Reflections on Mirror Therapy

  title={Reflections on Mirror Therapy},
  author={Frederik J. A. Deconinck and Ana R. P. Smorenburg and Alex Benham and Annick Ledebt and Max G Feltham and Geert J.P. Savelsbergh},
  journal={Neurorehabilitation and Neural Repair},
  pages={349 - 361}
Background. Mirror visual feedback (MVF), a phenomenon where movement of one limb is perceived as movement of the other limb, has the capacity to alleviate phantom limb pain or promote motor recovery of the upper limbs after stroke. The tool has received great interest from health professionals; however, a clear understanding of the mechanisms underlying the neural recovery owing to MVF is lacking. Objective. We performed a systematic review to assess the effect of MVF on brain activation… 

Parietal Activation Associated With Target-Directed Right Hand Movement Is Lateralized by Mirror Feedback to the Ipsilateral Hemisphere

Functional magnetic resonance imaging was used to investigate the interaction of target directed movement and MVF on the activation of, and functional connectivity between, regions within the visuomotor network and revealed that the interaction between the ipsilateral parietal lobe and the motor cortex was significantly greater during target-directed movements with mirror feedback compared to veridical feedback.

Role of kinaesthetic motor imagery in mirror-induced visual illusion as intervention in post-stroke rehabilitation

Evidence based on brain imaging studies for testing the hypothesis that neural processes associated with kinaesthetic motor imagery are attributed to ipsilateral M1 activation is reviewed, relationships in terms of shared neural substrates and mental processes between mirror-induced visual illusion and kinaesthesia generate new evidence on the role of the latter in mirror therapy.

Mirror Therapy Rehabilitation in Stroke: A Scoping Review of Upper Limb Recovery and Brain Activities

MT is a promising intervention for improving upper limb function for individuals with chronic stroke and the need to incorporate EEG into the MT study to capture brain activity and understand the mechanism underlying the therapy is highlighted.

The Mirror Illusion Increases Motor Cortex Excitability in Children With and Without Hemiparesis

MI increases the excitability of M1 in hemiparetic patients with contralateral corticospinal organization and in typically developing subjects, providing neurophysiological evidence supporting the application of mirror therapy in selected children and adolescents with hemiparesis.

Sequential neural activity in sensorimotor area and mirror neural system for graded mirror therapy with imagined hand movements.

It is suggested that graded MT might be a sequential therapeutic program that can enhance the sensorimotor cortex and the MNS might have an initiating role in graded MT.

Motor Cortex Plasticity during Unilateral Finger Movement with Mirror Visual Feedback

It can be concluded that a combination of motor training with MVF therapy may induce more robust neuroplastic changes through multisensory integration that is relevant to motor rehabilitation.

Do Mirror Glasses Have the Same Effect on Brain Activity as a Mirror Box? Evidence from a Functional Magnetic Resonance Imaging Study with Healthy Subjects

It is concluded that the mirror glasses might be a promising alternative to the mirror box, as they induce similar patterns of brain activation and can be easy applied in therapy and research.

Movement-Related Cortical Potentials in Embodied Virtual Mirror Visual Feedback

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.

Neural Processes Underlying Mirror-Induced Visual Illusion: An Activation Likelihood Estimation Meta-Analysis

The current meta-analysis is the first to reveal the visualization, mental rehearsal and motor-related processes underpinning the MVI and offers theoretical support on using MVI as a clinical intervention for post-stroke patients.



Different effects of the mirror illusion on motor and somatosensory processing.

The mirror illusion does not elicit immediate changes in motor areas, yet there is a direct effect on somatosensory areas, especially for left hand movements, which suggest different effects of mirror therapy on processing and rehabilitation of motor and sensory function.

Human Motor Plasticity Induced by Mirror Visual Feedback

Trans transcranial magnetic stimulation was used to test whether M1 plasticity is a physiological substrate of MVF-induced motor behavioral improvement and indicate that M1 Plasticity, especially in its excitatory connections, is an essential component of MVf-based therapies.

Functional Plasticity Induced by Mirror Training

FMRI analysis of action observation and imitation of grasping tasks demonstrated MTr-specific activation changes within the right dorsal and left ventral premotor cortex as well as in the left SMC (SMCleft).

A comparison of neural mechanisms in mirror therapy and movement observation therapy.

Lateralized cerebral activations elicited during self-initiated movement mirroring and observation of movements are elicited by inversion of visual feedback (movement mirroring), but not by movement observation.

Effect of a mirror-like illusion on activation in the precuneus assessed with functional near-infrared spectroscopy

Findings extend the understanding on interhemispheric rivalry and indicate that a MIR is integrated into visuomotor coordination similar to normal view, irrespective of the hand that is actually performing the task.

Sensorimotor cortex activation during mirror therapy in healthy right-handed subjects: A study with near-infrared spectroscopy

The findings suggest that MT is more effective when it is used for dominant right hand movement, and this phenomenon may be the related to the different manipulability between the dominant and non-dominant hands.

The neuronal correlates of mirror therapy: an fMRI study on mirror induced visual illusions in patients with stroke

The authors showed that during bimanual movement, the mirror illusion increases activity in the precuneus and the posterior cingulate cortex, areas associated with awareness of the self and spatial attention, which might reduce learnt non-use.

The Potential for Utilizing the “Mirror Neurone System” to Enhance Recovery of the Severely Affected Upper Limb Early after Stroke: A Review and Hypothesis

The hypothesis that observation of another’s movement might train the movement execution system of stroke patients who have severe paresis to bring them to the point at which they could actively participate in rehabilitation consisting of goal-directed activities is raised.

Optical illusion alters M1 excitability after mirror therapy: a TMS study.

The present study confirms the previous suggestion of the involvement of the "contralesional" left-side (ipsilateral to the hand behind the mirror) M1 after mirror therapy, which is not mediated by IHI.

Mirror, mirror on the wall: viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability

Findings provide neurophysiological evidence supporting the application of mirror therapy in stroke rehabilitation and interaction of these effects within M1 may account for recent research suggesting improved functional recovery of the impaired arm following stroke by viewing a mirror reflection of movements of the unimpaired arm superimposed over the (unseen) impaired arm.