The Activation of the Mirror Neuron System during Action Observation and Action Execution with Mirror Visual Feedback in Stroke: A Systematic Review

Abstract

Objective To evaluate the concurrent and training effects of action observation (AO) and action execution with mirror visual feedback (MVF) on the activation of the mirror neuron system (MNS) and its relationship with the activation of the motor cortex in stroke individuals. Methods A literature search using CINAHL, PubMed, PsycINFO, Medline, Web of Science, and SCOPUS to find relevant studies was performed. Results A total of 19 articles were included. Two functional magnetic resonance imaging (fMRI) studies reported that MVF could activate the ipsilesional primary motor cortex as well as the MNS in stroke individuals, whereas two other fMRI studies found that the MNS was not activated by MVF in stroke individuals. Two clinical trials reported that long-term action execution with MVF induced a shift of activation toward the ipsilesional hemisphere. Five fMRI studies showed that AO activated the MNS, of which, three found the activation of movement-related areas. Five electroencephalography (EEG) studies demonstrated that AO or MVF enhanced mu suppression over the sensorimotor cortex. Conclusions MVF may contribute to stroke recovery by revising the interhemispheric imbalance caused by stroke due to the activation of the MNS. AO may also promote motor relearning in stroke individuals by activating the MNS and motor cortex.

Immediate and long-term effects of BCI-based rehabilitation of the upper extremity after stroke: a systematic review and meta-analysis

“…Among them, the EEG signal-based BCI is the most commonly used system because of its relatively simple and inexpensive equipment requirements, as well as rich sources regarding its temporal resolution (e.g., visually evoked potential, P300, slow cortical potential) and frequency (e.g., power in given frequency bands) domains, the information can be extracted as the feature for controlling external devices [10]. The EEG signal-based BCI captures the signal of the event-related and time-locked decrease or increase in the oscillatory power in given frequency bands; in other words, the event-related desynchronization (ERD) or event-related synchronization (ERS), respectively [11,12]. At present, hybrid BCI systems that combine more than one signal can provide more efficient natural control of external devices [13].…”

The Effects of Priming Intermittent Theta Burst Stimulation on Movement-Related and Mirror Visual Feedback-Induced Sensorimotor Desynchronization

“…However, we did not nd any signi cant difference between the two TBS protocols. MVF-induced ERD is thought to be a summation of the activation of the sensorimotor cortex, presumed MNS, and other neural networks related to attention and cognitive control [25,49]. The magnitude of MVF-induced ERD may also be in uence with the level of perception of embodiment during the observation, thus resulting in greater variability in response [50].…”

“…There is functional connectivity between the MNS and primary sensorimotor cortex [21] and the downstream modulatory activity of the MNS on the primary sensorimotor cortex could be indexed by observation-induced sensorimotor ERD [18]. Mirror visual feedback (MVF) has been widely used in studies examining observation-induced sensorimotor ERD in healthy adults [22][23][24] and has also been utilized as a therapeutic form of intervention for the rehabilitation of upper limb motor functions after stroke (i.e., mirror therapy) [25]. In the MVF paradigm, mirror apparatus is placed at the midsagittal plane of the participant.…”

Rehabilitation in acute stroke from the point of view of evidence-based medicine: possibilities of drug treatment

“…Зеркальная терапия базируется на теории «зеркальных нейронов», согласно которой зоны коры, вовлеченные в выполнение какого-либо действия, могут быть активированы при наблюдении за движением. Активация системы зеркальных нейронов во время занятия сопровождается возбуждением ипсилатеральной первичной моторной коры и восстановлением межполушарного баланса, что способствует двигательной реабилитации [21]. Эффективность зеркальной терапии показана и у пациентов в остром периоде ИИ.…”