A comparison of neural mechanisms in mirror therapy and movement observation therapy.

OBJECTIVE To compare lateralized cerebral activations elicited during self-initiated movement mirroring and observation of movements. SUBJECTS A total of 15 right-handed healthy subjects, age range 22-56 years. METHODS Functional imaging study comparing movement mirroring with movement observation, in both hands, in an otherwise identical setting. Imaging data were analysed using statistical parametric mapping software, with significance threshold set at p < 0.01 (false discovery rate) and a minimum cluster size of 20 voxels. RESULTS Movement mirroring induced additional activation in primary and higher-order visual areas strictly contralateral to the limb seen by the subject. There was no significant difference of brain activity when comparing movement observation of somebody else's right hand with left hand. CONCLUSION Lateralized cerebral activations are elicited by inversion of visual feedback (movement mirroring), but not by movement observation.