Objective: To exploit the motor resonance mechanism of the mirror neuron system (MR-MNS) [1] in the rehabilitation of Cervical Dystonia (CD), we investigated its functional integrity in a group of CD patients.

Background: Cervical Dystonia (CD) is a movement disorder characterized by involuntary movements and postures of head and neck that, in the absence of clear brain damage, determines faulty sensorimotor integration and impaired motor planning. CD affects daily and social life activities. The botulinum toxin is the first line treatment with clinical improvement in about 60% of the patients. Nevertheless, to improve long term prognosis rehabilitative approaches are needed.Currently, new rehabilitative interventions are available based on MR-MNS: the action observation treatment. These rehabilitative approaches have proved to be useful in stroke [2] and Parkinson’s disease [3] but no data are available in patients with CD.

Method: Twenty-five healthy adults (HC, mean age [SD]= 56.12 [20.04]; 15 females) and 22 subjects with CD (mean age [SD]= 46.95 [9.19] 15 females) were enrolled. All subjects received a functional MRI (fMRI) exam on a 1.5 scanner. The fMRI task consisted of 2 runs: 1. subjects observed (“Observe” condition) and 2.subjects executed right hand grasping movements (“Move” condition), as in [4]. fMRI data were analysed with SPM12, according to the General Linear Model. A mixed factorial ANOVA, Group (2 levels: HC, CD) by Task (2 levels: Move, Observe), was carried out. To identify MNS, a conjunction analysis was performed between activations of the two conditions “Move” and “Observe”, separately for each group using an inclusive mask with both conditions (p<0.05 FWE corrected).

Results: No significant differences between the two groups were found in terms of age. Despite the visual inspection of fMRI data suggested a different pattern of activation in the ventral premotor cortex and cerebellum between the two groups, the statistical analysis did not show significant differences.

Conclusion: Our results showed substantial preservation of the MNS in CD. Differences in the activation of the ventral premotor and cerebellum cortices were not statistically significant. To better investigate this issue a larger sample size will be necessary in future studies. This data suggest the possibility to implement motor control and rehabilitation exercises based on the execution/observation matching system.

References: [1] Rizzolatti, G., & Craighero, L. (2004). The mirror-neuron system. Annu. Rev. Neurosci., 27, 169-192. [2] Carvalho, D., Teixeira, S., Lucas, M., Yuan, T. F., Chaves, F., Peressutti, C., … & Velasques, B. (2013). The mirror neuron system in post-stroke rehabilitation. International archives of medicine, 6(1), 41. [3] Buccino, G., Gatti, R., Giusti, M. C., Negrotti, A., Rossi, A., Calzetti, S., & Cappa, S. F. (2011). Action observation treatment improves autonomy in daily activities in Parkinson’s disease patients: results from a pilot study. Movement Disorders, 26(10), 1963-1964. [4] Cabinio, M., Blasi, V., Borroni, P., Montagna, M., Iadanza, A., Falini, A., & Cerri, G. (2010). The shape of motor resonance: right-or left-handed? Neuroimage, 51(1), 313-323.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/integrity-of-mirror-neuron-system-in-cervical-dystonia-an-fmri-study/