77, p < 0.05). Conclusions: Ai-Chi is an available, non-invasive intervention method that may serve as a tool to improve cerebellar activation that in turn might improve balance. In addition, our findings may provide new insights into the neuronal mechanisms that underlie both motor and cognitive abilities.

Practice in Mind (PIM) training help to resolve physical and psychological problem in sport skills performance. Therefore, the present study was done to investigate the effectiveness of PIM training on netball standing shot and jump shot performances. Twenty state level netball shooters with 3 to 5 years playing experiences participated in this experimental study. Participants were randomly assigned into PIM training group and control group with 10 participants for each group. Both groups completed 18 training sessions in 3 times a week for 6 weeks intervention program. Pre, post, and retention test were conducted prior to the 10 standing and jump shooting task. The results revealed that there was significant different of PIM training group versus control group for both standing shot (p < .05) and jump shot (p<.05) after 6 weeks. However, no significant different was observed after retention (week 12) for both groups. Based on the finding, it is suggested this present study will be beneficial to the athletes in terms of educating them about the importance of systematic imagery training to increase shooting performance in netball and for further improvement on their shooting techniques. Future studies are warranted to explore potential benefits of PIM training by focusing on a larger exposure and other netball specific motor-abilities.

Mini-invasive surgery—for example, laparoscopy—has challenged surgeons’ skills by extending their usual haptic space and displaying indirect visual feedback through a screen. This may require new mental abilities, including spatial orientation and mental representation. This study aimed to test the effect of cognitive training based on motor imagery (MI) and action observation (AO) on surgical skills. A total of 28 postgraduate residents in surgery took part in our study and were randomly distributed into 1 of the 3 following groups: (1) the basic surgical skill, which is a short 2-day laparoscopic course + MI + AO group; (2) the basic surgical skill group; and (3) the control group. The MI + AO group underwent additional cognitive training, whereas the basic surgical skill group performed neutral activity during the same time. The laparoscopic suturing and knot tying performance as well as spatial ability and mental workload were assessed before and after the training period. We did not observe an effect of cognitive training on the laparoscopic performance. However, the basic surgical skill group significantly improved spatial orientation performance and rated lower mental workload, whereas the 2 others exhibited lower performance in a mental rotation test. Thus, actual and cognitive training pooled together during a short training period elicited too high a strain, thus limiting potential improvements. Because MI and AO already showed positive outcomes on surgical skills, this issue may, thus, be mitigated according to our specific learning conditions. Distributed learning may possibly better divide and share the strain associated with new surgical skills learning.

Self-report and neural data were examined in 14 right-handed college-age males screened from a pool of 200 to verify neural activity during imagery and that the neural activity (area of brain) varies as a function of the imagery type. Functional magnetic resonance imaging data collected during real-time imagery of the three Movement Imagery Questionnaire-3 abilities indicated frontal areas, motor areas, and cerebellum active during kinesthetic imagery, motor areas, and superior parietal lobule during internal visual imagery, and parietal lobule and occipital cortex during external visual imagery. Central and imagery-specific neural patterns were found providing further biological validation of kinesthetic, internal visual, and external visual complementing results on females. Next, research should (a) compare neural activity between male participants screened by self-reported imagery abilities to determine if good imagers have more efficient neural networks than poor imagers and (b) determine if there is a statistical link between participants’ neural activity during imagery and self-report Movement Imagery Questionnaire-3 scores.

Evidence has shown that athletes with high motor skill proficiency possess higher motor imagery ability than those with low motor skill proficiency. However, less is known whether this superiority in motor imagery ability emerges over amateur athletes. To address the issue, the present study aimed to investigate the individual differences in motor imagery ability between amateur dancers and non-dancers. Forty participants completed a novel dance movement reproduction task and measures of the vividness of visual imagery questionnaire (VVIQ) and the vividness of motor imagery questionnaire (VMIQ). The results showed that, relative to non-dancers, amateur dancers had higher ability of motor imagery to reproduce the lower-limb and upper-limb dance movements during the dance movement reproduction task. Besides, amateur dancers displayed higher abilities of the visual motor imagery and the kinesthetic imagery, but comparable visual imagery ability as the non-dancers. These findings suggest that the mental representation of motors but not the visual is affected by the motor skill levels, due to the motor imagery practice in sports amateurs.

People in alcohol-detoxification experience deficits in motor and non-motor functions including cognitive performance. Imagery, the cognitive process of generating visual, auditory or kinesthetic experiences in the mind without the presence of external stimuli, has been little studied in Alcohol Use Disorders (AUD). This pilot study aims to observe the cognitive abilities useful for the inspection, maintenance, generation and manipulation of images in these patients during residential rehabilitation and investigate the relationships with their cognitive performance. Thirty-six subjects who completed the 28-day rehabilitation program for alcohol addiction, completed the Mental Imagery Test (MIT) and Neuropsychological Battery (ENB-2). The global score at MIT did not show pathological scores. The 11.1% of AUD patients showed an impaired global score in the cognitive performance and the 5.7% with scoring at limits of norm. Significant correlations were found between Mental Imagery abilities and ENB-2 subscale and stepwise regression analysis showed the close association between the ability of imagery (Mental Imagery Test) and the overall cognitive performance (ENB-2) in alcohol dependent patients and this relationship is stronger than other cognitive tasks.

Abstract Hypnosis can be considered an altered state of consciousness in which individuals produce movements under suggestion without apparent voluntary control. Despite its application in contexts implying motor control, evidence for the neurophysiological mechanisms underlying hypnosis is scarce. Inter-individual differences in hypnotic susceptibility suggest that sensorimotor strategies may manifest in a hypnotic state. We tested by means of transcranial magnetic stimulation applied over the primary motor cortex whether motor system activation during a motor imagery task differs in the awake and in the hypnotic state. To capture individual differences, 30 healthy volunteers were classified as high or low hypnotizable (Highs and Lows) according to ad-hoc validated scales measuring hypnotic susceptibility and personality questionnaires. Corticospinal activation during motor imagery in the hypnotic state was greater in the Highs than the Lows. Intrinsic motivation in task performance and level of persuasion modulated corticospinal activation in the Highs. Corticospinal system activation under hypnosis may have practical implications that merit research in areas where hypnosis can be applied to improve motor performance, such as loss of motor abilities and sports.

PurposeRecently, the convolutional neural network (ConvNet) has a wide application in the classification of motor imagery EEG signals. However, the low signal-to-noise electroencephalogram (EEG) signals are collected under the interference of noises. However, the conventional ConvNet model cannot directly solve this problem. This study aims to discuss the aforementioned issues.Design/methodology/approachTo solve this problem, this paper adopted a novel residual shrinkage block (RSB) to construct the ConvNet model (RSBConvNet). During the feature extraction from EEG signals, the proposed RSBConvNet prevented the noise component in EEG signals, and improved the classification accuracy of motor imagery. In the construction of RSBConvNet, the author applied the soft thresholding strategy to prevent the non-related motor imagery features in EEG signals. The soft thresholding was inserted into the residual block (RB), and the suitable threshold for the current EEG signals distribution can be learned by minimizing the loss function. Therefore, during the feature extraction of motor imagery, the proposed RSBConvNet de-noised the EEG signals and improved the discriminative of classification features.FindingsComparative experiments and ablation studies were done on two public benchmark datasets. Compared with conventional ConvNet models, the proposed RSBConvNet model has obvious improvements in motor imagery classification accuracy and Kappa coefficient. Ablation studies have also shown the de-noised abilities of the RSBConvNet model. Moreover, different parameters and computational methods of the RSBConvNet model have been tested on the classification of motor imagery.Originality/valueBased on the experimental results, the RSBConvNet constructed in this paper has an excellent recognition accuracy of MI-BCI, which can be used for further applications for the online MI-BCI.

AbstractDeep learning networks have been successfully applied to transfer functions so that the models can be adapted from the source domain to different target domains. This study uses multiple convolutional neural networks to decode the electroencephalogram (EEG) of stroke patients to design effective motor imagery (MI) brain-computer interface (BCI) system. This study has introduced ‘fine-tune’ to transfer model parameters and reduced training time. The performance of the proposed framework is evaluated by the abilities of the models for two-class MI recognition. The results show that the best framework is the combination of the EEGNet and ‘fine-tune’ transferred model. The average classification accuracy of the proposed model for 11 subjects is 66.36%, and the algorithm complexity is much lower than other models.These good performance indicate that the EEGNet model has great potential for MI stroke rehabilitation based on BCI system. It also successfully demonstrated the efficiency of transfer learning for improving the performance of EEG-based stroke rehabilitation for the BCI system.

AbstractDeep learning networks have been successfully applied to transfer functions so that the models can be adapted from the source domain to different target domains. This study uses multiple convolutional neural networks to decode the electroencephalogram (EEG) of stroke patients to design effective motor imagery (MI) brain-computer interface (BCI) system. This study has introduced ‘fine-tune’ to transfer model parameters and reduced training time. The performance of the proposed framework is evaluated by the abilities of the models for two-class MI recognition. The results show that the best framework is the combination of the EEGNet and ‘fine-tune’ transferred model. The average classification accuracy of the proposed model for 11 subjects is 66.36%, and the algorithm complexity is much lower than other models.These good performance indicate that the EEGNet model has great potential for MI stroke rehabilitation based on BCI system. It also successfully demonstrated the efficiency of transfer learning for improving the performance of EEG-based stroke rehabilitation for the BCI system.

Background: Motor imagery training is a cognitive process in which an internal representation of a movement is activated in working memory. The movement is mentally rehearsed, without any physical activity. Task-specific training emphasizes the repetitive practice of skilled movement to enhance functional abilities in hemiparesis. Objectives: To investigate whether task specific training preceded by motor imagery or task specific training alone was more effective for facilitating sit to stand in patients with stroke. Methods: Thirty male patients with stroke were selected from the Cairo University Outpatient Clinic; the median age of participants was 54.5 ± 3.51 years and they were divided equally into two groups. Patients in study group A (n = 15) received motor imagery training for 15 minutes followed by task specific training for 45 minutes, as well as a selected physical therapy program 3 times per week for 6 weeks. The control group B (n = 15) received task specific training for 45 minutes, as well as a selected physical therapy program 3 times per week for 6 weeks. The Fugl-Meyer section of the lower extremity (FMA-LE), Timed up and go test (TUG), and Biodex Balance system were assessed before and after treatment. Results: The results were highly significant for all variables including FMA-LE, TUG and Biodex Balance system in favor of the study group, post treatment. (P = 0.0004, P = 0.0001 and P = 0.0001, respectively). Conclusions: Motor imagery training results in greater improvement in sit to stand ability when used in conjunction with task specific training, rather than task specific training alone.

Self hypnosis and mental imagery are two sides of a coin, specially in case of modern sports. Hypnosis of oneself and mental imagery are totally immersive multi-sensory procedure that associates with numerous senses to create as a mental image and process it in absent of external stimuli. In the sport situation, imagery has been with a state in which person imagine while effecting abilities to deal with the future duty or improve performance capacity. Scientific analyses have stated that imagery increases performance in motor stimuli. Routines mental practice play an important role in sports and games, not only for the acquisition of motor skills, but also for preparation and sport injuries rehabilitation. Imagery techniques in sport are used for different purposes, as outlined by the process of self hypnosis and Model of Imagery Use in Sports, to improve skill acquisition, motivation, and sport confidence and to reduce anxiety.. Clinical sport hypnosis can help athletes acquire certain cognitive, psychological, behavioral and affective qualities so that their physical and mental capabilities are improved. According Wikipedia, sports hypnosis is defined as the use of hypnotherapy with athletes in order to improve sporting performance. Others define sport hypnosis as a form of mental training which can contribute to enhancing athletic performance. . It has been shown that different forms and functions of imagery prove to be effective for the above-mentioned functions depending on the characteristics of different sports and the expertise level of athletes. The present study reviews systematically the findings of other reports on various aspects of mental imagery and self hypnosis in the field of sports.

Abstract Background Motor imagery training might be helpful in stroke rehabilitation. This study explored if a single session of motor imagery (MI) training induces performance changes in mental chronometry (MC), motor execution, or changes of motor excitability. Methods Subacute stroke patients (n = 33) participated in two training sessions. The order was randomized. One training consisted of a mental chronometry task, the other training was a hand identification task, each lasting 30 min. Before and after the training session, the Box and Block Test (BBT) was fully executed and also performed as a mental version which served as a measure of MC. A subgroup analysis based on the presence of sensory deficits was performed. Patients were allocated to three groups (no sensory deficits, moderate sensory deficits, severe sensory deficits). Motor excitability was measured by transcranial magnetic stimulation (TMS) pre and post training. Amplitudes of motor evoked potentials at rest and during pre-innervation as well as the duration of cortical silent period were measured in the affected and the non-affected hand. Results Pre-post differences of MC showed an improved MC after the MI training, whereas MC was worse after the hand identification training. Motor execution of the BBT was significantly improved after mental chronometry training but not after hand identification task training. Patients with severe sensory deficits performed significantly inferior in BBT execution and MC abilities prior to the training session compared to patients without sensory deficits or with moderate sensory deficits. However, pre-post differences of MC were similar in the 3 groups. TMS results were not different between pre and post training but showed significant differences between affected and unaffected side. Conclusion Even a single training session can modulate MC abilities and BBT motor execution in a task-specific way. Severe sensory deficits are associated with poorer motor performance and poorer MC ability, but do not have a negative impact on training-associated changes of mental chronometry. Studies with longer treatment periods should explore if the observed changes can further be expanded. Trial registration DRKS, DRKS00020355, registered March 9th, 2020, retrospectively registered

IntroductionNeurofeedback (NFB) training and transcranial direct current stimulation (tDCS) have been shown to individually improve motor imagery (MI) abilities. However, the effect of combining both of them with MI has not been verified. Therefore, the aim of this study was to examine the effect of applying tDCS directly before MI with NFB.MethodsParticipants were divided into an NFB group (n = 10) that performed MI with NFB and an NFB + tDCS group (n = 10) that received tDCS for 10 min before MI with NFB. Both groups performed 60 MI trials with NFB. The MI task was performed 20 times without NFB before and after training, and μ-event-related desynchronization (ERD) and vividness MI were evaluated.Resultsμ-ERD increased significantly in the NFB + tDCS group compared to the NFB group. MI vividness significantly increased before and after training.DiscussionTranscranial direct current stimulation and NFB modulate different processes with respect to MI ability improvement; hence, their combination might further improve MI performance. The results of this study indicate that the combination of NFB and tDCS for MI is more effective in improving MI abilities than applying them individually.

Recent advances in neuroimaging technologies have provided insights into detecting residual consciousness and assessing cognitive abilities in patients with disorders of consciousness (DOC). Functional near-infrared spectroscopy (fNIRS) is non-invasive and portable and can be used for longitudinal bedside monitoring, making it uniquely suited for evaluating brain function in patients with DOC at appropriate spatiotemporal resolutions. In this pilot study, an active command-driven motor imagery (MI) paradigm based on fNIRS was used to detect residual consciousness in patients with prolonged DOC. A support vector machine (SVM) classifier was used to classify yes-or-no responses. The results showed that relatively reliable responses were detected from three out of five patients in a minimally consciousness state (MCS). One of the patients answered all the questions accurately when assessed according to this method. This study confirmed the feasibility of using portable fNIRS technology to detect residual cognitive ability in patients with prolonged DOC by active command-driven motor imagery. We hope to detect the exact level of consciousness in DOC patients who may have a higher level of consciousness.

Numerous studies have shown a significant positive relationship between the mental representation of hands in young children and their calculation performance. The literature indicates that certain components of manual motor skills may be critical to the quality of this relationship. The main objective of this study is to measure the benefit of an explicit training and teaching device for finger use in mathematics by measuring the initial motor imitation abilities of young children. A protocol of pretest, training, and post-test type was proposed to 101 children with an average age of 5 years and 3 months. Measurements focused on manual motor skills and arithmetical skills. The 12-week classroom-based device was designed to develop manual motor skills and explicitly teach finger use in mathematics. The results indicate that significant progress was made in arithmetic for the students who benefited from the training. Interestingly this progress is modulated by the children’s initial motor imitation skills. This contribution opens up new research and application perspectives on the relationships between mental motor imagery, fine motor skills, and arithmetic ability.

Objective To investigate the effects of Action Observation and Motor Imagery administered the day before surgery on functional recovery in patients after total hip arthroplasty. Design Randomised controlled trial. Setting Humanitas Clinical and Research Center, Milan, Italy Participants Eighty inpatients with end-stage hip osteoarthritis undergoing total hip arthroplasty. Interventions All patients followed a standardized postoperative rehabilitation program. Experimental group (AO + MI) performed two 12-minute Action Observation and Motor Imagery sessions on the preoperative day, whereas control group underwent usual care consisting of education without any additional preoperative activity. Outcome measures A blinded physiotherapist assessed participants for functional mobility (Timed Up and Go – TUG) (primary outcome), maximum walking speed (10-Meter Walk Test – 10MWT), pain (Numeric Pain Rating Scale – NPRS) and fear of movement (Tampa Scale of Kinesiophobia – TSK) the day before and at four days after surgery. Results No between-group differences were found at baseline. Although TUG and 10MWT worsened in both groups ( p < 0.001), better TUG was found for AO + MI group at four days (mean difference −5.8 s, 95% confidence interval from −11.3 to −0.3 s, p = 0.039). NPRS ( p < 0.001) and TSK ( p = 0.036 for AO + MI group, p = 0.003 for control group) improved after surgery without between-group differences. Conclusions Patients undergoing Action Observation and Motor Imagery on the day before surgery showed less functional decline than control group in the first days after total hip arthroplasty. This intervention may contribute to a safer discharge with higher functional abilities in patients hospitalized for total hip arthroplasty.

AbstractIt is likely that when using an artificially augmented hand with six fingers, the natural five plus a robotic one, corticospinal motor synergies controlling grasping actions might be different. However, no direct neurophysiological evidence for this reasonable assumption is available yet. We used transcranial magnetic stimulation of the primary motor cortex to directly address this issue during motor imagery of objects’ grasping actions performed with or without the Soft Sixth Finger (SSF). The SSF is a wearable robotic additional thumb patented for helping patients with hand paresis and inherent loss of thumb opposition abilities. To this aim, we capitalized from the solid notion that neural circuits and mechanisms underlying motor imagery overlap those of physiological voluntary actions. After a few minutes of training, healthy humans wearing the SSF rapidly reshaped the pattern of corticospinal outputs towards forearm and hand muscles governing imagined grasping actions of different objects, suggesting the possibility that the extra finger might rapidly be encoded into the user’s body schema, which is integral part of the frontal-parietal grasping network. Such neural signatures might explain how the motor system of human beings is open to very quickly welcoming emerging augmentative bioartificial corticospinal grasping strategies. Such an ability might represent the functional substrate of a final common pathway the brain might count on towards new interactions with the surrounding objects within the peripersonal space. Findings provide a neurophysiological framework for implementing augmentative robotic tools in humans and for the exploitation of the SSF in conceptually new rehabilitation settings.

ObjectiveThis study aimed to examine the effectiveness and safety of the Brain-computer interface (BCI) in treatment of upper limb dysfunction after stroke.MethodsEnglish and Chinese electronic databases were searched up to July 2021. Randomized controlled trials (RCTs) were eligible. The methodological quality was assessed using Cochrane’s risk-of-bias tool. Meta-analysis was performed using RevMan 5.4.ResultsA total of 488 patients from 16 RCTs were included. The results showed that (1) the meta-analysis of BCI-combined treatment on the improvement of the upper limb function showed statistical significance [standardized mean difference (SMD): 0.53, 95% CI: 0.26–0.80, P &lt; 0.05]; (2) BCI treatment can improve the abilities of daily living of patients after stroke, and the analysis results are statistically significant (SMD: 1.67, 95% CI: 0.61–2.74, P &lt; 0.05); and (3) the BCI-combined therapy was not statistically significant for the analysis of the Modified Ashworth Scale (MAS) (SMD: −0.10, 95% CI: −0.50 to 0.30, P = 0.61).ConclusionThe meta-analysis indicates that the BCI therapy or BCI combined with other therapies such as conventional rehabilitation training and motor imagery training can improve upper limb dysfunction after stroke and enhance the quality of daily life.

Abstract The association between early life greenness and child cognition is not well understood. Using prospective data from Project Viva (n=857) from 1999 to 2010, we examined associations of early life greenness exposure with mid-childhood cognition. We estimated residential greenness at birth, early childhood (median age 3.1y), and mid-childhood (7.8y) using 30m resolution Landsat satellite imagery [Normalized Difference Vegetation Index]. In early childhood and mid-childhood, we administered standardized assessments of verbal and nonverbal intelligence, visual-motor abilities, and visual memory. We used natural splines to examine associations of early life-course greenness with mid-childhood cognition, adjusting for age, sex, race, income, neighborhood socioeconomic status, maternal intelligence, and parental education. At lower levels of greenness (greenness&lt;0.6), greenness exposure at early childhood was associated with a 0.48% increase in non-verbal intelligence and 2.64% increase in visual memory in mid-childhood. The association between early childhood greenness and mid-childhood visual memory was observed after further adjusting for early childhood cognition and across different methodologies, while the association with non-verbal intelligence was not. No other associations between early life-course greenness and mid-childhood cognition were found. Early childhood greenness was nonlinearly associated with higher mid-childhood visual memory. Our findings highlight the importance of nonlinear associations between greenness and cognition.

Introduction In this article, I explore the phenomenon of augmentation by questioning its representational nature and analyzing aesthetic modes of our interrelationship with the environment. How can senses be augmented and how do they serve as mechanisms of enhancing the feeling of presence? Media art practices offer particularly valuable scenarios of activating such mechanisms, as the employment of digital technology allows them to operate on a more subtle level of perception. Given that these practices are continuously evolving, this analysis cannot claim to be a comprehensive one, but rather aims to introduce aspects of the specific relations between augmentation, sense of proprioception, technology, and art. Proprioception is one of the least detectable and trackable human senses because it involves our intuitive sense of positionality, which suggests a subtle equilibrium between a center (our individual bodies) and the periphery (our immediate environments). Yet, as any sense, proprioception implies a communicational chain, a network of signals traveling and exchanging information within the body-mind complex. The technological augmentation of this dynamic process produces an interference in our understanding of the structure and elements, the information sent/received. One way to understand the operations of the senses is to think about them as images that the mind creates for itself. Artistic intervention (usually) builds upon exactly this logic: representation of images generated in mind, supplementing or even supplanting the existing collection of inner images with new, created ones. Yet, in case of proprioception the only means to interfere with and augment these inner images is on bodily level. Hence, the question of communication through images (or representations) should be extended towards a more complex theory of embodied perception. Drawing on phenomenology, cognitive science, and techno-cultural studies, I focus on the potential of biofeedback technologies to challenge and transform our self-perception by conditioning new pathways of apprehension (sometimes by creating mechanisms of direct stimulation of neural activity). I am particularly interested in how the awareness of the self (grounded in the felt relationality of our body parts) is most significantly activated at the moments of disturbance of balance, in situations of perplexity and disorientation. Projects by Marco Donnarumma, Sean Montgomery, and other artists working with biofeedback aesthetically validate and instantiate current research about neuro-plasticity, with technologically mediated sensory augmentation as one catalyst of this process. Augmentation as Representation: Proprioception and Proprioceptive Media Representation has been one of the key ways to comprehend reality. But representation also constitutes a spatial relation of distancing and separation: the spectator encounters an object placed in front of him, external to him. Thus, representation is associated more with an analytical, rather than synthetic, methodology because it implies detachment and division into parts. Both methods involve relation, yet in the case of representation there is a more distinct element of distance between the representing subject and represented object. Representation is always a form of augmentation: it extends our abilities to see the "other", otherwise invisible sides and qualities of the objects of reality. Representation is key to both science and art, yet in case of the latter, what is represented is not a (claimed) "objective" scheme of reality, but rather images of the imaginary, inner reality (even figurative painting always presents a particular optical and psychological perspective, to say nothing about forms of abstract art). There are certain kinds of art (visual arts, music, dance, etc.) that deal with different senses and thus, build their specific representational structures. Proprioception is one of the senses that occupies relatively marginal position in artistic production (which is exactly because of the specificity of its representational nature and because it does not create a sense of an external object. The term "proprioception" comes from Latin propius, or "one's own", "individual", and capio, cepi – "to receive", "to perceive". It implies a sense of one's self felt as a relational unity of parts of the body most vividly discovered in movement and in effort employed in it. The loss of proprioception usually means loss of bodily orientation and a feeling of one's body (Sacks 43-54). On the other hand, in case of additional stimulation and training of this sense (not only via classical cyber-devices, like cyber-helmets, gloves, etc. that set a different optics, but also techniques of different kinds of altered states of mind, e.g. through psychotropics, but also through architecture of virtual space and acoustics) a sense of disorientation that appears at first changes towards some analogue of reactions of enthusiasm, excitement discovery, and emotion of approaching new horizons. What changes is not only perception of external reality, but a sense of one's self: the self is felt as fluid, flexible, with penetrable borders. Proprioception implies initial co-existence of the inner and outer space on the basis of originary difference and individuality/specificity of the occupied position. Yet, because they are related, the "external" and "other" already feels as "one's own", and this is exactly what causes the sense of presence. Among the many possible connections that the body, in its sense of proprioception, is always already ready for, only a certain amount gets activated. The result of proprioception is a special kind of meta-stable internal image. This image may not coincide with the optical, auditory, or haptic image. According to Brian Massumi, proprioception translates the exertions and ease of the body's encounters with objects into a muscular memory of relationality. This is the cumulative memory of skill, habit, posture. At the same time as proprioception folds tactility in, it draws out the subject's reactions to the qualities of the objects it perceives through all five senses, bringing them into the motor realm of externalizable response. (59) This internal image is not mediated by anything, though it depends directly on the relations between the parts. It cannot be grasped because it is by definition fluid and dynamic. The position in one point is replaced here by a position-in-movement (point-in-movement). "Movement is not indexed by position. Rather, the position is born in movement, from the relation of movement towards itself" (Massumi 179). Philosopher of "extended mind" Andy Clark notes that we should distinguish between a real body schema (non-conscious configuration) and a body image (conscious construct) (Clark). It is the former that is important to understand, and yet is the most challenging. Due to its fluidity and self-referentiality, proprioception is not presentable to consciousness (the unstable internal image that it creates resides in consciousness but cannot be grasped and thus re-presented). A feeling/sense, it is not bound by sensible forms that would serve as means of objectification and externalization. As Barbara Montero observes, while the objects of vision and hearing, i.e. the most popular senses involved in the arts, are beyond one's body, sense of proprioception relates directly to the bodily sensation, it does not represent any external objects, but the sensory itself (231). These characteristics of proprioception help to reframe the question of augmentation as mediation: in the case of proprioception, the medium of sensation is the very relational structure of the body itself, irrespective of the "exteroceptive" (tactile) or "interoceptive" (visceral) dimensions of sensibility. The body is understood, then, as the "body without image,” and its proprioceptive effect can then be described as "the sensibility proper to the muscles and ligaments" (Massumi 58). Proprioception in (Media) Art One of the most convincing ways of externalization and (re)presentation of the data of proprioception is through re-production of its structure and its artificial enhancement with the help of technology. This can be achieved in at least two ways: by setting up situations and environments that emphasize self-perspective and awareness of perception, and by presenting measurements of bio-data and inviting into dialogue with them. The first strategy may be connected to disorientation and shifted perspective that are created in immersive virtual environments that make the role of otherwise un-trackable, fluid sense of proprioception actually felt and cognized. These effects are closely related to the nuances of perception of space, for instance, to spatial illusion. Practice of spatial illusion in the arts traces its history as far back as Roman frescos, trompe l’oeil, as well as phantasmagorias, like magic lantern. Geometrically, the system of the 360º image is still the most effective in producing a sense of full immersion—either in spaces from panoramas, Stereopticon, Cinéorama to CAVE (Computer Augmented Virtual Environments), or in devices for an individual spectator’s usage, like a stereoscope, Sensorama and more recent Head Mounted Displays (HMD). All these devices provide a sense of hermetic enclosure and bodily engagement with its scenes (realistic or often fantastical). Their images are frameless and thus immeasurable (lack of the sense of proportion provokes feeling of disorientation), image apparatus and the image itself converge here into an almost inseparable total unity: field of vision is filled, and the medium becomes invisible (Grau 198-202; 248-255). Yet, the constructed image is even more frameless and more peculiarly ‘mental’ in environments created on the basis of objectless or "immaterial" media, like light or sound; or in installations prioritizing haptic sensation and in responsive architectures, i.e. environments that transform physically in reaction to their inhabitants. The examples may include works by Olafur Eliasson that are centered around the issues of conscious perception and employ various optical and other apparata (mirrors, curved surfaces, coloured glass, water systems) to shift the habitual perspective and make one conscious of the subtle changes in the environment depending on one's position in space (there have been instances of spectators in Eliasson's installations falling down after trying to lean against an apparent wall that turned out to be a mere optical construct.). Figure 1: Olafur Eliasson, Take Your Time, 2008. © Olafur Eliasson Studio. In his classic H2OExpo project for Delta Expo in 1997, the Dutch architect Lars Spuybroek experimented with the perception of instability. There is no horizontal surface in the pavilion; floors, composed of interconnected elliptical volumes, transform into walls and walls into ceilings, promoting a sense of fluidity and making people respond by falling, leaning, tilting and "experiencing the vector of one’s own weight, and becoming sensitized to the effects of gravity" (Schwartzman 63). Along the way, specially installed sensors detect the behaviour of the ‘walker’ and send signals to the system to contribute further to the agenda of imbalance and confusion by changing light, image projection, and sound.Figure 2: Lars Spuybroek, H2OExpo, 1994-1997. © NOX/ Lars Spuybroek. Philip Beesley’s Hylozoic Ground (2010) is also a responsive environment filled by a dense organic network of delicate illuminated acrylic tendrils that can extend out to touch the visitor, triggering an uncanny mixture of delight and discomfort. The motif of pulsating movement was inspired by fluctuations in coral reefs and recreated via the system of precise sensors and microprocessors. This reference to an unfamiliar and unpredictable natural environment, which often makes us feel cautious and ultra-attentive, is a reminder of our innate ability of proprioception (a deeply ingrained survival instinct) and its potential for a more nuanced, intimate, emphatic and bodily rooted communication. Figure 3: Philip Beesley, Hylozoic Ground, 2010. © Philip Beesley Architect Inc. Works of this kind stimulate awareness of both the environment and one's own response to it. Inviting participants to actively engage with the space, they evoke reactions of self-reflexivity, i.e. the self becomes the object of its own exploration and (potentially) transformation. Another strategy of revealing the processes of the "body without image" is through representing various kinds of bio-data, bodily affective reactions to certain stimuli. Biosignal monitoring technologies most often employed include EEG (Electroencephalogram), EMG (Electromyogram), GSR (Galvanic Skin Response), ECG (Electrocardiogram), HRV (Heart Rate Variability) and others. Previously available only in medical settings and research labs, many types of sensors (bio and environmental) now become increasingly available (bio-enabled products ranging from cardio watches—an instance of the "quantified self" trend—to brain wave-controlled video games). As the representatives of the DIY makers community put it: "By monitoring some phenomena (biofeedback) you can train yourself to modulate them, possibly improving your emotional state. Biosensing lets you interact more naturally with digital systems, creating cyborg-like extensions of your body that overcome disabilities or provide new abilities. You can also share your bio-signals, if you choose, to participate in new forms of communication" (Montgomery). What is it about these technologies besides understanding more accurately the unconscious and invisible signals? The critical question in relation to biofeedback data is about the adequacy of the transference of the initial signal, about the "new" brought by the medium, as well as the ontological status of the resulting representation. These data are reflections of something real, yet themselves have a different weight, also providing the ground for all sorts of simulative methods and creation of mixed realities. External representations, unlike internal, are often attributed a prosthetic nature that is treated as extensions of existing skills. Besides serving their direct purpose (for instance, maps give detailed picture of a distant location), these extensions provide certain psychological effects, such as disorientation, displacement, a shift in a sense of self and enhancement of the sense of presence. Artistic experiments with bio-data started in the 1960s most famously with employing the method of sonification. Among the pioneers were the composers Alvin Lucier, Richard Teitelbaum, David Rosenblum, Erkki Kurenemi, Pierre Henry, and others. Today's versions of biophysical performance may include not only acoustic, but also visual interpretation, as well as subtle narrative scenarios. An example can be Marco Donnarumma's Hypo Chrysos, a piece that translates visceral strain in sound and moving images. The title refers to the type of a punishing trial in one of the circles of hell in Dante's Divine Comedy: the eternal task of carrying heavy rocks is imitated by the artist-performer, while the audience can feel the bodily tension enhanced by sound and imagery. The state of the inner body is, thus, amplified, or augmented. The sense of proprioception experienced by the performer is translated into media perceivable by others. In this externalized form it can also be shared, i.e. released into a space of inter-subjectivity, where it receives other, collective qualities and is not perceived negatively, in terms of pressure. Figure 4: Marco Donnarumma, Hypo Chrysos, 2011. © Marco Donnarumma. Another example can be an installation Telephone Rewired by the artist-neuroscientist Sean Montgomery. Brainwave signals are measured from each visitor upon the entrance to the installation site. These individual data then become part of the collective archive of the brainwaves of all the participants. In the second room, the viewer is engulfed by pulsing light and sound that mimic endogenous brain waveforms of the previous viewers. As in the experience of Donnarumma's performance, this process encourages tuning in to the inner state of the other and finding resonating states in one's own body. It becomes a tool for self-exploration, self-knowledge, and self-control, as well as for developing skills of collective being, of shared body-mind topologies. Synchronization of mental and bodily states of multiple people serves here a broader and deeper goal of training collaborative and empathic abilities. An immersive experience, it triggers deep embodied neural circuits, reaching towards the most authentic reactions not mediated by conscious procedures and judgment. Figure 5: Sean Montgomery, Telephone Rewired, 2013. © Sean Montgomery. Conclusion The potential of biofeedback as a strategy for art projects is a rich area that artists have only begun to explore. The layer of the imaginary and the fictional (which makes art special and different from, for instance, science) can add a critical dimension to understanding the processes of augmentation and mediation. As the described examples demonstrate, art is an investigative journey that can be engaging, surprising, and awakening towards the more subtle and acute forms of thinking and feeling. This astuteness and percipience are especially needed as media and technologies penetrate and affect our very abilities to apprehend reality. We need new tools to make independent and individual judgment. The sense of proprioception establishes a productive challenge not only for science, but also for the arts, inviting a search for new mechanisms of representing the un-presentable and making shareable and communicable what is, by definition, individual, fluid, and ungraspable. Collaborative cognition emerging from the augmentation of proprioception that is enabled by biofeedback technologies holds distinct promise for exploration of not only subjective, but also inter-subjective states and aesthetic strategies of inducing them. References Beesley, Philip. Hylozoic Ground. 2010. Venice Biennale, Venice. Clark, Andy, and David J. Chalmers. “The Extended Mind.” Analysis 58.1 (1998):7-19. Donnarumma, Marco. Hypo Chrysos: Action Art for Vexed Body and Biophysical Media. 2011. Xth Sense Biosensing Wearable Technology. MADATAC Festival, Madrid. Eliasson, Olafur. Take Your Time, 2008. P.S.1 Contemporary Art Centre; Museum of Modern Art, New York. Grau, Oliver. Virtual Art: From Illusion to Immersion. Cambridge, Mass.: MIT Press, 2003. Massumi, Brian. Parables of the Virtual: Movement, Affect, Sensation. Durham: Duke University Press, 2002. Montero, Barbara. "Proprioception as an Aesthetic Sense." Journal of Aesthetics and Art Criticism 64.2 (2006): 231-242. Montgomery, Sean, and Ira Laefsky. "Biosensing: Track Your Body's Signals and Brain Waves and Use Them to Control Things." Make 26. 1 Oct. 2013 ‹http://www.make-digital.com/make/vol26?pg=104#pg104›. Sacks, Oliver. "The Disembodied Lady". The Man Who Mistook His Wife for a Hat and Other Clinical Tales. Philippines: Summit Books, 1985. Schwartzman, Madeline, See Yourself Sensing. Redefining Human Perception. London: Black Dog Publishing, 2011. Spuybroek, Lars. Waterland. 1994-1997. H2O Expo, Zeeland, NL.