The modulation of motor cortex excitability during motor imagery depends on imagery quality.

Motor imagery (MI) increases corticomotor excitability and modulates intracortical inhibition. This study aimed to relate these neurophysiological mechanisms to imagery quality. Twenty-three healthy adults participated. First, the ability to vividly and accurately imagine performing a finger-to-thumb opposition task was evaluated by calculating a MI index (MII) based on psychological, behavioural and psychophysiological measurements. These scores were used to distinguish good from poor imagers. Transcranial magnetic stimulation was then used to assess modulation of corticomotor excitability, short-interval intracortical inhibition (sICI) and short-interval intracortical facilitation (sICF). Participants imagined abduction of their right thumb paced by a 1-Hz metronome. Single and paired magnetic stimuli were delivered at rest, while listening to the metronome, and during or between imagined movements. Corticomotor excitability was facilitated in the right opponens pollicis for good and poor imagers during MI, and this was positively correlated to the MII score. Poor imagers also facilitated corticomotor excitability of the right abductor digiti minimi, which was not involved in the movement. No interactions were found with sICI and sICF for good imagers, whereas poor imagers recruited intracortical facilitation while imagining. Accurate MI performance was characterised by muscle-specific temporal modulation of corticomotor excitability.