Cortical mapping of mirror visual feedback training for unilateral upper extremity: A functional near-infrared spectroscopy study

Zhongfei Bai, Kenneth N K Fong, Jiaqi Zhang, Zhishan Hu, Zhongfei Bai, Kenneth N K Fong, Jiaqi Zhang, Zhishan Hu

Abstract

Introduction: Mirror therapy has been shown to be effective in promoting hemiplegic arm recovery in patients with stroke or unilateral cerebral palsy. This study aimed to explore the cortical mapping associated with mirror therapy in a group of healthy adults by using functional near-infrared spectroscopy.

Methods: Fifteen right-handed healthy adults were recruited by means of convenience sampling. A 2 × 2 factorial design was used: movement complexity with two levels-task-based (T) and movement-based (M), and visual direction with two levels-mirror visual feedback task (MT) and covered mirror with normal visual feedback task (NoT) as the control, constituting four conditions, namely TMT, MMT, TNoT, and MNoT. The regions of interest were the sensorimotor cortex (SMC), the supplementary motor area (SMA), the superior parietal cortex (SPL), and the precuneus in both the contralateral and ipsilateral hemispheres.

Results: Our findings showed that in the ipsilateral hemisphere, MT induced a higher activation in the SMA and SPL than NoT. With regard to the activation of the ipsilateral SMC, only one channel was found showing superior effects of MT compared with NoT. In addition, MT can strengthen the functional connectivity between the SMC and SMA. In the contralateral hemisphere, both movement complexity and visual direction showed significant main effects in the SMC, while only movement complexity showed a significant main effect in the SMA and SPL. The precuneus of both sides was deactivated and showed no significant difference among the four conditions.

Conclusions: Our experiment implies that the modest activation of ipsilateral SMC during MT is likely to be associated with the enhanced activity of ipsilateral SMA and that the precuneus may not be an essential component of the MT-related neural network.

Keywords: deactivation; functional near-infrared spectroscopy; mirror therapy; mirror visual feedback; precuneus; sensorimotor cortex; supplementary motor area.

© 2019 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

Figures

Figure 1
Figure 1
Experimental design. (a) Experimental setup. (b) Experimental design. MMT, movement‐based mirror therapy; MNoT, movement‐based with normal visual feedback; TMT, task‐based mirror therapy; TNoT, task‐based with normal visual feedback
Figure 2
Figure 2
Arrangement of fNIRS channels. (a) Two 3 × 3 and one 3 × 5 optode probe sets. (b) The locations of channels in the MNI standard brain template
Figure 3
Figure 3
Post hoc analysis and baseline‐corrected time course curves. The bar charts show the post hoc paired t test analysis, and the line charts show the baseline‐corrected time course curves between −5 and 40 s relative to the onset of tasks. *: Post hoc analysis which passed the Bonferroni correction at p ≤ .013 (0.05/4; 4 = number of comparisons); CH, channel; MMT, movement‐based mirror therapy; MNoT, movement‐based with normal visual feedback; PC, precuneus; ROI, region of interest‐based analysis; SMA, supplementary motor area; SMC, sensorimotor cortex; TMT, task‐based mirror therapy; TNoT, task‐based with normal visual feedback [Correction added on 20 December 2019, after first online publication: Figure 3 has been updated and p values in caption have been corrected.]
Figure 4
Figure 4
The differences of functional connectivity among conditions. a, b, e, and f show the significant functional connectivity of task‐based mirror therapy (TMT), movement‐based mirror therapy (MMT), task‐based with normal visual feedback (TNoT), and movement‐based with normal visual feedback (MNoT), respectively. c, d, g, h, i, and j show comparisons between conditions. “>” means functional connectivity whose left condition is stronger than right condition. PC, precuneus; SMA, supplementary motor area; SMC, sensorimotor cortex

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