Event-Related Desynchronization During Mirror Visual Feedback: A Comparison of Older Adults and People After Stroke

Event-related desynchronization (ERD), as a proxy for mirror neuron activity, has been used as a neurophysiological marker for motor execution after mirror visual feedback (MVF). Using EEG, this study investigated ERD upon the immediate effects of single-session MVF in unimanual arm movements compared with the ERD effects occurring without a mirror, in two groups: stroke patients with left hemiplegia and their healthy counterparts. During EEG recordings, each group performed one session of mirror therapy training in three task conditions: with a mirror, with no mirror, and with a covered mirror. An asymmetry index was calculated from the subtraction of the event-related spectrum perturbations between the C3 and C4 electrodes located over the sensorimotor cortices contralateral and ipsilateral to the moved arm. Results of the effect of task versus group in contralateral and ipsilateral motor areas showed that there was a significant effect of task condition at the contralateral motor area in the high beta band (17–35 Hz) at C3. High beta ERD showed that the suppression was greater over the contralateral hemisphere than it was over the ipsilateral hemisphere in both study groups. The magnitude of low beta (12–16 Hz) ERD in patients with stroke was more suppressed in contralesional C3 under the no mirror compared to that of the covered mirror and similarly more suppressed in ipsilesional C4 ERD under the no mirror compared to that of the mirror condition. The correlation analysis revealed that the magnitude of ERSP power correlated significantly with arm severity in the low and high beta bands in patients with stroke, and a higher asymmetry index in the low beta band was associated with higher arm functioning under the no-mirror condition. There was a shift in sensorimotor ERD toward the contralateral hemisphere as induced by MVF accompanying unimanual movement in both stroke patients and healthy controls. The use of ERD in the low beta band as a neurophysiological marker to indicate the relationships between the amount of MVF-induced ERD attenuation and motor severity, and the outcome indicator for improving stroke patients’ neuroplasticity in clinical trials using MVF are warranted to be explored in the future.

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The variety of methodology in Mirror Therapy practice for improving hand function after stroke

Physiotherapy and Health Activity ◽

10.1515/pha-2016-0002 ◽

2016 ◽

Vol 24 (1) ◽

pp. 7-11

Author(s):

Alina Radajewska ◽

Józef Opara ◽

Krzysztof Mehlich

Keyword(s):

Activities Of Daily Living ◽

Motor Imagery ◽

Visual Feedback ◽

Daily Living ◽

Hand Function ◽

Motor Recovery ◽

Mirror Therapy ◽

Stroke Patients ◽

Mirror Visual Feedback

Abstract Many studies have shown that a repeated exercises in the mirror visual feedback and motor imagery conditions may help to restore a lasted hand function in stroke patients. The evidence of effectiveness of mirror therapy is promising but the use of this method varies widely within studies. It has been postulated that there is a need to formulate basic rules of mirror therapy application with respect to different stages of stroke or severity of hand paresis. In this article the review of methodological variability of applying mirror therapy to patients after stroke has been presented. The review highlights the benefit effect of mirror therapy on motor recovery and activities of daily living after stroke.

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Modulation of Functional Connectivity in Response to Mirror Visual Feedback in Stroke Survivors: An MEG Study

Brain Sciences ◽

10.3390/brainsci11101284 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1284

Author(s):

Ruei-Yi Tai ◽

Jun-Ding Zhu ◽

Chih-Chi Chen ◽

Yu-Wei Hsieh ◽

Chia-Hsiung Cheng

Keyword(s):

Functional Connectivity ◽

Motor Cortex ◽

Visual Feedback ◽

Primary Motor Cortex ◽

Brain Regions ◽

Beta Band ◽

Stroke Patients ◽

Brain Areas ◽

Frequency Bands ◽

Mirror Visual Feedback

Background. Several brain regions are activated in response to mirror visual feedback (MVF). However, less is known about how these brain areas and their connectivity are modulated in stroke patients. This study aimed to explore the effects of MVF on brain functional connectivity in stroke patients. Materials and Methods. We enrolled 15 stroke patients who executed Bilateral-No mirror, Bilateral-Mirror, and Unilateral-Mirror conditions. The coherence values among five brain regions of interest in four different frequency bands were calculated from magnetoencephalographic signals. We examined the differences in functional connectivity of each two brain areas between the Bilateral-No mirror and Bilateral-Mirror conditions and between the Bilateral-Mirror and Unilateral-Mirror conditions. Results. The functional connectivity analyses revealed significantly stronger connectivity between the posterior cingulate cortex and primary motor cortex in the beta band (adjusted p = 0.04) and possibly stronger connectivity between the precuneus and primary visual cortex in the theta band (adjusted p = 0.08) in the Bilateral-Mirror condition than those in the Bilateral-No mirror condition. However, the comparisons between the Bilateral-Mirror and Unilateral-Mirror conditions revealed no significant differences in cortical coherence in all frequency bands. Conclusions. Providing MVF to stroke patients may modulate the lesioned primary motor cortex through visuospatial and attentional cortical networks.

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Veidrodžio terapijos reikšmė motorinei bei sensorinei funkcijai, skausminiam sindromui bei asocijuotos galvos smegenų žievės reorganizacijai po persirgto insulto

Sveikatos mokslai ◽

10.5200/sm-hs.2016.115 ◽

2017 ◽

Vol 26 (6) ◽

pp. 189-194

Author(s):

Monika Žilionytė ◽

Jurgita Savickaitė ◽

Andrius Kederys ◽

Lina Varžaitytė

Keyword(s):

Visual Feedback ◽

Upper Limb ◽

Mirror Neurons ◽

Recovery Of Function ◽

Phantom Limb Pain ◽

Phantom Limb ◽

Mirror Therapy ◽

Limb Pain ◽

Mirror Visual Feedback ◽

Mirror Movement

Tyrimo tikslas – apžvelgti patikimais įrodymais pagrįstą literatūrą apie veidrodinės terapijos (VT) efektyvumą pacientams, persirgusiems galvos smegenų insultu. Tyrimo medžiaga ir metodai. Atliekant sisteminę apžvalgą, mokslinių straipsnių paieška vykdyta duomenų bazėse: PubMed, BioMedCentral, Tylor&amp;Francis, CohraneLibrary, ScienceDirect. Mokslinių straipsnių paieška atlikta pagal kiekvienai duomenų bazei pritaikytą specialią paieškos strategiją. Paieškai buvo panaudoti šie raktažodžiai: „mirror therapy“, „rehabilitation“, „stroke“, „upper limb“, „recovery of function“, „mirror movement“, „phantom limb pain „, „mirror visual feedback“, „mirror neurons system“. Į sisteminę apžvalgą įtraukti anglų kalba 2008–2016 metais publikuoti atsitiktinių imčių kontroliuojami arba kontroliuojami prieš ir po tyrimai, kuriuose buvo vertinama VT įtaka paralyžiuotos galūnės motorinei ir sensorinei funkcijai, skausmo intensyvumui bei asocijuotos galvos smegenų žievės reorganizacijai. Tyrimo rezultatai. Į sisteminę apžvalgą įtraukta 11 tyrimų. Tyrimuose buvo suformuotos dvi grupės: tiriamųjų, kuriems buvo taikyta standartinė bei VT, ir kontrolinė grupė, kuriai buvo taikoma tik standartinė terapija. Daugelyje tyrimų VT taikyta vieną mėnesį. Rezultatai buvo vertinami prieš taikytą terapiją ir po jos. Apžvelgus visus šiuos 11 straipsnių stebime, kad tose tiriamųjų grupėse, kuriose naudojama VT, ženkliai pagerėja pacientų paralyžiuotos galūnės motorinė funkcija, padidėja vikrumas, sumažėja skausmas. Išvados. VT didina smegenų aktyvumą ipsilateralinėje motorinėje žievėje, somatosensorinėje zonoje, skatina asocijuotos žievės reorganizaciją, taip pat ji padeda pasiekti geresnių rezultatų pacientams, patyrusiems nedominuojančio pusrutulio insultą, sumažina persirgus insultu atsiradusį skausmą bei padidina po insulto sumažėjusį galūnių vikrumą. VT yra veiksminga ne tik gydant ūmiu ir poūmiu insultu, tačiau ir lėtiniu galvos smegenų insultu sergančius pacientus.

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Mirror Visual Feedback Training Improves Intermanual Transfer in a Sport-Specific Task: A Comparison between Different Skill Levels

Neural Plasticity ◽

10.1155/2016/8628039 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 4

Author(s):

Fabian Steinberg ◽

Nils Henrik Pixa ◽

Michael Doppelmayr

Keyword(s):

Motor Skills ◽

Visual Feedback ◽

Neural Plasticity ◽

Skill Level ◽

Fine Motor ◽

Control Group ◽

Intermanual Transfer ◽

Specific Task ◽

Mirror Therapy ◽

Mirror Visual Feedback

Mirror training therapy is a promising tool to initiate neural plasticity and facilitate the recovery process of motor skills after diseases such as stroke or hemiparesis by improving the intermanual transfer of fine motor skills in healthy people as well as in patients. This study evaluated whether these augmented performance improvements by mirror visual feedback (MVF) could be used for learning a sport-specific skill and if the effects are modulated by skill level. A sample of 39 young, healthy, and experienced basketball and handball players and 41 novices performed a stationary basketball dribble task at a mirror box in a standing position and received either MVF or direct feedback. After four training days using only the right hand, performance of both hands improved from pre- to posttest measurements. Only the left hand (untrained) performance of the experienced participants receiving MVF was more pronounced than for the control group. This indicates that intermanual motor transfer can be improved by MVF in a sport-specific task. However, this effect cannot be generalized to motor learning per se since it is modulated by individuals’ skill level, a factor that might be considered in mirror therapy research.

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A feasible customized camera-based mirror visual feedback apparatus in stroke patients

Annals of Physical and Rehabilitation Medicine ◽

10.1016/j.rehab.2018.05.1171 ◽

2018 ◽

Vol 61 ◽

pp. e503

Author(s):

L. Ding ◽

X. Wang ◽

X. Guo ◽

J. Jia

Keyword(s):

Visual Feedback ◽

Stroke Patients ◽

Mirror Visual Feedback

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Neurophysiological effects of mirror visual feedback in stroke patients with unilateral hemispheric damage

Brain Research ◽

10.1016/j.brainres.2018.09.003 ◽

2018 ◽

Vol 1700 ◽

pp. 170-180 ◽

Cited By ~ 5

Author(s):

Gadi Bartur ◽

Hillel Pratt ◽

Silvi Frenkel-Toledo ◽

Nachum Soroker

Keyword(s):

Visual Feedback ◽

Stroke Patients ◽

Mirror Visual Feedback

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The Priming Effects of Mirror Visual Feedback on Bilateral Task Practice: A Randomized Controlled Study

Occupational Therapy International ◽

10.1155/2019/3180306 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9

Author(s):

Yi-chun Li ◽

Ching-yi Wu ◽

Yu-wei Hsieh ◽

Keh-chung Lin ◽

Grace Yao ◽

...

Keyword(s):

Visual Feedback ◽

Priming Effect ◽

Controlled Study ◽

Mirror Therapy ◽

Beneficial Effects ◽

Mirror Visual Feedback ◽

Stroke Impact Scale ◽

Impact Scale ◽

Task Practice ◽

Task Oriented

The priming effect of mirror visual feedback can be simply provided by inexpensive mirror therapy (MT), which exhibits beneficial effects on sensorimotor recovery in stroke. The present study was a single-blind pretest-posttest study that examined whether the priming effect of mirror visual feedback on bilateral task practice would render better outcomes. Twenty-three patients with chronic stroke were randomized to receive hospital-based task-oriented MT or bilateral arm training (BAT) for 4 weeks at 90 minutes/day, 3 days/week and a home practice for 30-40 minutes/day, 5 days/week. There was the potential trend for MT to improve temperature sense as measured by the revised Nottingham Sensory Assessment (Cohen’s d=1.00; 95% confidence interval, -0.09 to 2.09), and MT increased the Stroke Impact Scale 3.0 total score (d=0.89; 0.003 to 1.71). MT also showed a trend for greater improvements in the Motor Activity Log (amount of use: d=0.62; -0.24 to 1.44; quality of movement: d=0.50; -0.35 to 1.31). MT involving bilateral movement practice with the priming effect of mirror visual feedback may render beneficial effects. The unilateral approach or MT augmented by extra feedback might be appropriate modifications.

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Movement-Related Cortical Potentials in Embodied Virtual Mirror Visual Feedback

Frontiers in Neurology ◽

10.3389/fneur.2021.646886 ◽

2021 ◽

Vol 12 ◽

Author(s):

Gangadhar Garipelli ◽

Tamara Rossy ◽

Daniel Perez-Marcos ◽

Jane Jöhr ◽

Karin Diserens

Keyword(s):

Visual Feedback ◽

Stroke Patient ◽

Contralateral Side ◽

National Institutes Of Health ◽

Proof Of Concept ◽

Mirror Therapy ◽

Mirror Visual Feedback ◽

Electroencephalogram Eeg ◽

Healthy Participants ◽

Cortical Potentials

Background: Mirror therapy is thought to drive interhemispheric communication, resulting in a balanced activation. We hypothesized that embodied virtual mirror visual feedback (VR-MVF) presented on a computer screen may produce a similar activation. In this proof-of-concept study, we investigated differences in movement-related cortical potentials (MRCPs) in the electroencephalogram (EEG) from different visual feedback of user movements in 1 stroke patient and 13 age-matched adults.Methods: A 60-year-old right-handed (Edinburgh score >95) male ischemic stroke [left paramedian pontine, National Institutes of Health Stroke Scale (NIHSS) = 6] patient and 13 age-matched right-handed (Edinburgh score >80) healthy adults (58 ± 9 years; six female) participated in the study. We recorded 16-electrode electroencephalogram (EEG), while participants performed planar center-out movements in two embodied visual feedback conditions: (i) direct (movements translated to the avatar's ipsilateral side) and (ii) mirror (movements translated to the avatar's contralateral side) with left (direct left/mirror left) or right (direct right/mirror right) arms.Results: As hypothesized, we observed more balanced MRCP hemispheric negativity in the mirror right compared to the direct right condition [statistically significant at the FC4 electrode; 99.9% CI, (0.81, 13)]. MRCPs in the stroke participant showed reduced lateralized negativity in the direct left (non-paretic) situation compared to healthy participants. Interestingly, the potentials were stronger in the mirror left (non-paretic) compared to direct left case, with significantly more bilateral negativity at FC3 [95% CI (0.758 13.2)] and C2 [95% CI (0.04 9.52)].Conclusions: Embodied mirror visual feedback is likely to influence bilateral sensorimotor cortical subthreshold activity during movement preparation and execution observed in MRCPs in both healthy participants and a stroke patient.

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