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      Imagine There Is No Plegia. Mental Motor Imagery Difficulties in Patients with Traumatic Spinal Cord Injury

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          In rehabilitation of patients with spinal cord injury (SCI), imagination of movement is a candidate tool to promote long-term recovery or to control futuristic neuroprostheses. However, little is known about the ability of patients with spinal cord injury to perform this task. It is likely that without the ability to effectively perform the movement, the imagination of movement is also problematic. We therefore examined, whether patients with SCI experience increased difficulties in motor imagery (MI) compared to healthy controls. We examined 7 male patients with traumatic spinal cord injury (aged 23–70 years, median 53) and 20 healthy controls (aged 21–54 years, median 30). All patients had incomplete SCI, with AIS (ASIA Impairment Scale) grades of C or D. All had cervical lesions, except one who had a thoracic injury level. Duration after injury ranged from 3 to 314 months. We performed the Movement Imagery Questionnaire Revised as well as the Beck Depression Inventory in all participants. The self-assessed ability of patients to visually imagine movements ranged from 7 to 36 ( Md = 30) and tended to be decreased in comparison to healthy controls (ranged 16–49, Md = 42.5; W = 326.5, p = 0.055). Also, the self-assessed ability of patients to kinesthetically imagine movements (range = 7–35, Md = 31) differed significantly from the control group (range = 23–49, Md = 41; W = 337.5, p = 0.0047). Two patients yielded tendencies for depressive mood and they also reported most problems with movement imagination. Statistical analysis however did not confirm a general relationship between depressive mood and increased difficulty in MI across both groups. Patients with spinal cord injury seem to experience difficulties in imagining movements compared to healthy controls. This result might not only have implications for training and rehabilitation programs, but also for applications like brain-computer interfaces used to control neuroprostheses, which are often based on the brain signals exhibited during the imagination of movements.

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          Most cited references 75

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              Mu rhythm (de)synchronization and EEG single-trial classification of different motor imagery tasks.

              We studied the reactivity of EEG rhythms (mu rhythms) in association with the imagination of right hand, left hand, foot, and tongue movement with 60 EEG electrodes in nine able-bodied subjects. During hand motor imagery, the hand mu rhythm blocked or desynchronized in all subjects, whereas an enhancement of the hand area mu rhythm was observed during foot or tongue motor imagery in the majority of the subjects. The frequency of the most reactive components was 11.7 Hz +/- 0.4 (mean +/- SD). While the desynchronized components were broad banded and centered at 10.9 Hz +/- 0.9, the synchronized components were narrow banded and displayed higher frequencies at 12.0 Hz +/- 1.0. The discrimination between the four motor imagery tasks based on classification of single EEG trials improved when, in addition to event-related desynchronization (ERD), event-related synchronization (ERS) patterns were induced in at least one or two tasks. This implies that such EEG phenomena may be utilized in a multi-class brain-computer interface (BCI) operated simply by motor imagery.

                Author and article information

                1Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University , Salzburg, Austria
                2Spinal Cord Injury and Tissue Regeneration Center Salzburg , Salzburg, Austria
                3Department of Psychology, Paris-Lodron University of Salzburg , Salzburg, Austria
                4Department of Mathematics, Paris-Lodron University of Salzburg , Salzburg, Austria
                5Center for Cognitive Neuroscience Salzburg , Salzburg, Austria
                Author notes

                Edited by: Mikhail Lebedev, Duke University, United States

                Reviewed by: Feroze Mohamed, Thomas Jefferson University, United States; Mariella Pazzaglia, Sapienza Università di Roma, Italy

                *Correspondence: Aljoscha Thomschewski a.thomschewski@

                This article was submitted to Neuroprosthetics, a section of the journal Frontiers in Neuroscience

                Front Neurosci
                Front Neurosci
                Front. Neurosci.
                Frontiers in Neuroscience
                Frontiers Media S.A.
                11 December 2017
                : 11
                Copyright © 2017 Thomschewski, Ströhlein, Langthaler, Schmid, Potthoff, Höller, Leis, Trinka and Höller.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Figures: 4, Tables: 3, Equations: 0, References: 78, Pages: 9, Words: 6949
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