Human Motor Plasticity Induced by Mirror Visual Feedback
Human Motor Plasticity Induced by Mirror Visual Feedback
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DOI：
10.1523/jneurosci.5364-11.2012
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发表时间：
2012-01-25
影响因子：
5.3
通讯作者：
Kawamata, Toshio
中科院分区：
文献类型：
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作者：
Nojima, Ippei;Mima, Tatsuya;Kawamata, Toshio
镜像视觉反馈（MVF）的临床应用最初是为了减轻幻肢痛，后来被应用于改善中风后的轻偏瘫。然而，目前尚不清楚MVF是否可以通过在人类初级运动皮层（M1）中产生塑性变化来恢复运动功能。在这里，我们使用经颅磁刺激来测试M1可塑性是否是MVF诱导的运动行为改善的生理基质。在正常志愿者中使用镜盒进行MVF干预，改善了运动行为，增强了M1的兴奋功能。此外，行为和生理措施的MVF引起的变化呈正相关。观察一个简单的动作后，运动表现得到改善，但在没有MVF的非目标手重复运动训练后，运动表现没有改善，这表明视觉反馈的重要性。MVF的有益作用被M1上的连续θ脉冲串刺激（cTBS）破坏，但不是枕叶皮质中的对照部位。然而，cTBS后MVF可进一步改善运动功能。我们的研究结果表明，M1可塑性，特别是在其兴奋性连接，是MVF为基础的治疗的一个重要组成部分。
The clinical use of mirror visual feedback (MVF) was initially introduced to alleviate phantom pain, and has since been applied to the improvement of hemiparesis following stroke. However, it is not known whether MVF can restore motor function by producing plastic changes in the human primary motor cortex (M1). Here, we used transcranial magnetic stimulation to test whether M1 plasticity is a physiological substrate of MVF-induced motor behavioral improvement. MVF intervention in normal volunteers using a mirror box improved motor behavior and enhanced excitatory functions of the M1. Moreover, behavioral and physiological measures of MVF-induced changes were positively correlated with each other. Improved motor performance occurred after observation of a simple action, but not after repetitive motor training of the nontarget hand without MVF, suggesting the crucial importance of visual feedback. The beneficial effects of MVF were disrupted by continuous theta burst stimulation (cTBS) over the M1, but not the control site in the occipital cortex. However, MVF following cTBS could further improve the motor functions. Our findings indicate that M1 plasticity, especially in its excitatory connections, is an essential component of MVF-based therapies.