Motor imagery: a backdoor to the motor system after stroke?

Full Abstract

BACKGROUND

AND PURPOSE:
Understanding brain plasticity after stroke is important in developing rehabilitation strategies. Active movement therapies show considerable promise but depend on motor performance, excluding many otherwise eligible patients. Motor imagery is widely used in sport to improve performance, which raises the possibility of applying it both as a rehabilitation method and to access the motor network independently of recovery. Specifically, whether the primary motor cortex (M1), considered a prime target of poststroke rehabilitation, is involved in motor imagery is unresolved.

SUMMARY OF REVIEW:
We review methodological considerations when applying motor imagery to healthy subjects and in patients with stroke, which may disrupt the motor imagery network. We then review firstly the motor imagery training literature focusing on upper-limb recovery, and secondly the functional imaging literature in healthy subjects and in patients with stroke.

CONCLUSIONS:
The review highlights the difficulty in addressing cognitive screening and compliance in motor imagery studies, particularly with regards to patients with stroke. Despite this, the literature suggests the encouraging effect of motor imagery training on motor recovery after stroke. Based on the available literature in healthy volunteers, robust activation of the nonprimary motor structures, but only weak and inconsistent activation of M1, occurs during motor imagery. In patients with stroke, the cortical activation patterns are essentially unexplored as is the underlying mechanism of motor imagery training. Provided appropriate methodology is implemented, motor imagery may provide a valuable tool to access the motor network and improve outcome after stroke.

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Author information

Author/s: Sharma, Nikhil (N); Pomeroy, Valerie M (VM); Baron, Jean-Claude (JC);

Affiliation: Department of Clinical Neurosciences, University of Cambridge, England.

Grants: (Agency:Wellcome Trust)

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review

Journal: Stroke; a journal of cerebral circulation (Stroke), published in United States. (Language: eng)

Reference: 2006-Jul; vol 37 (issue 7) : pp 1941-52

Dates: Created 2006/06/27; Completed 2006/07/18; Revised 2007/11/15;

PMID: 16741183, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Motor Cortex - physiopathology
Movement
Neuronal Plasticity - physiology
Paralysis - etiology; physiopathology; radionuclide imaging; rehabilitation
Positron-Emission Tomography
Psychomotor Performance - physiology
Questionnaires
Research Design
Stroke - complications; physiopathology; psychology; rehabilitation
Treatment Outcome

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