Motor imagery enhances corticospinal transmission mediated by cervical premotoneurons in humans

Motor imagery is known to affect the reacquisition of motor functioning after damage to the central nervous system. However, it remains unclear whether motor imagery influences corticospinal (CST) excitation mediated via cervical premotoneurons, which may be important for functional motor recovery in animals and humans. To investigate this, we examined the spatial facilitation of motor-evoked potentials (MEPs) induced by combined stimulation (CS) of CST and peripheral nerves. Thirty-two healthy volunteers were included and electromyograms from the biceps brachii (BB) were recorded. Transcranial magnetic stimulation (TMS) to motor cortex and electrical stimulation of ulnar nerve at wrist (NERVE) were delivered separately or in combination with 6-15 ms of interstimulus intervals (ISIs). Subjects were instructed to imagine performing an elbow flexion at rest and during tonic BB contraction. During both motor imagery and control tasks, CS (7.5-12 ms of ISIs) facilitated MEPs, compared with the mathematical summation of responses obtained with either only TMS or NERVE (P < 0.01). Interestingly, the CS-induced facilitation was significantly increased by motor imagery compared with control (P < 0.01). Single-motor unit recording also revealed increased facilitation during motor imagery, which was observed in peaks of the peristimulus time histogram 1-2 ms later than the onset latency (P < 0.01). The present findings suggest that motor imagery facilitates oligosynaptic CST excitation of arm motoneurons, mediated by cervical premotoneurons. Thus motor imagery may be a useful tool for activating the premotoneuron systems, which may contribute to motor reacquisition.NEW & NOTEWORTHY Imaging movement has positive effects on the reacquisition of motor functions after damage to the central nervous system. This study shows that motor imagery facilitates oligosynaptic corticospinal excitation that is mediated via cervical premotoneurons, which may be important for motor recovery in monkeys and humans. Current findings highlight how this imagery might be a beneficial tool for movement disorders through effects on premotoneuron circuitry.