Mirror Illusion Research Articles

What’s left of the mirror illusion when the mirror can no longer be seen? Bilateral integration of proprioceptive afferents!

Recent data suggest that manipulating the muscle afferents of one arm affects both ipsilateral and contralateral perceptual estimates. Here, we used the mirror paradigm to study the bimanual integration of kinesthetic muscle afferents. The reflection of a moving hand in a mirror positioned in the sagittal plane creates an illusion of symmetrical bimanual movement. Although vision clearly has a role in kinesthesia, its role in the mirror illusion might have been overestimated. Conversely, the role of bimanual integration of muscle afferents might have been underestimated. We hypothesized that muscle-proprioceptive afferents of the passively displaced arm (the image of which was reflected in the mirror) are involved in this illusion. We evoked in 19 healthy adult participants the mirror illusion by displacing passively their left arm, the image of which was reflected in the mirror. Once participants experienced the illusion that their hidden right arm was moving, we then either occluded their view of the mirror (using occlusive glasses) and/or prevent the passive left arm displacement. Participants’ illusion characteristics (duration and kinematic) under these conditions were compared with classical mirror illusion (without visual occlusion). We found that as long as the arm was still moving, the kinesthetic illusion decayed slowly after visual occlusion. These findings suggest that the mirror illusion results from the combination of visuo-proprioceptive signals from the two arms and is not purely visual in origin. Our findings also support the more general concept whereby proprioceptive afferents are integrated bilaterally for the purpose of kinesthesia during bimanual tasks.

The neuronal correlates of mirror illusion in children with spastic hemiparesis: a study with functional magnetic resonance imaging.

To investigate the neuronal activation pattern underlying the effects of mirror illusion in children/adolescents with normal motor development and in children/adolescents with hemiparesis and preserved contralateral corticospinal organisation. The type of cortical reorganisation was classified according to results of transcranial magnetic stimulation. Only subjects with congenital lesions and physiological contralateral cortical reorganisation were included. Functional magnetic resonance imaging was performed to investigate neuronal activation patterns with and without a mirror box. Each test consisted of a unimanual and a bimanual motor task. Seven children/adolescents with congenital hemiparesis (10-20 years old, three boys and four girls) and seven healthy subjects (8-17 years old, four boys and three girls) participated in this study. In the bimanual experiment, children with hemiparesis showed a significant effect of the mirror illusion (p<0.001 at voxel level, family-wise error corrected at cluster level) in the dorsolateral prefrontal cortex and anterior cingulate cortex of the affected and unaffected hemispheres, respectively. No significant effects of the mirror illusion were observed in unimanual experiments and in healthy participants. Mirror illusion in children/adolescents with hemiparesis leads to activation of brain areas involved in visual conflict detection and cognitive control to resolve this conflict. This effect is observed only in bimanual training. We consider that for mirror therapy in children and adolescents with hemiparesis a bimanual approach is more suitable than a unimanual approach.

Body Schema Illusions: A Study of the Link between the Rubber Hand and Kinesthetic Mirror Illusions through Individual Differences.

Background The well-known rubber hand paradigm induces an illusion by having participants feel the touch applied to a fake hand. In parallel, the kinesthetic mirror illusion elicits illusions of movement by moving the reflection of a participant's arm. Experimental manipulation of sensory inputs leads to emergence of these multisensory illusions. There are strong conceptual similarities between these two illusions, suggesting that they rely on the same neurophysiological mechanisms, but this relationship has never been investigated. Studies indicate that participants differ in their sensitivity to these illusions, which provides a possibility for studying the relationship between these two illusions. Method We tested 36 healthy participants to confirm that there exist reliable individual differences in sensitivity to the two illusions and that participants sensitive to one illusion are also sensitive to the other. Results The results revealed that illusion sensitivity was very stable across trials and that individual differences in sensitivity to the kinesthetic mirror illusion were highly related to individual differences in sensitivity to the rubber hand illusion. Conclusions Overall, these results support the idea that these two illusions may be both linked to a transitory modification of body schema, wherein the most sensitive people have the most malleable body schema.

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

Background. Mirror therapy provides a visual illusion of a normal moving limb by using the mirror reflection of the unaffected arm instead of viewing the paretic limb and is used in rehabilitation to improve hand function. Little is known about the mechanism underlying its effect in children with hemiparesis. Objective. To investigate the effect of the mirror illusion (MI) on the excitability of the primary motor cortex (M1) in children and adolescents. Methods. Twelve patients with hemiparesis (10-20 years) and 8 typically developing subjects (8-17 years) participated. Corticospinal reorganization was classified as contralateral (projection from contralateral hemisphere to affected hand) or ipsilateral (projection from ipsilateral hemisphere to affected hand). M1 excitability of the hemisphere projecting to the affected (nondominant in typically developing subjects) hand was obtained during 2 different conditions using single-pulse transcranial magnetic stimulation (TMS). Each condition (without/with mirror) consisted of a unimanual and a bimanual task. Motor-evoked potentials (MEPs) were recorded from the abductor pollicis brevis and flexor digitorum superficialis muscles. Results. MEP amplitudes were significantly increased during the mirror condition (P = .005) in typically developing subjects and in patients with contralateral reorganization. No significant effect of MI was found in subjects with ipsilateral reorganization. MI increased M1 excitability during active movements only. This increase was not correlated to hand function. Conclusion. MI increases the excitability of M1 in hemiparetic patients with contralateral corticospinal organization and in typically developing subjects. This finding provides neurophysiological evidence supporting the application of mirror therapy in selected children and adolescents with hemiparesis.

Visualization Method for Proprioceptive Drift on a 2D Plane Using Support Vector Machine.

Proprioceptive drift, which is a perceptual shift in body-part position from the unseen real body to a visible body-like image, has been measured as the behavioral correlate for the sense of ownership. Previously, the estimation of proprioceptive drift was limited to one spatial dimension, such as height, width, or depth. As the hand can move freely in 3D, measuring proprioceptive drift in only one dimension is not sufficient for the estimation of the drift in real life situations. In this article, we provide a novel method to estimate proprioceptive drift on a 2D plane using the mirror illusion by combining an objective behavioral measurement (hand position tracking) and subjective, phenomenological assessment (subjective assessment of hand position and questionnaire) with a sophisticated machine learning approach. This technique permits not only an investigation of the underlying mechanisms of the sense of ownership and agency but also assists in the rehabilitation of a missing or paralyzed limb and in the design rules of real-time control systems with a self-body-like usability, in which the operator controls the system as if it were part of his/her own body.

Mirror therapy in children with hemiparesis: a randomized observer-blinded trial.

To determine the efficacy of mirror therapy in children with hemiparesis. The design was an observer-blinded parallel-group randomized controlled trial (International Standard Randomised Controlled Trial Number 48748291). Randomization was computer-generated, 1:1 allocation to mirror therapy or comparison groups. The settings were home-based intervention and tertiary centre assessments. Participants were 90 children with hemiparesis aged 7 to 17 years. Intervention was 15 minutes per day of simultaneous arm training, 5 days a week, for 5 weeks. The mirror therapy group used a mirror; those in the comparison group looked at their paretic limb. Assessments comprised measures of upper limb strength, function (Melbourne Assessment 2), daily performance (ABILHAND-Kids), and sensory function at weeks 0 (T0 ), 5 (T1 ), and 10 (T2 ). There were no significant differences in outcomes and their progression over time between the mirror therapy and comparison groups. Post-hoc intention-to-treat analyses showed significant improvements in both groups for grasp strength (T0 -T1 +12.6%), pinch strength (T0 -T2 +9.1%), upper limb function in terms of accuracy (T0 -T2 +2.7%) and fluency (T0 -T2 +5.0%), as well as daily performance (T0 -T2 +16.6%). Per protocol analyses showed additional improvements in dexterity (T0 -T2 +4.0%). The use of the mirror illusion during therapy had no significant effect on treatment outcomes. However, 5 weeks of daily simultaneous arm training significantly improved paretic upper limb strength, function, and daily use.

The kinaesthetic mirror illusion: How much does the mirror matter?

The reflection of a moving hand in a mirror positioned in the sagittal plane can create an illusion of symmetrical, bimanual movement. This illusion is implicitly presumed to be of visual origin. However, muscle proprioceptive afferents of the arm reflected in the mirror might also affect the perceived position and movement of the other arm. We characterized the relative contributions of visual and proprioceptive cues by performing two experiments. In Experiment 1, we sought to establish whether kinaesthetic illusions induced using the mirror paradigm would survive marked visual impoverishment (obtained by covering between 0 and 100% of the mirror in 16% steps). We found that the mirror illusion was only significantly influenced when the visual degradation was 84% or more. In Experiment 2, we masked the muscle proprioceptive afferents of the arm reflected in the mirror by co-vibrating antagonistic muscles. We found that masking the proprioceptive afferents reduced the velocity of the illusory displacement of the other arm. These results confirm that the mirror illusion is not a purely visual illusion but emerges from a combination of congruent signals from the two arms, i.e. visual afferents from the virtually moving arm and proprioceptive afferents from the contralateral, moving arm.

Potential determinants of efficacy of mirror therapy in stroke patients--A pilot study.

Background: Mirror therapy (MT) was found to improve motor function after stroke. However, there is high variability between patients regarding motor recovery. Objectives: The following pilot study was designed to identify potential factors determining this variability between patients with severe upper limb paresis, receiving MT. Methods: Eleven sub-acute stroke patients with severe upper limb paresis participated, receiving in-patient rehabilitation. After a set of pre-assessments (including measurement of brain activity at the primary motor cortex and precuneus during the mirror illusion, using near-infrared spectroscopy as described previously), four weeks of MT were applied, followed by a set of post-assessments. Discriminant group analysis for MT responders and non-responders was performed. Results: Six out of eleven patients were defined as responders and five as non-responders on the basis of their functional motor improvement. The initial motor function and the activity shift in both precunei (mirror index) were found to discriminate significantly between responders and non-responders. Conclusions: In line with earlier results, initial motor function was confirmed as crucial determinant of motor recovery. Additionally, activity response to the mirror illusion in both precunei was found to be a candidate for determination of the efficacy of MT.

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.

Since its original proposal, mirror therapy has been established as a successful neurorehabilitative intervention in several neurological disorders to recover motor function or to relieve pain. Mirror therapy seems to operate by reactivating the contralesional representation of the non-mirrored limb in primary motor- and somatosensory cortex. However, mirror boxes have some limitations which prompted the use of additional mirror visual feedback devices. The present study evaluated the utility of mirror glasses compared to a mirror box. We also tested the hypothesis that increased interhemispheric communication between the motor hand areas is the mechanism by which mirror visual feedback recruits the representation of the non-mirrored limb. Therefore, mirror illusion capacity and brain activations were measured in a within-subject design during both mirror visual feedback conditions in counterbalanced order with 20 healthy subjects inside a magnetic resonance imaging scanner. Furthermore, we analyzed task-dependent functional connectivity between motor hand representations using psychophysiological interaction analysis during both mirror tasks. Neither the subjective quality of mirror illusions nor the patterns of functional brain activation differed between the mirror tasks. The sensorimotor representation of the non-mirrored hand was recruited in both mirror tasks. However, a significant increase in interhemispheric connectivity between the hand areas was only observed in the mirror glasses condition, suggesting different mechanisms for the recruitment of the representation of the non-mirrored hand in the two mirror tasks. We conclude that the mirror glasses might be a promising alternative to the mirror box, as they induce similar patterns of brain activation. Moreover, the mirror glasses can be easy applied in therapy and research. We want to emphasize that the neuronal mechanisms for the recruitment of the affected limb representation might differ depending on conceptual differences between MVF devices. However, our findings need to be validated within specific patient groups.

Enhancing the mirror illusion with transcranial direct current stimulation

Visual feedback has a strong impact on upper-extremity movement production. One compelling example of this phenomena is the mirror illusion (MI), which has been used as a treatment for post-stroke movement deficits (mirror therapy). Previous research indicates that the MI increases primary motor cortex excitability, and this change in excitability is strongly correlated with the mirror’s effects on behavioral performance of neurologically-intact controls. Based on evidence that primary motor cortex excitability can also be increased using transcranial direct current stimulation (tDCS), we tested whether bilateral tDCS to the primary motor cortices (anode right-cathode left and anode left-cathode right) would modify the MI. We measured the MI using a previously-developed task in which participants make reaching movements with the unseen arm behind a mirror while viewing the reflection of the other arm. When an offset in the positions of the two limbs relative to the mirror is introduced, reaching errors of the unseen arm are biased by the reflected arm’s position. We found that active tDCS in the anode right-cathode left montage increased the magnitude of the MI relative to sham tDCS and anode left-cathode right tDCS. We take these data as a promising indication that tDCS could improve the effect of mirror therapy in patients with hemiparesis.

The mirror illusion: does proprioceptive drift go hand in hand with sense of agency?

Vection can be regarded as the illusion of “whole-body” position perception. In contrast, the mirror illusion is that of “body-part” position perception. When participants viewed their left hands in a mirror positioned along the midsaggital axis while moving both hands synchronously, they hardly noticed the spatial offset between the hand in the mirror and the obscured real right hand. This illusion encompasses two phenomena: proprioceptive drift and sense of agency. Proprioceptive drift represented a perceptual change in the position of the obscured hand relative to that of the hand in the mirror. Sense of agency referred to the participants' subjective sense of controlling body image as they would their own bodies. We examined the spatial offset between these two phenomena. Participants responded to a two-alternative forced choice (2AFC) question regarding the subjective position of their right hands and questionnaires regarding sense of agency at various positions of the right hand. We analyzed the 2AFC data using a support vector machine and compared its classification result and the questionnaire results. Our data analysis suggested that the two phenomena were observed in concentric space, but the estimated range of the proprioceptive drift was slightly narrower than the range of agency. Although this outcome can be attributed to differences in measurement or analysis, to our knowledge, this is the first report to suggest that proprioceptive drift and sense of agency are concentric and almost overlap.

Kinaesthetic mirror illusion and spatial congruence.

Position sense and kinaesthesia are mainly derived from the integration of somaesthetic and visual afferents to form a single, coherent percept. However, visual information related to the body can play a dominant role in these perceptual processes in some circumstances, and notably in the mirror paradigm. The objective of the present study was to determine whether or not the kinaesthetic illusions experienced in the mirror paradigm obey one of the key rules of multisensory integration: spatial congruence. In the experiment, the participant's left arm (the image of which was reflected in a mirror) was either passively flexed/extended with a motorized manipulandum (to induce a kinaesthetic illusion in the right arm) or remained static. The right (unseen) arm remained static but was positioned parallel to the left arm's starting position or placed in extension (from 15° to 90°, in steps of 15°), relative to the left arm's flexed starting position. The results revealed that the frequency of the illusion decreased only slightly as the incongruence prior to movement onset between the reflected left arm and the hidden right arm grew and remained quite high even in the most incongruent settings. However, the greater the incongruence between the visually and somaesthetically specified positions of the right forearm (from 15° to 90°), the later the onset and the lower the perceived speed of the kinaesthetic illusion. Although vision dominates perception in a context of visuoproprioceptive conflict (as in the mirror paradigm), our results show that the relative weightings allocated to proprioceptive and visual signals vary according to the degree of spatial incongruence prior to movement onset.

Mirror illusion reduces motor cortical inhibition in the ipsilateral primary motor cortex during forceful unilateral muscle contractions.

Forceful, unilateral contractions modulate corticomotor paths targeting the resting, contralateral hand. However, it is unknown whether mirror-viewing of a slowly moving but forcefully contracting hand would additionally affect these paths. Here we examined corticospinal excitability and short-interval intracortical inhibition (SICI) of the right-ipsilateral primary motor cortex (M1) in healthy young adults under no-mirror and mirror conditions at rest and during right wrist flexion at 60% maximal voluntary contraction (MVC). During the no-mirror conditions neither hand was visible, whereas in the mirror conditions participants looked at the right hand's reflection in the mirror. Corticospinal excitability increased during contractions in the left flexor carpi radialis (FCR) (contraction 0.41 mV vs. rest 0.21 mV) and extensor carpi radialis (ECR) (contraction 0.56 mV vs. rest 0.39 mV), but there was no mirror effect (FCR: P = 0.743, ηp (2) = 0.005; ECR: P = 0.712, ηp (2) = 0.005). However, mirror-viewing of the contracting and moving wrist attenuated SICI relative to test pulse in the left FCR by ∼9% compared with the other conditions (P < 0.05, d ≥ 0.62). Electromyographic activity in the resting left hand prior to stimulation was not affected by the mirror (FCR: P = 0.255, ηp (2) = 0.049; ECR: P = 0.343, ηp (2) = 0.035) but increased twofold during contractions. Thus viewing the moving hand in the mirror and not just the mirror image of the nonmoving hand seems to affect motor cortical inhibitory networks in the M1 associated with the mirror image. Future studies should determine whether the use of a mirror could increase interlimb transfer produced by cross-education, especially in patient groups with unilateral orthopedic and neurological conditions.

The mirror illusion induces high gamma oscillations in the absence of movement

We tested whether mirror visual feedback (MVF) from a moving hand induced high gamma oscillation (HGO) response in the hemisphere contralateral to the mirror and ipsilateral to the self-paced movement. MEG was recorded in 14 subjects under three conditions: bilateral synchronous movements of both index fingers (BILATERAL), movements of the right hand index finger while observing the immobile left index finger (NOMIRROR), and movements of the right hand index finger while observing its mirror reflection (MIRROR). The right hemispheric spatiospectral regions of interests (ROIs) in the sensor space, sensitive to bilateral movements, were found by statistical comparison of the BILATERAL spectral responses to baseline. For these ROIs, the post-movement HGO responses were compared between the MIRROR and NOMIRROR conditions. We found that MVF from the moving hand, similarly to the real movements of the opposite hand, induced HGOs (55–85Hz) in the sensorimotor cortex. This MVF effect was frequency-specific and did not spread to oscillations in other frequency bands. This is the first study demonstrating movement-related HGO induced by MVF from the moving hand in the absence of proprioceptive feedback signaling. Our findings support the hypothesis that MVF can trigger the feedback-based control processes specifically associated with perception of one's own movements.

No. 102 Cerebral Activation Evoked by the Mirror Illusion of the Hand in Stroke Patients Compared to Normal Subjects

No. 102 Cerebral Activation Evoked by the Mirror Illusion of the Hand in Stroke Patients Compared to Normal Subjects

Mirror illusion triggers high gamma oscillations in the absence of movement

Mirror illusion triggers high gamma oscillations in the absence of movement

Mirror illusion reduces ipsilateral motor cortical inhibition in healthy young adults: implications for rehabilitation

Mirror illusion reduces ipsilateral motor cortical inhibition in healthy young adults: implications for rehabilitation

Different effects of the mirror illusion on motor and somatosensory processing

Mirror therapy can improve motor and sensory functions, but effects of the mirror illusion on primary motor and somatosensory cortex could not be established consistently. Fifteen right handed healthy volunteers performed or observed a finger-thumb opposition task. Cerebral activations during normal movement (NOR), mirrored movement (MIR) and movement observation (OBS) by means of a video chain were recorded with functional magnetic resonance imaging (fMRI). Activation sizes in movement > static conditions were identified using SPM8 (p < 0.001, unc.) and attributed to predefined areas employing the Anatomy toolbox 1.8. Laterality indices for the responsive areas were calculated on the basis of the number of activated voxels. Relevant bilateral BOLD responses were found in primary motor (M1) and somatosensory (S1 - BA 2, 3b and 3a) cortex, premotor and parietal areas and V5. When comparing MIR to NOR, no significant change of contralateral activation in M1 was found, but clearly at S1 with differences between hands. 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. These results suggest different effects of mirror therapy on processing and rehabilitation of motor and sensory function.

Cerebral activation evoked by the mirror illusion of the hand in stroke patients compared to normal subjects

Mirror therapy (MT) was found to improve motor function after stroke, but its neural mechanisms remain unclear, especially in single stroke patients. The following imaging study was designed to compare brain activation patterns evoked by the mirror illusion in single stroke patients with normal subjects. Fifteen normal volunteers and five stroke patients with severe arm paresis were recruited. Cerebral activations during movement mirroring by means of a video chain were recorded with functional magnetic resonance imaging (fMRI). Single-subject analysis was performed using SPM 8. For normal subjects, ten and thirteen subjects displayed lateralized cerebral activations evoked by the mirror illusion while moving their right and left hand respectively. The magnitude of this effect in the precuneus contralateral to the seen hand was not dependent on movement speed or subjective experience. Negative correlation of activation strength with age was found for the right hand only. The activation pattern in stroke patients is comparable to that of normal subjects and present in four out of five patients. In summary, the mirror illusion can elicit cerebral activation contralateral to the perceived hand in the majority of single normal subjects, but not in all of them. This is similar even in stroke patients with severe hemiparesis.

Scaling space with the mirror illusion: The influence of body plasticity on perceived affordances

How do body representations influence decisions about action? We developed a novel paradigm using the mirror illusion (Holmes, Crozier, & Spence, in Cognitive, Affective, & Behavioral Neuroscience, 4, 193-200, 2004) to examine two ways of evoking body plasticity-extension of body capabilities and visual capture-and its influence on perceived affordances. In two experiments, we manipulated the action capabilities of a seen left hand by lengthening the arm with a rod (Exp. 1) or enlarging the hand with a glove (Exp. 2). The right hand was unaltered physically and was occluded by placement in a mirror box. We induced visual capture through synchronous finger movements of both hands. Right-hand estimates of reaching and of fitting through apertures increased relative to actual capabilities during visual capture, supporting the claim that visual capture can induce the incorporation of an apparent body extension into action decisions. The results suggest that both perceptual and cognitive influences on bodily awareness underlie perceived affordances.