Abstract
BackgroundObservation of a goal-directed motor action can excite the respective mirror neurons, and this is the theoretical basis for action observation (AO) as a novel tool for functional recovery during stroke rehabilitation. To explore the therapeutic potential of AO for dysphagia, we conducted a task-based functional magnetic resonance imaging (fMRI) study to identify the brain areas activated during observation and execution of swallowing in healthy participants.MethodsTwenty-nine healthy volunteers viewed the following stimuli during fMRI scanning: an action-video of swallowing (condition 1, defined as AO), a neutral image with a Chinese word for “watching” (condition 2), and a neutral image with a Chinese word for “swallowing” (condition 3). Action execution (AE) was defined as condition 3 minus condition 2. One-sample t-tests were performed to define the brain regions activated during AO and AE.ResultsMany brain regions were activated during AO, including the middle temporal gyrus, inferior frontal gyrus, pre- and postcentral gyrus, supplementary motor area, hippocampus, brainstem, and pons. AE resulted in activation of motor areas as well as other brain areas, including the inferior parietal lobule, vermis, middle frontal gyrus, and middle temporal gyrus. Two brain areas, BA6 and BA21, were activated with both AO and AE.ConclusionThe left supplementary motor area (BA6) and left middle temporal gyrus (BA21), which contains mirror neurons, were activated in both AO and AE of swallowing. In this study, AO activated mirror neurons and the swallowing network in healthy participants, supporting its potential value in the treatment of dysphagia.
Highlights
Mirror neurons are a specific neuronal population that discharge during the performance of a particular action, and during observation of others performing a similar action (Cook et al, 2014; Marshall, 2014)
In addition to the intrinsic advantage of functional magnetic resonance imaging (fMRI) for extracting deep or multiple blood oxygen level-dependent (BOLD) signals, we considered that observation of the action-video for a daily performance activity may be better than animation or auditory stimuli for activating the brain regions of mirror neurons related to swallowing
The present study provided a simple comparison of neuronal correlates between mirror neurons and the swallowing network, and showed that the left supplementary motor area (BA6) and left middle temporal gyrus (BA21) may be foundational to the role of action observation (AO) in treatment for dysphagia
Summary
Mirror neurons are a specific neuronal population that discharge during the performance of a particular action, and during observation of others performing a similar action (Cook et al, 2014; Marshall, 2014). Action observation (AO), in which patients observe a specific video describing an action to recruit the relevant action-related mirror neurons and enable a direct matching between others’ gestures and their own motor system, has emerged as a novel and effective option as an add-on intervention to rehabilitation therapy (Hetu et al, 2010; Sale and Mattingley, 2013; Bassolino et al, 2014; Vesia et al, 2019) To date, this approach has been successfully applied in the rehabilitation of upper limb motor functions in chronic stroke patients (Borges et al, 2018), in the language rehabilitation of post-stroke aphasia patients (Gili et al, 2017), in motor recovery of Parkinson’s disease patients (Pelosin et al, 2013), including those presenting with freezing of gait (Pelosin et al, 2018), and in children with cerebral palsy (Kirkpatrick et al, 2016). To explore the therapeutic potential of AO for dysphagia, we conducted a task-based functional magnetic resonance imaging (fMRI) study to identify the brain areas activated during observation and execution of swallowing in healthy participants
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