The voluntary control of motor imagery. Imagined movements in individuals with feigned motor impairment and conversion disorder

The ability to volitionally control motor imagery was investigated by comparing the chronometry of real and imagined movements in a patient (AB) with conversion disorder who presented with paralysis of the left arm and hand and in a patient (MM) with an actual injury to the left arm. Control experiments investigated voluntary control of motor imagery in a group of healthy individuals who feigned a motor impairment with one limb and in one group who were instructed to move carefully and slowly. The visually guided pointing task was used to investigate the speed for accuracy trade-offs that occur as target size is varied for both real and imagined performance. In the healthy individuals, the speed for accuracy trade-off for both real and imagined performance on the motor task conformed to Fitts' law provided both the speed and accuracy of movements was emphasised. In MM, real and imagined performance was also within normal limits despite considerable pain and discomfort. In AB and in subjects feigning a motor impairment, motor task performance with the affected limb was slow and did not conform to Fitts' law. However, although imagined performance with the affected limb was generally slower than with the unaffected limb, it did conform to Fitts' law. These results suggest subjects cannot anticipate the effects of an actual limb injury. Furthermore, while they are able to control the general duration of imagined movements they have little voluntary control over their relative timing.     

The effect of an external load on the force and timing components of mentally represented actions

The chronometry of real and imagined movements was investigated in a group of eight subjects under varying conditions. The visually-guided pointing task was used to investigate the speed for accuracy trade-offs that occur as target size is varied for both real and imagined performance. The task was performed both with and without an external load of 2 kg. For the no-load condition and load conditions, the speed for accuracy trade-off for both real and imagined performance conformed to Fitts' law. Movement durations of real movements remained largely unaffected by the addition of the load, however, movement durations of imagined movements increased significantly with the addition of the load. These patterns of results suggest that the weight disrupted the force calculation component of imagined movements but not the relative timing.     

Asymmetries between dominant and non-dominant hands in real and imagined motor task performance

Motor imagery is a dynamic state in which an individual mentally simulates the performance of a specific motor action or motor task. Recent behavioural and neuroimaging evidence suggests that the same neurocognitive networks control real and imagined movements. This hypothesis was tested by investigating whether motor asymmetries related to cerebral dominance also occurred for imagined movements. Fifty subjects performed the visually guided pointing task of Sirigu et al. [Sirigu, A., Duhamel, J., Cohen, L., Pillon, B., Dubois, B. and Agid, Y., The mental representation of hand movements after parietal cortex damage. Science, 1996, 273, 1564-1567.] using their dominant and non-dominant hands. Analysis of group data indicated that both real and imagined movement conformed to Fitts' law. Analysis of individual data indicated that asymmetries arising from motor dominance in real movements also occurred for imagined movements. However, the relative slowing and error associated with the non-dominant hand was greater for imagined movements than for real movements. These asymmetries support the hypothesis that real and imagined movements are represented within the same neurocognitive networks but suggest that asymmetries in performance related to handedness are greater for imagined movements. In addition, while the visually guided pointing task provides a useful test of the ability to make imagined movements, asymmetries in the speed and reliability of imagined performance are significantly greater than those for real performance.     

Abnormalities of motor imagery associated with somatic passivity phenomena in schizophrenia

Some patients with schizophrenia report that their limbs are under the control of an alien force (motor passivity). This is hypothesised to be due to the dysfunction of an internal self-monitoring system that normally permits distinctions between internally generated and external influences on intentional behaviour. Motor imagery is the mental simulation of specific motor actions and it is based upon the internal representation of intended but unexecuted motor actions. Therefore, the generation of motor imagery should be impaired in schizophrenia characterised by passivity phenomena. The generation of motor imagery was compared using the visually guided pointing task (VGPT) and the Florida praxis imagery questionnaire (FPIQ) between patients with schizophrenia characterised by high levels of passivity symptoms (passivity) and patients without passivity symptoms (no-passivity). In both the passivity and no-passivity groups, the speed of real motor sequences on the VGPT was constrained by the distance of the movement and the width of the target in accordance with Fitts' law. For the no-passivity group, the same relationship was found for imagined movements. However, in the passivity group, imagined movements were not constrained by Fitts' law. The effect of a 2-kg load to the limb performing real or imagined movements on the VGPT was identical in both groups. The duration of imagined movements was slowed although the duration of real movements was unaffected. The FPIQ showed that the passivity group had difficulty answering questions that required them to imagine kinaesthetic aspects of performing simple gestures. These results suggest that passivity phenomena in schizophrenia are associated with a specific inability to represent the timing of motor actions internally. This is consistent with the hypothesis that patients with passivity phenomena have difficulty with maintaining an internal representation of intentional behaviour.     

Internal representation of movement in children with developmental coordination disorder: a mental rotation task

Recent studies show that children with developmental coordination disorder (DCD) have difficulties in generating an accurate visuospatial representation of an intended action, which are shown by deficits in motor imagery. This study sought to test this hypothesis further using a mental rotation paradigm. It was predicted that children with DCD would not conform to the typical pattern of responding when required to imagine movement of their limbs. Participants included 16 children with DCD and 18 control children; mean age for the DCD group was 10 years 4 months, and for controls 10 years. The task required children to judge the handedness of single-hand images that were presented at angles between 0 degrees and 180 degrees at 45 degrees intervals in either direction. Results were broadly consistent with the hypothesis above. Responses of the control children conformed to the typical pattern of mental rotation: a moderate trade-off between response time and angle of rotation. The response pattern for the DCD group was less typical, with a small trade-off function. Response accuracy did not differ between groups. It was suggested that children with DCD, unlike controls, do not automatically enlist motor imagery when performing mental rotation, but rely on an alternative object-based strategy that preserves speed and accuracy. This occurs because these children manifest a reduced ability to make imagined transformations from an egocentric or first-person perspective.     

Differences in motor imagery between children with developmental coordination disorder with and without the combined type of ADHD

It has been proposed, and questioned, whether motor impairments in attention-deficit-hyperactivity disorder, combined type (ADHD-C) alone, developmental coordination disorder (DCD) alone, and ADHD-C and comorbid DCD (ADHD-C/DCD) may arise from disruption to a common set of cognitive functions and their related neural substrate. This study examined movement durations for real and imagined movements in a visually guided pointing task in 58 prepubertal children aged 8 to 12 years old with ADHD-C alone (n=14), ADHD-C/DCD (n=14), DCD alone (n=15), and an age-, sex-, and Full-scale IQ-matched healthy comparison group (n=15). There were 10 males and 4 or 5 females in each group. The DCD alone group demonstrated an inability to generate imagined movements that was not present in the ADHD-C group, with or without comorbid DCD, or healthy comparison participants. These findings add to the emerging literature characterizing intended and actual motor impairments associated with DCD alone.     

Children with developmental coordination disorder demonstrate a spatial mismatch when estimating coincident-timing ability with tools

Coincident timing or interception ability can be defined as the capacity to precisely time sensory input and motor output. This study compared accuracy of typically developing (TD) children and those with Developmental Coordination Disorder (DCD) on a task involving estimation of coincident timing with their arm and various tool lengths. Forty-eight (48) participants performed two experiments where they imagined intercepting a target moving toward (Experiment 1) and target moving away (Experiment 2) from them in 5 conditions with their arm and tool lengths: arm, 10, 20, 30, and 40 cm. In Experiment 1, the DCD group overestimated interception points approximately twice as much as the TD group, and both groups overestimated consistently regardless of the tool used. Results for Experiment 2 revealed that those with DCD underestimated about three times as much as the TD group, with the exception of when no tool was used. Overall, these results indicate that children with DCD are less accurate with estimation of coincident-timing; which might in part explain their difficulties with common motor activities such as catching a ball or striking a baseball pitch.     

Developmental coordination disorder in children with attention-deficit-hyperactivity disorder and physical therapy intervention

Although physical therapy (PT) is effective in improving motor function in children with developmental coordination disorder (DCD), insufficient data are available on the impact of this intervention in children with combined attention-deficit-hyperactivity disorder (ADHD) and DCD. This prospective study aimed to establish the prevalence of DCD among a cohort of patients with ADHD, characterize the motor impairment, identify additional comorbidities, and determine the role of PT intervention on these patients. DCD was detected in 55.2% of 96 consecutive children with ADHD (81 males, 15 females), mostly among patients with the inattentive type (64.3% compared with 11% of those with the hyperactive/impulsive type, p<0.05). Mean age was 8 years 4 months (SD 2 y). Individuals with both ADHD and DCD more often had specific learning disabilities (p=0.05) and expressive language deficits (p=0.03) than children with ADHD only. Twenty-eight patients with ADHD and DCD randomly received either intensive group PT (group A, mean age 9 y 3 mo, SD 2 y 3 mo) or no intervention (group B, mean age 9 y 3 mo, SD 2 y 2 mo). PT significantly improved motor performance (assessed by the Movement Assessment Battery for Children; p=0.001). In conclusion, DCD is common in children with ADHD, particularly of the inattentive type. Patients with both ADHD and DCD are more likely to exhibit specific learning disabilities and phonological (pronunciation) deficits. Intensive PT intervention has a marked impact on the motor performance of these children.     

Development of bilateral motor control in children with developmental coordination disorders

This research examined behavioral (i.e. movement time) and neuromuscular (EMG) characteristics of unilateral and bilateral aiming movements of children with normal motor development and children with developmental coordination disorders (DCD). Two age groups of children were studied: 6 to 7, and 9 to 10 year olds. Bilateral aiming movements involved moving the two hands to targets of either (1) the same amplitude - symmetrical bilateral movements, or (2) different amplitudes - asymmetrical bilateral movements. Unilateral aiming movements involved moving one hand to either near or far targets associated with that hand. In general, unilateral and bilateral movement times were slower in younger than older children, and in children with DCD than children with normal motor development. Our neuromuscular data suggest that the faster movement times that typically accompany increasing age in children may be the result of a change in the capacity to initiate antagonist muscle contractions. The prolonged burst of agonist activity and delayed onset of antagonist activity observed in children with DCD may contribute to their inability to produce fast, accurate unilateral movements. On both symmetrical and asymmetrical bilateral aiming movements, children with DCD had more performance errors and greater temporal inconsistencies between neuromuscular (EMG) parameters and behavioral (movement time) parameters than children with normal motor development. These new neuromuscular data suggest that there are important differences in the way the motor control systems of children with and without DCD organize bilateral aiming responses.     

Head–torso–hand coordination in children with and without developmental coordination disorder

Aim This study investigated the nature of coordination and control problems in children with developmental coordination disorder (DCD). Method Seven adults (two males, five females, age range 20–28y; mean 23y, SD 2y 8mo) and eight children with DCD (six males, two females, age range 7–9y; mean 8y, SD 8mo), and 10 without DCD (seven males, three females, age range 7–9y; mean 8y, SD 7mo) sat in a swivel chair and looked at or pointed to targets. Optoelectronic apparatus recorded head, torso, and hand movements, and the spatial and temporal characteristics of the movements were computed. Results Head movement times were longer (p<0.05) in children with DCD than in the comparison group, even in the looking task, suggesting that these children experience problems at the lowest level of coordination (the coupling of synergistic muscle groups within a single degree of freedom). Increasing the task demands with the pointing condition affected the performance of children with DCD to a much greater extent than the other groups, most noticeably in key feedforward kinematic landmarks. Temporal coordination data indicated that all three groups attempted to produce similar movement patterns to each other, but that the children with DCD were much less successful than age‐matched children in the comparison group. Interpretation Children with DCD have difficulty coordinating and controlling single degree‐of‐freedom movements; this problem makes more complex tasks disproportionately difficult for them. Quantitative analysis of kinematics provides key insights into the nature of the problems faced by children with DCD.     

Does order and timing in performance of imagined and actual movements affect the motor imagery process? The duration of walking and writing task

The purpose of the present study was to investigate the effects on the duration of imagined movements of changes in timing and order of performance of actual and imagined movement. Two groups of subjects had to actually execute and imagine a walking and a writing task. The first group first executed 10 trials of the actual movements (block A) and then imagined the same movements at different intervals: immediately after actual movements (block I-1) and after 25 min (I-2), 50 min (I-3) and 75 min (I-4) interval. The second group first imagined and then actually executed the tasks. The duration of actual and imagined movements, recorded by means of an electronic stopwatch operated by the subjects, was analysed. The duration of imagined movements was very similar to those of actual movements, for both tasks, regardless of either the interval elapsed from the actual movements (first group) or the order of performance (second group). However, the variability of imagined movement duration was significantly increased compared to variability of the actual movements, for both motor tasks and groups. The findings give evidence of similar cognitive processes underlying both imagination and actual performance of movement.     

Impaired visuo-motor sequence learning in Developmental Coordination Disorder

The defining feature of Developmental Coordination Disorder (DCD) is the marked impairment in the development of motor coordination (DSM-IV-TR, American Psychiatric Association, 2000). In the current study, we focused on one core aspect of motor coordination: learning to correctly sequence movements. We investigated the procedural, visuo-motor sequence learning abilities of 18 children with DCD and 20 matched typically developing (TD) children, by means of the serial reaction time (SRT) task. Reaction time measurements yielded two important findings. Overall, DCD children demonstrated general learning of visuo-motor task demands comparable to that of TD children but failed to learn the visuo-motor sequence. Interestingly, a sequence recall test, administered after the SRT task, indicated some awareness of the repeating sequence pattern. This suggests that the sequence learning problems of DCD children might be located at the stage of motor planning rather than sequence acquisition.     

A comparison of motor imagery performance in children with spastic hemiplegia and developmental coordination disorder

Individuals with hemiplegia have difficulty planning movements, which may stem from deficits in motor imagery ability. We explored motor imagery ability in three groups of 21 children, aged 8-12 years: children with hemiplegia; children with developmental coordination disorder (DCD); and a comparison group. They completed two tasks requiring laterality judgments of body parts--hand and whole-body rotation. Accuracy in both was reduced for the motor-impaired groups, and response time was atypical for the whole-body task. This suggests that motor imagery deficits exist in children with hemiplegia and DCD, supporting previous findings that planning deficits in hemiplegia may result from deficits in motor imagery.     

Decline in motor prediction in elderly subjects: right versus left arm differences in mentally simulated motor actions

This study investigates the effects of age upon the temporal features of executed and imagined movements performed with the dominant (D; right) and nondominant (ND; left) arms. Thirty right-handed subjects were divided into two groups: (i) the young group (n=15; mean age: 22.5+/-2.5 years) and (ii) the elderly group (n=15; mean age: 70.2+/-2.2 years). The motor task, involving arm pointing movements among four pairs of targets (.5cm, 1cm, 1.5cm and 2cm), imposed strong spatiotemporal constraints. During overt performance, young and elderly subjects modulated movement duration according to the size of targets, despite the fact that movement speed decreased with age as well as in the left arm compared with the right. This observation was also valid for the covert performance produced by the young group. However, such a strong relationship between covert movement durations and target size was not as obvious in the elderly group. Young, compared to elderly subjects, showed stronger correlations and smaller absolute differences between executed and imagined movements for both arms. Additionally, the absolute difference between executed and imagined arm movement durations was more pronounced for the left than the right arm in aged subjects. This result suggests a selective decline with age of mental prediction of motor actions, which is more prominent when the ND arm is involved.     

Developmental changes in lateralized inhibition of symmetric movements in children with and without Developmental Coordination Disorder

The present study investigates developmental changes in selective inhibition of symmetric movements with a lateralized switching task from bimanual to unimanual tapping in typically developing (TD) children and with Developmental Coordination Disorder (DCD) from 7 to 10 years old. Twelve right-handed TD children and twelve gender-matched children with DCD and probable DCD produce a motor switching task in which they have (1) to synchronize with the beat of an auditory metronome to produce bimanual symmetrical tapping and (2) to selectively inhibit their left finger's tapping while continuing their right finger's tapping and conversely. We assess (1) the development of the capacity to inhibit the stopping finger (number of supplementary taps after the stopping instruction) and (2) the development of the capacity to maintain the continuing finger (changes in the mean tempo and its variability for the continuing finger's tapping) and (3) the evolution of performance through trials. Results indicate that (1) TD children present an age-related increase in the capacity to inhibit and to maintain the left finger's tapping, (2) DCD exhibits persistent difficulties to inhibit the left finger's tapping, and (3) both groups improve their capacity to inhibit the left finger's movements through trials. In conclusion, the lateralized switching task provides a simple and fine tool to reveal differences in selective inhibition of symmetric movements in TD children and children with DCD. More theoretically, the specific improvement in selective inhibition of the left finger suggests a progressive development of inter-hemispheric communication during typical development that is absent or delayed in children with DCD.     

A dyspraxic deficit in specific language impairment and developmental coordination disorder? Evidence from hand and arm movements

The extent to which children with either specific language impairment (SLI) or developmental coordination disorder (DCD) could be considered dyspraxic was examined using three tasks involving either familiar, or unfamiliar actions. SLI is diagnosed in children who fail to develop language in the normal fashion for no apparent reason, while the DCD diagnosis is applied to a child who experiences problems with movement in the absence of other difficulties. Seventy-two children aged between 5 and 13 years participated, falling into one of four groups: (1) children with specific language impairment (SLI), (2) children with developmental coordination disorder (DCD), (3) age-matched control children, and (4) younger control children. The performance of the clinical groups resembled that of younger normally developing children. Children with SLI, DCD, and the younger controls showed significant difficulty on the task requiring the production of familiar, but not unfamiliar postures. The deficit observed in the SLI group is particularly striking because it was seen both in those with and those without recognized motor difficulties.     

Functional connectivity during real vs imagined visuomotor tasks: an EEG study

It is proposed that real and imagined movements activate identical neural networks. Cortical oscillatory activity is proposed as a mechanism through which distributed neuronal networks may bind into coherent ensembles and coupling of oscillators is used as a tool to investigate modulations of cortical connectivity. The aim of the present study was to test the hypothesis that, although the same brain network is involved in both real and imagined movements, the functional connectivity within the network differs. To do so, we measured interregional coupling, quantified using coherence between scalp EEG electrodes, during different periods of a prehension task during real and imagined movements. The results demonstrated a different pattern of coupling in the beta frequency range between electrodes overlying occipital and motor cortices during executed and imagined movements. These findings are consistent with the hypothesis that the neural networks during real and imagined movements are not identical.     

Postural responses to a suprapostural visual task among children with and without developmental coordination disorder

We sought to determine the effects of varying the perceptual demands of a suprapostural visual task on the postural activity of children with developmental coordination disorder (DCD), and typically developing children (TDC). Sixty-four (32 per group) children aged between 9 and 10 years participated. In a within-participants design, each child performed a signal detection task at two levels of difficulty, low (LD) and high difficulty (HD). During performance of the signal detection tasks we recorded positional variability of the head and torso using a magnetic tracking system. We found that task difficulty had a greater effect on task performance among the TDC group than among children with DCD. Overall positional variability was greater the DCD group than in the TDC group. In the TDC group, positional variability was reduced during performance of the HD task, relative to sway during performance of the LD task. In the DCD group, positional variability was greater during performance of the HD task than during performance of the LD task. In children, DCD may reduce the strength of functional integration of postural activity with the demands of suprapostural visual tasks.     

A prospective cohort study comparing workload in children with and without developmental coordination disorder

The purpose of this prospective cohort study was to assess how cardiorespiratory fitness (CRF) of children with probable developmental coordination disorder (DCD) changes over a period of 4.7 years relative to a group of typically developing controls. A school-based sample of children in a large region of Ontario, Canada with 75 out of a possible 92 schools consented to participate. Children enrolled in Grade 4 (mean = 9.9 years, SD = 0.35) at baseline (n = 2278) were followed over the course of 56 months. A total of eight waves of data collection were carried out throughout the study period. The short form of the Bruininks-Oseretsky test of motor proficiency was used to identify children with probable DCD and the maximal speed attained on the Léger 20-m shuttle run to measure CRF. Mixed-effects modeling was used to estimate the change over time in maximal Leger run speed for both groups adjusting for relevant covariates (e.g., gender, BMI, school, activity level, predilection for activity). Children with pDCD had consistently lower maximal run speed relative to controls. The trajectories of run speed in children with probable DCD and those without the disorder differed by gender with pDCD females demonstrating the lowest scores over time. Both genders with probable DCD showed a greater rate of decline in CRF over time relative to the controls. In conclusion, the difference in CRF between children with and without probable DCD is substantial, and it tends to increase over time. This adds to the argument suggesting that interventions intended to improve CRF may be appropriate and necessary for children with motor difficulties.