Objective: The present study explored the relationship between interoceptive awareness and motor imagery in individuals with PD.

Background: Motor imagery is the imagination of movement, with associated images and sensations, which has shown potential as a neurorehabilitation technique for Parkinson’s disease (PD) (1). However, some studies have found motor imagery to be altered in PD (2), which could limit the effectiveness of imagery-based therapeutic approaches. Interoception, which is the perception and representation of internal body signals, can also be altered in PD, possibly related to disrupted functioning of the insula (3). Interoception has been linked to action control and sense of agency, and is thought to be involved in the generation of motor imagery (4). Understanding the connections between interoception, motor imagery and motor control could have important implications for rehabilitative strategies for PD.

Method: Participants with mild to moderate PD (N = 15; 7 females; mean age 65.4 years) completed an interoception questionnaire (Multidimensional Assessment of Interoceptive Awareness; MAIA-2 (5)), a general measure of motor imagery vividness (Kinesthetic and Visual Imagery Questionnaire; KVIQ-10 (6)), and a questionnaire assessing task-specific use and vividness of MI while practicing seated dance movement sequences.

Results: Interoceptive awareness (MAIA-2) was positively associated (p < .05) with self-reported use and vividness of motor imagery while watching dance sequences prior to physically performing the same movements. MAIA-2 scores did not correlate significantly with general motor imagery vividness (KVIQ-10), overall or for visual or kinesthetic subscales.

Conclusion: Interoceptive awareness may support the generation of motor imagery in individuals with PD, particularly for more complex or sequential movements. Further research should compare the relationship between interoception and motor imagery in people with PD and neurologically healthy older adults. Training in interoceptive awareness could be incorporated into imagery-based interventions for PD.

References: 1. Singer T, Fahey P, Liu KPY. Effectiveness of Motor Imagery in the Rehabilitation of People With Parkinson’s Disease: A Systematic Review and Meta-Analysis. Neurorehabil Neural Repair. 2024;38(6):460-475. doi:10.1177/15459683241246493
2. Heremans E, Feys P, Nieuwboer A, et al. Motor Imagery Ability in Patients With Early- and Mid-Stage Parkinson Disease. Neurorehabilitation and Neural Repair. 2011;25(2):168-177. doi:10.1177/1545968310370750
3. Santangelo G, Vitale C, Baiano C, et al. Interoceptive processing deficit: A behavioral marker for subtyping Parkinson’s disease. Parkinsonism & Related Disorders. 2018;53:64-69. doi:10.1016/j.parkreldis.2018.05.001
4. Ridderinkhof KR, Brass M. How Kinesthetic Motor Imagery works: A predictive-processing theory of visualization in sports and motor expertise. Journal of Physiology-Paris. 2015;109(1):53-63. doi:10.1016/j.jphysparis.2015.02.003
5. Mehling WE, Acree M, Stewart A, Silas J, Jones A. The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLOS ONE. 2018;13(12):e0208034. doi:10.1371/journal.pone.0208034
6. Malouin F, Richards CL, Jackson PL, Lafleur MF, Durand A, Doyon J. The Kinesthetic and Visual Imagery Questionnaire (KVIQ) for assessing motor imagery in persons with physical disabilities: a reliability and construct validity study. Journal of Neurologic Physical Therapy: JNPT. 2007;31(1):20-29.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-role-of-interoception-in-motor-imagery-in-parkinsons-disease/