Numata Kenji, Murayama Takashi, Takasugi Jun, Monma Masahiko, Oga Masaru
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan.
Department of Physical Therapy for Adult, Chiba Rehabilitation Center, Chiba, Japan.
J Jpn Phys Ther Assoc. 2013;16(1):1-6. doi: 10.1298/jjpta.Vol16_001.
Mirror therapy can be used to promote recovery from paralysis in patients with post-stroke hemiplegia, There are a lot of reports that mirror-image observation of the unilateral moving hand enhanced the excitability of the primary motor area (M1) ipsilateral to the moving hand in healthy subjects. but the neural mechanisms underlying its therapeutic effects are currently unclear. To investigate this issue, we used functional magnetic resonance imaging to measure activity in brain regions related to visual information processing during mirror image movement observation. Thirteen healthy subjects performed a finger-thumb opposition task with the left and right hands separately, with or without access to mirror observation. In the mirror condition, one hand was reflected in a mirror placed above the abdomen in the MRI scanner. In the masked mirror condition, subjects performed the same task but with the mirror obscured. In both conditions, the other hand was held at rest behind the mirror. A between-task comparison (mirror versus masked mirror) revealed significant activation in the ipsilateral hemisphere in the anterior intraparietal sulcus (aIP) while performing all tasks, regardless of which hand was used. The right aIP was significantly activated while moving the right hand. In contrast, in the left aIP, a small number of voxels showed a tendency toward activation during both left and right hand movement. The enhancement of ipsilateral aIP activity by the mirror image observation of finger action suggests that bimodal aIP neurons can be activated by visual information. We propose that activation in the M1 ipsilateral to the moving hand can be induced by information passing through the ventral premotor area from the aIP.
镜像疗法可用于促进中风后偏瘫患者瘫痪的恢复。有许多报告表明,在健康受试者中,对单侧移动手进行镜像观察可增强与移动手同侧的初级运动区(M1)的兴奋性。但其治疗效果背后的神经机制目前尚不清楚。为了研究这个问题,我们使用功能磁共振成像来测量在镜像运动观察期间与视觉信息处理相关的脑区活动。13名健康受试者分别用左手和右手进行拇指对指任务,有或没有镜像观察。在镜像条件下,一只手在MRI扫描仪中通过放置在腹部上方的镜子反射。在遮罩镜像条件下,受试者执行相同任务,但镜子被遮挡。在两种条件下,另一只手在镜子后面保持静止。任务间比较(镜像与遮罩镜像)显示,在执行所有任务时,无论使用哪只手,同侧半球的前顶内沟(aIP)均有显著激活。在移动右手时,右侧aIP有显著激活。相比之下,在左侧aIP中,少数体素在左手和右手运动时均显示出激活趋势。通过手指动作的镜像观察增强同侧aIP活动表明,双模式aIP神经元可被视觉信息激活。我们提出,通过从aIP经腹侧运动前区传递的信息可诱导与移动手同侧的M1激活。