Comparison of Spectral Analysis of Gamma Band Activity During Actual and Imagined Movements as a Cognitive Tool

Background. Imagined motor movement is a cognitive process in which a subject imagines a movement without doing it, which activates similar brain regions as during actual motor movement. Brain gamma band activity (GBA) is linked to cognitive functions such as perception, attention, memory, awareness, synaptic plasticity, motor control, and Imagination. Motor imagery can be used in sports to improve performance, raising the possibility of using it as a rehabilitation method through brain plasticity through mirror neurons. Method. A comparative observational study was conducted on 56 healthy male subjects after obtaining clearance from the Ethics Committee. EEG recordings for GBA were taken for resting, real, and imaginary motor movements and compared. The power spectrum of gamma waves was analyzed using the Kruskal-Wallis test; a p-value <.05 was considered significant. Results. The brain gamma rhythm amplitude was statistically increased during both actual and imaginary motor movement compared to baseline (resting stage) in most of the regions of the brain except the occipital region. There was no significant difference in GBA between real and imaginary movements. Conclusions. Increased gamma rhythm amplitude during both actual and imaginary motor movement than baseline (resting stage) indicating raised brain cognitive activity during both types of movements. There was no potential difference between real and imaginary movements suggesting that the real movement can be replaced by the imaginary movement to enhance work performance through mirror therapy.

Effects of a single session action observation training on hand function in healthy young adults: a randomised controlled assessor and participants-blinded trial

PURPOSE

The aim was to investigate the effects of a single session action observation training (AOT) on hand function and evaluate whether observing self-actions would be more effective than observing someone else.

MATERIALS AND METHODS

A total of 60 right-handed healthy young adults, (32 female, 28 males and the mean age was 21.32 ± 1.07 years) were included in the study. The participants were randomly divided into five groups, self-action observation (sAO), observation of a third person (AO), action practice (AP), non-action observation (nAO), and control. A single session was performed for all participants. The primary outcome was the Jebsen Taylor Hand Function Test (JTHFT) assessed by a masked assessor.

RESULTS

Significant differences were observed between the sAO and control group in total left side JTHFT performance (p < 0.001). Additionally, there were significant differences between the AO and control group (p < 0.001), and AP and nAO group (p = 0.003) and AP and control group (p < 0.001) in total JTHFT performance change of the left side. Significant differences were found between the sAO and nAO (p = 0.001) and control groups (p < 0.001) in dominant side total JTHFT performance change. No difference between sAO and AP groups were observed (p > 0.05).

CONCLUSION

It was observed that a single session of action observation training improved hand function in healthy adults. The better performance achieved in the group watching the self-video may suggest that watching the self-image activates more mirror neurons.

Effects of mirror neuron activation therapies on functionality in older adults: Systematic review and meta-analysis

PURPOSE

To identify the effects of mirror neuron activation (MNAT) combined or not with physical exercise (PE) in healthy older adults, on functionality, balance, gait velocity and risk of falls.

METHODS

A systematic electronic search was performed in PubMed/MEDLINE, Cochrane, and Embase databases.

RESULTS

Thirteen randomized controlled trials were included in the qualitative analysis, and eleven in the quantitative analysis. All studies showed fair to high quality and the most frequent high-risk bias was "Blinding of participants and personnel". Compared to the control condition, higher improvement was shown in older people who received MNAT, on functionality (1.57 [0.57, 2.62], balance (1.95 [1.32, 2.572]), and gait velocity (1.20 [0.30, 2.11]). Compared to PE, MNAT combined with PE does not improve functionality. More studies are needed to assess MNAT effectiveness in the rest of the outcomes.

CONCLUSIONS

Neuron system activation through MNAT improves relevant abilities in older adults, with better results when including functional activities. However, the beneficial effects on these variables of adding MNAT to a PE program are controversial.

Facial emotional congruence in healthy adults and patients suffering from a psychiatric or neurological disorder

The production of facial emotions is an important conveyor of social communication. The present review of the literature concerns the congruence of facial emotions, that is the facial muscular activation that takes place in response to the emotional facial expression perceived in others. Although scientific interest in facial emotions has increased exponentially in the last few years, the production of facial emotions is still underexplored as compared to emotional perception. Several studies, mainly conducted with electromyography, have shown that facial emotional congruence exists in a robust way, largely for anger and happiness. While facial emotional congruence was long considered as innate and automatic, recent work has demonstrated that several sociocultural factors may influence or reduce this ability, challenging its automaticity. From a neuroanatomical point of view, studies have clearly highlighted the implication of mirror neurons but our knowledge is still limited because of the few methodologies assessing this system and the lack of homogeneity between the protocols used. Many explanatory, and probably not mutually exclusive, theories of emotional facial congruence have been put forward. In experimental neuropsychology, emotional facial congruence has seldom been investigated but the few available results suggest an impairment in psychiatric and neurological patients. In view of the important role of emotional facial productions in human relations and social interactions, new methods for easy clinical assessment need to be designed for the diagnosis and the cognitive care of these abilities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reflexive structure of the conscious subject and the origin of language codes

The code paradigm in biological and social sciences arises to Aristotle. For conscious activity, Aristotle introduced the notion of reflexive self-awareness in sense perception. This reflexive process generates the codes that signify sensual perceptive events and constrain human behavior. Coding systems grow via the generation of hypertextual statements reflecting new meanings in the process defined by Marcello Barbieri as a codepoiesis. It results in the establishment of higher-level codes (metacodes) forming the semiotic screen that has a nature of the set of perceived objects internalized by the conscious subject in encoding the symbolic actions. The characteristic feature of the semiotic screen consists in its property of being shared between the communicating agents. A sufficient complexity of nervous system, through the appearance of mirror neurons that are fired both when a subject executes certain action and when he observes another subject performing a similar action, represents a prerequisite for the emergence of reflexive codes in evolution. The codes appearing as a result of reflexive awareness and establishing different sociotypes, span from the symbolic systems of art and music through the common language to the formal language of logic and mathematics. Social dynamics is based on the implementation of reflexive coding activity and results in the growth and decay of social systems and civilizations.

To see is to experience: Aggression neurons light up when witnessing a fight

Fighting is an intense experience not only for the executors but also for the observers. In the current issue of Cell, Yang et al. identified hypothalamic aggression mirror neurons, activated during both physical fighting and witnessing a fight, possibly representing a neural mechanism for understanding social experiences in other minds.

Hypothalamic neurons that mirror aggression

Social interactions require awareness and understanding of the behavior of others. Mirror neurons, cells representing an action by self and others, have been proposed to be integral to the cognitive substrates that enable such awareness and understanding. Mirror neurons of the primate neocortex represent skilled motor tasks, but it is unclear if they are critical for the actions they embody, enable social behaviors, or exist in non-cortical regions. We demonstrate that the activity of individual VMHvl^PR neurons in the mouse hypothalamus represents aggression performed by self and others. We used a genetically encoded mirror-TRAP strategy to functionally interrogate these aggression-mirroring neurons. We find that their activity is essential for fighting and that forced activation of these cells triggers aggressive displays by mice, even toward their mirror image. Together, we have discovered a mirroring center in an evolutionarily ancient region that provides a subcortical cognitive substrate essential for a social behavior.

Effects of integrated action and sensory observation therapy based on mirror neuron and embodied cognition theory on upper limb sensorimotor function in chronic stroke: a study protocol for a randomised controlled trial

INTRODUCTION

This study protocol aims to explore the effectiveness and neural mechanism of the integration of action observation therapy (AOT) and sensory observation therapy (SOT) for post-stroke patients on upper limb sensorimotor function.

METHODS AND ANALYSIS

This is a single-centre, single-blind, randomised controlled trial. A total of 69 patients with upper extremity hemiparesis after stroke will be recruited and randomly divided into an AOT group, a combined action observation and somatosensory stimulation therapy (AOT+SST) group, and a combined AOT and SOT (AOT+SOT) group in a 1:1:1 ratio. Each group will receive 30 min of daily treatment, five times weekly for 4 weeks. The primary clinical outcome will be the Fugl-Meyer Assessment for Upper Extremity. Secondary clinical outcomes will include the Box and Blocks Test, modified Barthel Index and sensory assessment. All clinical assessments and resting-state functional MRI and diffusion tensor imaging data will be obtained at pre-intervention (T1), post-intervention (T2) and 8 weeks of follow-up (T3).

ETHICS AND DISSEMINATION

The trial was approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Chinese Traditional Medicine (Grant No. 2020-178). The results will be submitted to a peer-review journal or at a conference.

TRIAL REGISTRATION NUMBER

ChiCTR2000040568.

Multisensory and Sensorimotor Integration in the Embodied Self: Relationship between Self-Body Recognition and the Mirror Neuron System

The embodied self is rooted in the self-body in the "here and now". The senses of self-ownership and self-agency have been proposed as the basis of the sense of embodied self, and many experimental studies have been conducted on this subject. This review summarizes the experimental research on the embodied self that has been conducted over the past 20 years, mainly from the perspective of multisensory integration and sensorimotor integration regarding the self-body. Furthermore, the phenomenon of back projection, in which changes in an external object (e.g., a rubber hand) with which one has a sense of ownership have an inverse influence on the sensation and movement of one's own body, is discussed. This postulates that the self-body illusion is not merely an illusion caused by multisensory and/or sensorimotor integration, but is the incorporation of an external object into the self-body representation in the brain. As an extension of this fact, we will also review research on the mirror neuron system, which is considered to be the neural basis of recognition of others, and discuss how the neural basis of self-body recognition and the mirror neuron system can be regarded as essentially the same.

Effects of Mirror Neurons-Based Rehabilitation Techniques in Hand Injuries: A Systematic Review and Meta-Analysis

Background: Hand trauma requires specific rehabilitation protocol depending on the different structures involved. According to type of surgical intervention, and for monitoring pain and edema, post-operative rehabilitation of a hand that has experienced trauma involves different timings for immobilization. Several protocols have been used to reduce immobilization time, and various techniques and methods are adopted, depending on the structures involved. Objective: To measure the effects of mirror neurons-based rehabilitation techniques in hand injuries throughout a systematic review and meta-analysis. Methods: The protocol was accepted in PROSPERO database. A literature search was conducted in Cinahl, Scopus, Medline, PEDro, OTseeker. Two authors independently identified eligible studies, based on predefined inclusion criteria, and extracted the data. RCT quality was assessed using the JADAD scale. Results: Seventy-nine suitable studies were screened, and only eleven were included for qualitative synthesis, while four studies were selected for quantitative analysis. Four studies were case reports/series, and seven were RCTs. Nine investigate the effect of Mirror Therapy and two the effect of Motor Imagery. Quantitative analyses revealed Mirror Therapy as effective for hand function recovery (mean difference = −14.80 95% Confidence Interval (CI) = −17.22, −12.38) (p < 0.00001) in the short term, as well as in long follow-up groups (mean difference = −13.11 95% Confidence Interval (CI) = −17.53, −8.69) (p < 0.00001). Clinical, but not statistical, efficacy was found for manual dexterity (p = 0.15), while no benefit was reported for range of motion. Conclusions: Mirror neurons-based rehabilitation techniques, combined with conventional occupational and physical therapy, can be a useful approach in hand trauma. Mirror therapy seems to be effective for hand function recovery, but, for motor imagery and action observation, there is not sufficient evidence to recommend its use. Further research on the efficacy of the mirror neurons-based technique in hand injury is recommended.

EEG-Based Evidence of Mirror Neuron Activity from App-Mediated Stroke Patient Observation

Background and Objectives: The mirror neuron system in the sensorimotor region of the cerebral cortex is equally activated during both action observation and execution. Action observation training mimics the functioning of the mirror neuron system, requiring patients to watch and imitate the actions necessary to perform activities of daily living. StrokeCare is a user-friendly application based on the principles of action observation training, designed to assist people recovering from stroke. Therefore, when observing the daily life behavior provided in the StrokeCare app, whether the MNS is activated and mu inhibition appears. Materials and Methods: We performed electroencephalography (EEG) on 24 patients with chronic stroke (infarction: 11, hemorrhage: 13) during tasks closely related to daily activities, such as dressing, undressing, and walking. The StrokeCare app provided action videos for patients to watch. Landscape imagery observation facilitated comparison among tasks. We analyzed the mu rhythm from the C3, CZ, and C4 regions and calculated the mean log ratios for comparison of mu suppression values. Results: The EEG mu power log ratios were significantly suppressed during action observation in dressing, undressing, walking, and landscape conditions, in decreasing order. However, there were no significant activity differences in the C3, C4 and CZ regions. The dressing task showed maximum suppression after a color spectrum was used to map the relative power values of the mu rhythm for each task. Conclusions: These findings reveal that the human mirror neuron system was more strongly activated during observation of actions closely related to daily life activities than landscape images.

Whether Mirror and Conceptual Neurons are Myths? Sparse vs. Distributed Neuronal Representations

Multi-layer neural networks, mirror neurons, and gnostic neurons are concepts that assign neural representations to mental representations of percepts and inner sensations. However, none of these approaches alone can explain the higher mental functions, which we observe in natural minds from the third and first-person perspectives through introspection. Recent concepts of preservation of chemical traces of sensory stimuli and hierarchical structures of postsynaptic associations represented by specifically organized groups of neurons combine these concepts and effectively explain much more complex mental functions. To find an operative model and understand how knowledge in the mind creates conscious sensations, we explain how perceptions, sensory impressions, and environment models gain their neural representations. It was pointed out ways to detect the similarity of structures representing previously remembered patterns to the mental and neuronal representations of new perceptions, ways of their associations, and principles of information processing. Supplemented, presented in earlier works, concepts of competition of representations stimulation and factors stimulating their action explain the mind's complex functions, including speech production and recognition. We postulate that using new methods of modelling the neural network's functions through the parallel physical process allows creating a physical model of natural and artificial, conscious, intelligent minds.

Is motor cortex deactivation during action observation related to imitation in infancy? A commentary on Köster et al., 2020

Sensorimotor alpha suppression is present both during the observation and execution of actions, and is a commonly used tool to investigate neural mirroring in infancy. Köster et al. (2020) used this measure to investigate infants' motor cortex activation during the observation of action demonstrations and its relationship to subsequent imitation of these actions. Contrary to what is implied in the paper and to common findings in the literature, the study's results appear to suggest that the motor system was deactivated during the observation of the actions, and that greater deactivation during action observation was associated with a greater tendency to copy the action. Here we present potential methodological explanations for these unexpected findings and discuss them in relation to common recommendations in the field.

Acting with shared intentions: A systematic review on joint action coordination in Autism Spectrum Disorder

BACKGROUND

Joint actions, described as a form of social interaction in which individuals coordinate their actions in space and time to bring about a change in the environment, rely on sensory-motor processes that play a role in the development of social skills. Two brain networks, associated with "mirroring" and "mentalizing", are engaged during these actions: the mirror neuron and the theory of mind systems. People with autism spectrum disorder (ASD) showed impairment in interpersonal coordination during joint actions. Studying joint action coordination in ASD will contribute to clarify the interplay between sensory-motor and social processes throughout development and the interactions between the brain and the behavior.

METHOD

This review focused on empirical studies that reported behavioral and kinematic findings related to joint action coordination in people with ASD.

RESULTS

Literature on mechanisms involved in the joint action coordination impairment in ASD is still limited. Data are controversial. Different key-components of joint action coordination may be impaired, such as cooperative behavior, temporal coordination, and motor planning.

CONCLUSIONS

Interpersonal coordination during joint actions relies on early sensory-motor processes that have a key role in guiding social development. Early intervention targeting the sensory-motor processes involved in the development of joint action coordination could positively support social skills.

Abnormal dynamic functional network connectivity of the mirror neuron system network and the mentalizing network in patients with adolescent-onset, first-episode, drug-naïve schizophrenia

Previous studies based on an assumption of connectivity stationarity reported disconnections in mirror neuron system (MNS) and mentalizing networks of schizophrenic brains with social cognitive disruptions. However, recent studies demonstrated that functional brain connections are dynamic, and static connectivity metrics fail to capture time-varying properties of functional connections. The present study used a dynamic functional connectivity (dFC) method to test whether alterations of functional connectivity in the two networks are time-varying in adolescent-onset schizophrenia (AOS) patients. We collected resting-state fMRI data from 28 patients with AOS and 22 matched healthy controls. Static functional connectivity and dFC were used to explore the connectivity difference in the MNS and mentalizing networks between the two groups, respectively. Then a Pearson's correlation analysis between the connectivity showing intergroup differences and clinical scores was conducted in the AOS group. Compared with static functional connectivity analyses, dFC revealed state-specific connectivity decreases within the MNS network in the AOS group. Additionally, the dFC between the left middle temporal gyrus and left V5 was negatively correlated with the item2 of PANSS negative scores across all the AOS patients. Our findings suggest that social dysfunctions in AOS patients may be associated with the altered integrity and interaction of the MNS and mentalizing networks, and the functional impairments in the MNS are dynamic over time.

Action simulation and mirroring in children with autism spectrum disorders

Mental imitation, perhaps a precursor to motor imitation, involves visual perspective-taking and motor imagery. Research on mental imitation in autism spectrum disorders (ASD) has been rather limited compared to that on motor imitation. The main objective of this fMRI study is to determine the differences in brain responses underlying mirroring and mentalizing networks during mental imitation in children and adolescents with ASD. Thirteen high-functioning children and adolescents with ASD and 15 age-and- IQ-matched typically developing (TD) control participants took part in this fMRI study. In the MRI scanner, participants were shown cartoon pictures of people performing everyday actions (Transitive actions: e.g., ironing clothes but with the hand missing; and Intransitive actions: e.g., clapping hands with the palms missing) and were asked to identify which hand or palm orientation would best fit the gap. The main findings are: 1) both groups performed equally while processing transitive and intransitive actions; 2) both tasks yielded activation in the bilateral inferior frontal gyrus (IFG) and inferior parietal lobule (IPL) in ASD and TD groups; 3) Increased activation was seen in ASD children, relative to TD, in left ventral premotor and right middle temporal gyrus during intransitive actions; and 4) ASD symptom severity positively correlated with activation in left parietal, right middle temporal, and right premotor regions across all subjects. Overall, our findings suggest that regions mediating mirroring may be recruiting more brain resources in ASD and may have implications for understanding social movement through modeling.

Uncovering the neuroanatomical correlates of cognitive, affective and conative theory of mind in paediatric traumatic brain injury: a neural systems perspective

Deficits in theory of mind (ToM) are common after neurological insult acquired in the first and second decade of life, however the contribution of large-scale neural networks to ToM deficits in children with brain injury is unclear. Using paediatric traumatic brain injury (TBI) as a model, this study investigated the sub-acute effect of paediatric traumatic brain injury on grey-matter volume of three large-scale, domain-general brain networks (the Default Mode Network, DMN; the Central Executive Network, CEN; and the Salience Network, SN), as well as two domain-specific neural networks implicated in social-affective processes (the Cerebro-Cerebellar Mentalizing Network, CCMN and the Mirror Neuron/Empathy Network, MNEN). We also evaluated prospective structure-function relationships between these large-scale neural networks and cognitive, affective and conative ToM. 3D T1- weighted magnetic resonance imaging sequences were acquired sub-acutely in 137 children [TBI: n = 103; typically developing (TD) children: n = 34]. All children were assessed on measures of ToM at 24-months post-injury. Children with severe TBI showed sub-acute volumetric reductions in the CCMN, SN, MNEN, CEN and DMN, as well as reduced grey-matter volumes of several hub regions of these neural networks. Volumetric reductions in the CCMN and several of its hub regions, including the cerebellum, predicted poorer cognitive ToM. In contrast, poorer affective and conative ToM were predicted by volumetric reductions in the SN and MNEN, respectively. Overall, results suggest that cognitive, affective and conative ToM may be prospectively predicted by individual differences in structure of different neural systems-the CCMN, SN and MNEN, respectively. The prospective relationship between cerebellar volume and cognitive ToM outcomes is a novel finding in our paediatric brain injury sample and suggests that the cerebellum may play a role in the neural networks important for ToM. These findings are discussed in relation to neurocognitive models of ToM. We conclude that detection of sub-acute volumetric abnormalities of large-scale neural networks and their hub regions may aid in the early identification of children at risk for chronic social-cognitive impairment.

Imagining and Imaging the Social Brain: The Case of Mirror Neurons

In a contemporary setting in which all things "neuro" have great cultural sway, an analysis of the ways in which neuroscience is indebted to the methods and findings of the social sciences has received less attention. Indeed, in the new specialization of social neuroscience, neuroscientists now collaborate with contemporary psychologists and invoke historical psychological theories to help theorize empathy and social understanding. This article examines the overlap between psychological frameworks of social emotion and neuroscience in the case of mirror neurons, discovered in the 1990s. Some neuroscientists purport that mirror neurons underlie the social behaviours of imitation and empathy, and have found support for this view of theories of simulation and embodied cognition. They have also invoked pragmatic and phenomenological approaches to mind and behaviour dating back to the early 20^th century. Neuroscientists have thus imported, adapted, and interpreted psychological models to help define social understanding, empathy, and imitation in many imaging studies.

'It's All Done With Mirrors': V.S. Ramachandran and the Material Culture of Phantom Limb Research

This article examines the material culture of neuroscientist Vilayanur S. Ramachandran's research into phantom limbs. In the 1990s Ramachandran used a 'mirror box' to 'resurrect' phantom limbs and thus to treat the pain that often accompanied them. The experimental success of his mirror therapy led Ramachandran to see mirrors as a useful model of brain function, a tendency that explains his attraction to work on 'mirror neurons'. I argue that Ramachandran's fascination with and repeated appeal to the mirror can be explained by the way it allowed him to confront a perennial problem in the mind and brain sciences, that of the relationship between a supposedly immaterial mind and a material brain. By producing what Ramachandran called a 'virtual reality', relating in varied and complex ways to the material world, the mirror reproduced a form of psycho-physical parallelism and dualistic ontology, while conforming to the materialist norms of neuroscience today.

A Serious Game for Upper Limb Stroke Rehabilitation Using Biofeedback and Mirror-Neurons Based Training

Upper limb stroke rehabilitation requires early, intensive and repetitive practice to be effective. Consequently, it is often difficult to keep patients committed to their rehabilitation regimen. In addition to direct measures of rehabilitation achievable through targeted assessments, other factors can indirectly lead to rehabilitation. Current levels of integration between commodity graphics software, hardware, and body-tracking devices have provided a reliable tool to build what are referred to as serious games, focusing on the rehabilitation paradigm. More specifically, serious games can captivate and engage players for a specific purpose such as developing new knowledge or skills. This paper discusses a serious game application with a focus on upper limb rehabilitation in patients with hemiplegia or hemiparesis. The game makes use of biofeedback and mirror-neurons to enhance the patient's engagement. Results from the application of a quantitative self-report instrument to assess in-game engagement suggest that the serious game is a viable instructional approach rather than an entertaining novelty and, furthermore, demonstrates the future potential for dual action therapy-focused games.

Continuous theta-burst stimulation demonstrates a causal role of premotor homunculus in action understanding

Although it is well established that regions of premotor cortex (PMC) are active during action observation, it remains controversial whether they play a causal role in action understanding. In the experiment reported here, we used off-line continuous theta-burst stimulation (cTBS) to investigate this question. Participants received cTBS over the hand and lip areas of left PMC, in separate sessions, before completing a pantomime-recognition task in which half of the trials contained pantomimed hand actions, and half contained pantomimed mouth actions. The results reveal a double dissociation: Participants were less accurate in recognizing pantomimed hand actions after receiving cTBS over the hand area than over the lip area and less accurate in recognizing pantomimed mouth actions after receiving cTBS over the lip area than over the hand area. This finding constrains theories of action understanding by showing that somatotopically organized regions of PMC contribute causally to action understanding and, thus, that the mechanisms underpinning action understanding and action performance overlap.

Brain repair after stroke--a novel neurological model

Following stroke, patients are commonly left with debilitating motor and speech impairments. This article reviews the state of the art in neurological repair for stroke and proposes a new model for the future. We suggest that stroke treatment--from the time of the ictus itself to living with the consequences--must be fundamentally neurological, from limiting the extent of injury at the outset, to repairing the consequent damage. Our model links brain and behaviour by targeting brain circuits, and we illustrate the model though action observation treatment, which aims to enhance brain network connectivity. The model is based on the assumptions that the mechanisms of neural repair inherently involve cellular and circuit plasticity, that brain plasticity is a synaptic phenomenon that is largely stimulus-dependent, and that brain repair required both physical and behavioural interventions that are tailored to reorganize specific brain circuits. We review current approaches to brain repair after stroke and present our new model, and discuss the biological foundations, rationales, and data to support our novel approach to upper-extremity and language rehabilitation. We believe that by enhancing plasticity at the level of brain network interactions, this neurological model for brain repair could ultimately lead to a cure for stroke.

The value of adding mirror therapy for upper limb motor recovery of subacute stroke patients: a randomized controlled trial

BACKGROUND

Upper limb paresis remains a relevant challenge in stroke rehabilitation.

AIM

To evaluate if adding mirror therapy (MT) to conventional therapy (CT) can improve motor recovery of the upper limb in subacute stroke patients.

DESIGN

Prospective, single-center, single-blind, randomised, controlled trial.

SETTING

Subacute stroke patients referred to a Physical and Rehabilitation Medicine Unit between October 2009 and August 2011.

POPULATION

Twenty-six subacute stroke patients (time from stroke <4 weeks) with upper limb paresis (Motricity Index ≤ 77).

METHODS

Patients were randomly allocated to the MT (N.=13) or to the CT group (N.=13). Both followed a comprehensive rehabilitative treatment. In addition, MT Group had 30 minutes of MT while the CT group had 30 minutes of sham therapy. Action Research Arm Test (ARAT) was the primary outcome measures. Motricity Index (MI) and the Functional Independence Measure (FIM) were the secondary outcome measures.

RESULTS

After one month of treatment patients of both groups showed statistically significant improvements in all the variables measured (P<0.05). Moreover patients of the MT group had greater improvements in the ARAT, MI and FIM values compared to CT group (P<0.01, Glass's Δ Effect Size: 1.18). No relevant adverse event was recorded during the study.

CONCLUSION

MT is a promising and easy method to improve motor recovery of the upper limb in subacute stroke patients.

CLINICAL REHABILITATION IMPACT

While MT use has been advocated for acute patients with no or negligible motor function, it can be usefully extended to patients who show partial motor recovery. The easiness of implementation, the low cost and the acceptability makes this therapy an useful tool in stroke rehabilitation.

How frontoparietal brain regions mediate imitative and complementary actions: an FMRI study

The ‘mirror neuron system’ (MNS), located within inferior parietal lobe (IPL) and inferior frontal gyrus (IFG), creates an internal motor representation of the actions we see and has been implicated in imitation. Recently, the MNS has been implicated in non-identical responses: when the actions we must execute do not match those that we observe. However, in such conflicting situations non action-specific cognitive control networks also located in frontoparietal regions may be involved. In the present functional magnetic resonance imaging (fMRI) study participants made both similar and dissimilar actions within two action contexts: imitative and complementary. We aimed to determine whether activity within IPL/IFG depends on (i) responding under an imitative versus complementary context (ii) responding with similar versus dissimilar responses, and (iii) observing hand actions versus symbolic arrow cue stimuli. Activity within rIPL/rIFG regions was largest during observation of hand actions compared with arrow cues. Specifically, rIPL/rIFG were recruited only during the imitative context, when participants responded with similar actions. When responding to symbolic arrow cues, rIPL/rIFG activity increased during dissimilar responses, reflecting increased demands placed on general cognitive control mechanisms. These results suggest a specific role of rIPL/rIFG during imitation of hand actions, and also a general role of frontoparietal areas in mediating dissimilar responses to both hand actions and symbolic stimuli. We discuss our findings in relation to recent work that has examined the role of frontoparietal brain structures in joint-actions and inter-actor cooperation. We conclude that the specific brain regions identified here to show increased activation during action observation conditions are likely to form part of a mechanism specifically involved in matching observed actions directly with internal motor plans. Conversely, observation of arrow cues recruited part of a wider cognitive control network involved in the rapid remapping of stimulus-response associations.

[Legal approach of antisocial personality disorders]

We mention the different terms used over time to describe those behavioral disorders where prevailing selfishness, brutality, insensitivity, irresponsibility, manipulation and lack of empathy. It takes into account the biological, psychological and environmental theories. It refers to the importance of mirror neurons and its value in relation to the understanding of feelings. The criteria for the diagnosis, stressing the differences between psychopathic personalitya and antisocial personality disorder. Some sentences from different courts with various criteria are transcribed, for the apportionment or insanity of cases whose diagnosis is the psychopathic personality. Culminating with the legal approach of this type of personalities, from a civil and criminal perspective.