Mirror Therapy: Using Mirror Neurons to Treat Stroke
Mirror neurons are cells in the brain that activate when someone observes another person performing the same action. The overarching network of these neurons, also known as the mirror system, was first identified in the prefrontal cortical regions of monkeys through experiments where they watched other monkeys and lab members complete various tasks. The activation of a specific set of neurons in this region occurred when the monkey observed a distinct, meaningful behavior, indicating a neural underpinning for how animals understand the purposes of other animals’ actions.
Recent research relating to mirror neurons has focused on examining clinical applications of the mirror system, especially in therapeutic contexts. These interventions fall under the umbrella category of mirror therapy, a non-invasive form of therapy that uses visual feedback to promote recovery from various injuries and conditions such as stroke, Parkinsons, phantom limb pain, osteoarthritis, fibromyalgia, and complex regional pain syndrome.
One recent study from 2024 has examined a new application of mirror therapy, one that uses a variant of the “mirror box” to apply the therapy in different conditions for individuals with stroke and osteoarthritis. The mirror box, invented in 1996 to reduce phantom limb pain in patients with amputations, gives patients the illusion that an amputated limb is still there and relies on the activation of mirror neurons to convince the brain to reduce the body's sensation of pain. Today, the mirror box is an essential component of mirror therapy.
The designed device in the 2024 study, like the original mirror box, implemented therapy based on a credibly visualized image (one that would make the user feel their affected limb as if it were normal) and visual feedback that would hopefully cue the activation of mirror neurons. In this experiment, an observing therapist provided commentary on the participants’ movements as they were being projected onto a monitor.
Recent research relating to mirror neurons has focused on examining clinical applications of the mirror system, especially in therapeutic contexts. These interventions fall under the umbrella category of mirror therapy, a non-invasive form of therapy that uses visual feedback to promote recovery from various injuries and conditions such as stroke, Parkinsons, phantom limb pain, osteoarthritis, fibromyalgia, and complex regional pain syndrome.
One recent study from 2024 has examined a new application of mirror therapy, one that uses a variant of the “mirror box” to apply the therapy in different conditions for individuals with stroke and osteoarthritis. The mirror box, invented in 1996 to reduce phantom limb pain in patients with amputations, gives patients the illusion that an amputated limb is still there and relies on the activation of mirror neurons to convince the brain to reduce the body's sensation of pain. Today, the mirror box is an essential component of mirror therapy.
The designed device in the 2024 study, like the original mirror box, implemented therapy based on a credibly visualized image (one that would make the user feel their affected limb as if it were normal) and visual feedback that would hopefully cue the activation of mirror neurons. In this experiment, an observing therapist provided commentary on the participants’ movements as they were being projected onto a monitor.
When using a mirror box, the visual feedback from the hand reflects off of the mirror. The visual feedback combines with the activation of mirror neurons to encourage recovery in the affected limb, which is usually hidden from the patient’s view.
Image Source: Pixabay
The first assessment in the study included individuals who were diagnosed with hemiparesis after ischemic stroke. During the treatment, individuals would flex and extend their fingers and wrists and gradually complete more and more complex tasks such as grasping and reaching for objects. The second assessment involved individuals with hand osteoarthritis who completed the same fine motor skills as the first group. For both groups, an image of their healthy limb was reflected off the mirror and visualized in real-time, and they were unable to see their affected limb (the one being instructed to complete the actions).
Observations of the subjects following the mirror therapy included a reduction in tremors, improvements in movement coordination and grasping, faster learning of opposability (placing one body part opposite to its corresponding part), reduction in pain, increased elasticity of the hand, and higher reported levels of concentration and motivation. The primary improvement specific to the hemiparetic group was functional hand recovery, and the primary improvement for the osteoarthritic group was pain relief. Overall, subjects reported that the visualized image gave them the feeling that they could truly move their affected limb.
Ultimately, this study not only confirmed an enduring understanding of the significance of implicating mirror neurons in the treatment of physical and psychological conditions, but it also added multiple new means of improving treatment effectiveness, such as structural modifications for patient comfort and 3D glasses to help patients with focusing on the images.
Hopefully, related research will continue examining the mirror box and discover ways in which its features can be improved for clinical and therapeutic use. In this way, mirror therapy can be applied to an even greater population with an increasingly diverse set of conditions.
Observations of the subjects following the mirror therapy included a reduction in tremors, improvements in movement coordination and grasping, faster learning of opposability (placing one body part opposite to its corresponding part), reduction in pain, increased elasticity of the hand, and higher reported levels of concentration and motivation. The primary improvement specific to the hemiparetic group was functional hand recovery, and the primary improvement for the osteoarthritic group was pain relief. Overall, subjects reported that the visualized image gave them the feeling that they could truly move their affected limb.
Ultimately, this study not only confirmed an enduring understanding of the significance of implicating mirror neurons in the treatment of physical and psychological conditions, but it also added multiple new means of improving treatment effectiveness, such as structural modifications for patient comfort and 3D glasses to help patients with focusing on the images.
Hopefully, related research will continue examining the mirror box and discover ways in which its features can be improved for clinical and therapeutic use. In this way, mirror therapy can be applied to an even greater population with an increasingly diverse set of conditions.
Featured Image Source: ColiN00B
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