Impact of Neurologic Deficits on Motor Imagery: A Systematic Review of Clinical Evaluations

Franck Di Rienzo, Christian Collet, Nady Hoyek, Aymeric Guillot

Motor imagery (MI, the mental representation of an action without engaging in its actual execution) is a therapeutically relevant technique to promote motor recovery after neurologic disorders. MI shares common neural and psychological bases with physical practice. Interestingly, both acute and progressive neurologic disorders impact brain motor networks, hence potentially eliciting changes in MI capacities. How experimental neuroscientists and medical practitioners should assess and take into account these changes in order to design fruitful interventions is largely unresolved. Understanding how the psychometric, behavioral and neurophysiological correlates of MI are impacted by neurologic disorders is required. To address this brain-behavior issue, we conducted a systematic review of MI data in stroke, Parkinson's disease, spinal cord injury, and amputee participants. MI evaluation methods are presented. Redundant MI profiles, primarily based on psychometric and behavioral evaluations, emerged in each clinical population. When present, changes in the psychometric and behavioral correlates of MI were highly congruent with the corresponding motor impairments. Neurophysiological recordings yielded specific changes in cerebral activations during MI, which mirrored structural and functional reorganizations due to neuroplasticity. In this view, MI capacities may not be deteriorated per se by neurologic diseases resulting in chronic motor incapacities, but adjusted to the current state of the motor system. Literature-driven orientations for future clinical research are provided.