Dataset Information

Longitudinal Follow-Up of Mirror Movements after Stroke: A Case Study.

ABSTRACT: Mirror movement (MM), or visible involuntary movements of a relaxed hand during voluntary fine finger movements of an activated opposite hand, can be observed in the hand that is on the unaffected side of patients with stroke. In the present study, we longitudinally examined the relationship between voluntary movement of the affected hand and MM in the unaffected hand in a single case. We report a 73-year-old woman with a right pontine infarct and left moderate hemiparesis. MM was observed as an extension movement of the unaffected right index finger during extension movement of the affected left index finger. The affected right index movement was found to increase, while MM of the unaffected left index finger was observed to decrease with time. These results indicate that the assessment of MM might be useful for studying the process of motor recovery in patients with stroke.

SUBMITTER: Ohtsuka H

PROVIDER: S-EPMC4663000 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Longitudinal Follow-Up of Mirror Movements after Stroke: A Case Study.

Ohtsuka Hiroyuki H Matsuzawa Daisuke D Ishii Daisuke D Shimizu Eiji E

Case reports in neurological medicine 20151115

Mirror movement (MM), or visible involuntary movements of a relaxed hand during voluntary fine finger movements of an activated opposite hand, can be observed in the hand that is on the unaffected side of patients with stroke. In the present study, we longitudinally examined the relationship between voluntary movement of the affected hand and MM in the unaffected hand in a single case. We report a 73-year-old woman with a right pontine infarct and left moderate hemiparesis. MM was observed as an ...[more]

PMID: 26649211

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Project description:Following a stroke, mirror movements are unintended movements that appear in the non-paretic hand when the paretic hand voluntarily moves. Mirror movements have previously been linked to overactivation of sensorimotor areas in the non-lesioned hemisphere. In this study, we hypothesized that mirror movements might instead have a subcortical origin, and are the by-product of subcortical motor pathways upregulating their contributions to the paretic hand. To test this idea, we first characterized the time course of mirroring in 53 first-time stroke patients, and compared it to the time course of activities in sensorimotor areas of the lesioned and non-lesioned hemispheres (measured using functional MRI). Mirroring in the non-paretic hand was exaggerated early after stroke (Week 2), but progressively diminished over the year with a time course that parallelled individuation deficits in the paretic hand. We found no evidence of cortical overactivation that could explain the time course changes in behaviour, contrary to the cortical model of mirroring. Consistent with a subcortical origin of mirroring, we predicted that subcortical contributions should broadly recruit fingers in the non-paretic hand, reflecting the limited capacity of subcortical pathways in providing individuated finger control. We therefore characterized finger recruitment patterns in the non-paretic hand during mirroring. During mirroring, non-paretic fingers were broadly recruited, with mirrored forces in homologous fingers being only slightly larger (1.76 times) than those in non-homologous fingers. Throughout recovery, the pattern of finger recruitment during mirroring for patients looked like a scaled version of the corresponding control mirroring pattern, suggesting that the system that is responsible for mirroring in controls is upregulated after stroke. Together, our results suggest that post-stroke mirror movements in the non-paretic hand, like enslaved movements in the paretic hand, are caused by the upregulation of a bilaterally organized subcortical system.

Dataset Information

Longitudinal Follow-Up of Mirror Movements after Stroke: A Case Study.

Publications

Longitudinal Follow-Up of Mirror Movements after Stroke: A Case Study.

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