Advances in the Study of Mirror Neurons and Their Impact on Neuroscience: An Editorial.

The mirror neurons are complex neuronal circuits in the brain, and they respond to the actions that we observe in others. The mirror neurons constitute a revolutionary discovery in the field of neuroscience that has not only reshaped our understanding of social cognition and empathetic behavior but also bridged gaps in our comprehension of the human brain's intricate workings. This article aims to distill the crux of these groundbreaking discoveries and their transformative ramifications regarding our perception of human interactions and the advancement of neurorehabilitation techniques. The integration of non-invasive and patient-centric therapies into clinical practice underscores the immense potential that research on mirror neurons holds in enhancing patient outcomes and quality care. Research in mirror neurons will contribute significantly to the field of neuroscience, specifically neurorehabilitation.

Two distinct networks for encoding goals and forms of action: An effective connectivity study.

Goal-directed actions are characterized by two main features: the content (i.e., the action goal) and the form, called vitality forms (VF) (i.e., how actions are executed). It is well established that both the action content and the capacity to understand the content of another's action are mediated by a network formed by a set of parietal and frontal brain areas. In contrast, the neural bases of action forms (e.g., gentle or rude actions) have not been characterized. However, there are now studies showing that the observation and execution of actions endowed with VF activate, in addition to the parieto-frontal network, the dorso-central insula (DCI). In the present study, we established-using dynamic causal modeling (DCM)-the direction of information flow during observation and execution of actions endowed with gentle and rude VF in the human brain. Based on previous fMRI studies, the selected nodes for the DCM comprised the posterior superior temporal sulcus (pSTS), the inferior parietal lobule (IPL), the premotor cortex (PM), and the DCI. Bayesian model comparison showed that, during action observation, two streams arose from pSTS: one toward IPL, concerning the action goal, and one toward DCI, concerning the action vitality forms. During action execution, two streams arose from PM: one toward IPL, concerning the action goal and one toward DCI concerning action vitality forms. This last finding opens an interesting question concerning the possibility to elicit VF in two distinct ways: cognitively (from PM to DCI) and affectively (from DCI to PM).

Exploring the transformative potential of out-of-body experiences: A pathway to enhanced empathy.

Out-of-body experiences (OBEs) are subjective phenomena during which individuals feel disembodied or perceive themselves as outside of their physical bodies, often resulting in profound and transformative effects. In particular, experiencers report greater heightened pro-social behavior, including more peaceful relationships, tolerance, and empathy. Drawing parallels with the phenomenon of ego dissolution induced by certain psychedelic substances, we explore the notion that OBEs may engender these changes through ego dissolution, which fosters a deep-seated sense of unity and interconnectedness with others. We then assess potential brain mechanisms underlying the link between OBEs and empathy, considering the involvement of the temporoparietal junction and the Default Mode Network. This manuscript offers an examination of the potential pathways through which OBEs catalyze empathic enhancement, shedding light on the intricate interplay between altered states of consciousness and human empathy.

Navigating Virtual Learning Landscapes: Perspectives of Health Sciences Students in Saudi Arabia During the COVID-19 Pandemic.

Introduction In December 2019, COVID-19 originated in Wuhan, China, triggering a global pandemic. However, the Saudi Arabian Ministry of Education ensured the safe continuation of teaching and learning activities. Amid the pandemic, health sciences students were exposed to diverse learning opportunities. Methods This study seeks to explore their experiences with online teaching. Conducted as a descriptive cross-sectional study, it involved 397 health sciences students from three universities in the Makkah province who had encountered both traditional and virtual teaching methods. Results Most participants were female (71.1%), predominantly from Jeddah city (76.5%). The highest agreement scores were observed for student comprehension during online sessions (61.1%). A significant proportion (74.4%) found paying attention during online lectures easier than traditional ones. Blackboard emerged as the preferred educational platform for online teaching. Notably, there were no significant variations in students' perceptions of online teaching based on location, gender, or specialisation. Approximately 54.7% of students preferred watching their instructors through a webcam during online lectures. Conclusion Medical educators can leverage these findings to develop standardised teaching protocols and enhance the effectiveness of online education systems. The study underscores the importance of instructors using webcams during online teaching sessions, as it allows students to visually connect with their instructors, potentially improving the learning experience.

Neuroarchitecture: How the Perception of Our Surroundings Impacts the Brain.

The study of neuroarchitecture is concerned with the significant effects of architecture on human behavior, emotions and thought processes. This review explores the intricate relationship between the brain and perceived environments, focusing on the roles of the anterior cingulate cortex (ACC) and parahippocampal place area (PPA) in processing architectural stimuli. It highlights the importance of mirror neurons in generating empathetic responses to our surroundings and discusses how architectural elements like lighting, color, and space layout significantly impact emotional and cognitive experiences. The review also presents insights into the concept of cognitive maps and spatial navigation, emphasizing the role of architecture in facilitating wayfinding and orientation. Additionally, it addresses how neuroarchitecture can be applied to enhance learning and healing environments, drawing upon principles from the Reggio Emilia approach and considerations for designing spaces for the elderly and those with cognitive impairments. Overall, this review offers a neuroscientific basis for understanding how human cognition, emotions, spatial navigation, and well-being are influenced by architectural design.

Mu-ERD reflects action understanding, but the effect is small.

Since the mid-2000's, many researchers have provided evidence that mu-ERD measured at the motor cortex may reflect the collective activation of upstream brain regions associated with the human mirror system during action observation paradigms; however, several recent papers have called these findings into question. Our study represents an effort to address these criticisms. In our study, participants watched videos in which the type of grip an actor used to grasp a coffee mug either conveyed the goal with 100 % certainty (unambiguous-goal trials), or offered no predictive information (ambiguous-goal trials). If mu-ERD indexes action understanding, then we predicted that mu-ERD should increase while participants watched the actor grasp the mug for unambiguous-goal trials, but not for ambiguous-goal trials. During the intervals where participants watched the actor execute the goal, mu-ERD for unambiguous-goal trials should remain steady, whereas mu-ERD for ambiguous-goal trials should now increase. Conversely, if mu-ERD does not index action understanding, and instead reflects general motor processes associated with action (such as the activation of population vectors in M1 or planning processes), then mu-ERD should show no difference across conditions. Across most comparisons, we found that mu-ERD mostly reflected general motor processes; however, there was a small effect when participants overserved unambiguous-goal trials while watching the actor execute the goal suggesting that mu-ERD does reflect mirroring, but the effect is small.

Behavioural Synchronisation between Dogs and Humans: Unveiling Interspecific Motor Resonance?

Dogs' behavioural synchronisation with humans is of growing scientific interest. However, studies lack a comprehensive exploration of the neurocognitive foundations of this social cognitive ability. Drawing parallels from the mechanisms underlying behavioural synchronisation in humans, specifically motor resonance and the recruitment of mirror neurons, we hypothesise that dogs' behavioural synchronisation with humans is underpinned by a similar mechanism, namely interspecific motor resonance. Based on a literature review, we argue that dogs possess the prerequisites for motor resonance, and we suggest that interspecific behavioural synchronisation relies on the activation of both human and canine mirror neurons. Furthermore, interspecific behavioural studies highlight certain characteristics of motor resonance, including motor contagion and its social modulators. While these findings strongly suggest the potential existence of interspecific motor resonance, direct proof remains to be established. Our analysis thus paves the way for future research to confirm the existence of interspecific motor resonance as the neurocognitive foundation for interspecific behavioural synchronisation. Unravelling the neurocognitive mechanisms underlying this behavioural adjustment holds profound implications for understanding the evolutionary dynamics of dogs alongside humans and improving the day-to-day management of dog-human interactions.

Anatomo-functional basis of emotional and motor resonance elicited by facial expressions.

Simulation theories predict that the observation of other's expressions modulates neural activity in the same centers controlling their production. This hypothesis has been developed by two models, postulating that the visual input is directly projected either to the motor system for action recognition (motor resonance) or to emotional/interoceptive regions for emotional contagion and social synchronization (emotional resonance). Here we investigated the role of frontal/insular regions in the processing of observed emotional expressions by combining intracranial recording, electrical stimulation and effective connectivity. First, we intracranially recorded from prefrontal, premotor or anterior insular regions of 44 patients during the passive observation of emotional expressions, finding widespread modulations in prefrontal/insular regions (anterior cingulate cortex, anterior insula, orbitofrontal cortex and inferior frontal gyrus) and motor territories (rolandic operculum and inferior frontal junction). Subsequently, we electrically stimulated the activated sites, finding that (a) in the anterior cingulate cortex and anterior insula, the stimulation elicited emotional/interoceptive responses, as predicted by the 'emotional resonance model', (b) in the rolandic operculum it evoked face/mouth sensorimotor responses, in line with the 'motor resonance' model, and (c) all other regions were unresponsive or revealed functions unrelated to the processing of facial expressions. Finally, we traced the effective connectivity to sketch a network-level description of these regions, finding that the anterior cingulate cortex and the anterior insula are reciprocally interconnected while the rolandic operculum is part of the parieto-frontal circuits and poorly connected with the formers. These results support the hypothesis that the pathways hypothesized by the 'emotional resonance' and the 'motor resonance' models work in parallel, differing in terms of spatio-temporal fingerprints, reactivity to electrical stimulation and connectivity patterns.

Effects of a single session action observation training on hand function in healthy young adults: a randomised controlled assessor and participants-blinded trial.

PURPOSE: The aim was to investigate the effects of a single session action observation training (AOT) on hand function and evaluate whether observing self-actions would be more effective than observing someone else. MATERIALS AND METHODS: A total of 60 right-handed healthy young adults, (32 female, 28 males and the mean age was 21.32 ± 1.07 years) were included in the study. The participants were randomly divided into five groups, self-action observation (sAO), observation of a third person (AO), action practice (AP), non-action observation (nAO), and control. A single session was performed for all participants. The primary outcome was the Jebsen Taylor Hand Function Test (JTHFT) assessed by a masked assessor. RESULTS: Significant differences were observed between the sAO and control group in total left side JTHFT performance (p < 0.001). Additionally, there were significant differences between the AO and control group (p < 0.001), and AP and nAO group (p = 0.003) and AP and control group (p < 0.001) in total JTHFT performance change of the left side. Significant differences were found between the sAO and nAO (p = 0.001) and control groups (p < 0.001) in dominant side total JTHFT performance change. No difference between sAO and AP groups were observed (p > 0.05). CONCLUSION: It was observed that a single session of action observation training improved hand function in healthy adults. The better performance achieved in the group watching the self-video may suggest that watching the self-image activates more mirror neurons.

Guidelines for reporting action simulation studies (GRASS): Proposals to improve reporting of research in motor imagery and action observation.

Researchers from multiple disciplines have studied the simulation of actions through motor imagery, action observation, or their combination. Procedures used in these studies vary considerably between research groups, and no standardized approach to reporting experimental protocols has been proposed. This has led to under-reporting of critical details, impairing the assessment, replication, synthesis, and potential clinical translation of effects. We provide an overview of issues related to the reporting of information in action simulation studies, and discuss the benefits of standardized reporting. We propose a series of checklists that identify key details of research protocols to include when reporting action simulation studies. Each checklist comprises A) essential methodological details, B) essential details that are relevant to a specific mode of action simulation, and C) further points that may be useful on a case-by-case basis. We anticipate that the use of these guidelines will improve the understanding, reproduction, and synthesis of studies using action simulation, and enhance the translation of research using motor imagery and action observation to applied and clinical settings.

The physiological basis of leader-follower roles in the dyadic alternating tapping task.

Introduction: Cooperative and collaborative behaviors are important concepts for co-creative communication. One of the key elements for these behaviors is the leader-follower roles in human communication. Leaders are those who maintain their own pace and rhythm, on the contrary, followers are those who follow the pace and rhythm of the other. Well-coordinated leader-follower roles would produce better cooperative and collaborative behaviors, which could promote co-creative communication. Methods: Here, to explore the physiological basis for the leader-follower roles, we conducted the dyadic alternating tapping task with electrocardiographic and electroencephalographic recordings. The task would be stable for modeling human communication in the laboratory because it includes timing control in tens of milliseconds and turn-taking. Given that human communications are complex and constantly fluctuating, this study estimated the degree of leader-follower with the state-space model. This model allowed us to calculate two parameters independently for estimating the degree of leader-follower of each participant: αSelf (degree of one's tap(n) was explained by one's tap(n-1)) and αPair (degree of one's tap(n) was explained by one's tap (n-1) and pair's tap (n-1)). Results: The result showed heart rate synchronization in the group in which both participants had high αPair. Also, the high-frequency component of heart rate variability was positively correlated with αPair. EEG analyses suggested the deactivation of the mirror neuron system (increasing φ1) in the participants with higher αSelf than lower ones. The activation of the mirror neuron system (increasing φ2) was shown in the participants with lower αPair than higher ones. Discussion: These data of physiological basis for leader-follower roles could be useful for the constructivist approach to co-creative communication.

Recomendaciones para aplicar la terapia de observación acción en accidente cerebrovascular. Revisión de la literatura / Recommendation for appliying action observation therapy in stroke. Literature review

Objetivos: unificar los criterios para la aplicación clínica de la terapia de observación de acción en accidente cerebrovascular. Métodos: realizamos una revisión bibliográfica en los meses de febrero y marzo de 2023, incluyendo siete artículos que cumplían los criterios de selección. Resultados: tras analizar los estudios, la mayoría utiliza la terapia de observación acción para tratar pacientes con accidente cerebrovascular sin otras patologías añadidas, realizando valoración del miembro superior parético, con proyección de vídeos, y ejecución de las actividades o actos motores tras su visualización. Conclusiones: se unifican los criterios con el uso de la técnica en pacientes con un primer accidente cerebrovascular unilateral, sin patologías añadidas que afecten a su aplicación; valorando las capacidades y funcionalidad de los pacientes; visualizando vídeos de actos motores o tares funcionales proyectados en primera persona, y ejecutando las tareas observadas, con el apoyo verbal o físico del terapeuta si es necesario.(AU)

Objective: unify the criteria for the clinical application of action observation therapy in stroke. Methods: we carried out a bibliographic review in the months of February and March 2023, including seven articles that met the selection criteria. Results: after analyzing the studies, the majority use action observation therapy to treat patients with stroke without other added pathologies, carrying out assessment of the paretic upper limb, with video projection, and execution of the activities or motor acts after viewing them. Conclusions: the criteria are unified with the use of the technique in patients with a first unilateral stroke, without additional pathologies that affect its application; assessing the abilities and functionality of patients; viewing videos of motor acts or functional tasks projected in first person, and executing the observed tasks, with the therapist's verbal or physical support if necessary.(AU)

Observational Learning in Surgical Skill Development.

Observation plays a key role in the development of surgical skills, as it allows trainees to learn from experts and improve their performance through trial-and-error practice. This process, known as motor learning, involves the creation of new neural pathways that enable precise control of surgical instruments through hand movements. In recent years, there has been a shift towards minimally invasive surgery, which requires surgeons to continually learn new motor skills to control specialized instrumentation. Motor learning can be enhanced through repetition and the observation of expert performances. Observational learning is particularly useful when it is used in combination with physical practice, as it can provide hints and clues about important aspects of the task that may not be immediately apparent through verbal instruction alone. The role of mirror neurons, which are activated both when an action is performed and when it is observed, is also important in the process of observational learning. By understanding the mechanisms behind observational learning and the factors that influence its effectiveness, trainers can optimize the use of this method in surgical training.

Non-shared coding of observed and executed actions prevails in macaque ventral premotor mirror neurons.

According to the mirror mechanism the discharge of F5 mirror neurons of a monkey observing another individual performing an action is a motor representation of the observed action that may serve to understand or learn from the action. This hypothesis, if strictly interpreted, requires mirror neurons to exhibit an action tuning that is shared between action observation and execution. Due to insufficient data it remains contentious if this requirement is met. To fill in the gaps, we conducted an experiment in which identical objects had to be manipulated in three different ways in order to serve distinct action goals. Using three methods, including cross-task classification, we found that at most time points F5 mirror neurons did not encode observed actions with the same code underlying action execution. However, in about 20% of neurons there were time periods with a shared code. These time periods formed a distinct cluster and cannot be considered a product of chance. Population classification yielded non-shared coding for observed actions in the whole population, which was at times optimal and consistently better than shared coding in differentially selected subpopulations. These results support the hypothesis of a representation of observed actions based on a strictly defined mirror mechanism only for small subsets of neurons and only under the assumption of time-resolved readout. Considering alternative concepts and recent findings, we propose that during observation mirror neurons represent the process of a goal pursuit from the observer's viewpoint. Whether the observer's goal pursuit, in which the other's action goal becomes the observer's action goal, or the other's goal pursuit is represented remains to be clarified. In any case, it may allow the observer to use expectations associated with a goal pursuit to directly intervene in or learn from another's action.

Motor resonance to non-visible postural adaptation: A novel aspect of the mirror mechanism.

The activation of the Mirror Neuron System (MNS) has been described to reflect visible movements, but not postural, non-visible, adaptations that accompany the observed movements. Since any motor act is the result of a well-tailored dialogue between these two components, we decided to investigate whether a motor resonance to nonvisible postural adaptations could be detected. Possible changes in soleus corticospinal excitability were investigated by eliciting the H-reflex during the observation of three videos, corresponding to three distinct experimental conditions: 'Chest pass', 'Standing' and 'Sitting', and comparing its size with that measured during observation of a control videoclip (a landscape). In the observed experimental conditions, the Soleus muscle has different postural roles: a dynamic role in postural adaptations during the Chest pass; a static role while Standing still; no role while Sitting. The H-reflex amplitude was significantly enhanced in the 'Chest pass' condition compared to the 'Sitting' and 'Standing' conditions. No significant difference was found between 'Sitting' and 'Standing' conditions. The increased corticospinal excitability of the Soleus during the 'Chest pass' condition suggests that the mirror mechanisms produce a resonance to postural components of an observed action, although they may not be visible. This observation highlights the fact that mirror mechanisms echo non intentional movements as well and points to a novel possible role of mirror neurons in motor recovery.

Reversed Mirror Therapy (REMIT) after Stroke-A Proof-of-Concept Study.

In mirror training (MIT), stroke patients strive to move their hands while looking at the reflected image of the unaffected one. The recruitment of the mirror neurons and visual-proprioceptive conflict are expected to facilitate the paretic voluntary movement. Here, a reversed MIT (REMIT) is presented, which requires moving hands while looking at the reflected image of the paretic one, giving the illusion of being unable to move the unimpaired hand. This study compares MIT and REMIT on post-stroke upper-limb recovery to gain clues on the mechanism of action of mirror therapies. Eight chronic stroke patients underwent two weeks of MIT and REMIT (five sessions each) in a crossover design. Upper-limb Fugl-Meyer, Box and Block and handgrip strength tests were administered at baseline and treatments end. The strength of the mirror illusion was evaluated after each session. MIT induced a larger illusory effect. The Fugl-Meyer score improved to the same extent after both treatments. No changes occurred in the Box and Block and the handgrip tests. REMIT and MIT were equally effective on upper-limb dexterity, challenging the exclusive role of mirror neurons. Contrasting learned nonuse through an intersensory conflict might provide the rationale for both forms of mirror-based rehabilitation after stroke.

Cerebral Projection of Mirrored Touch via sLORETA Imaging.

Touch is one of the primary communication tools. Interestingly, the sensation of touch can also be experienced when observed in another person. Due to the system of mirror neurons, it is, in fact, being mapped on the somatosensory cortex of the observer. This phenomenon can be triggered not only by observing touch in another individual, but also by a mirror reflection of the contralateral limb. Our study aims to evaluate and localize changes in the intracerebral source activity via sLORETA imaging during the haptic stimulation of hands, while modifying this contact by a mirror illusion. A total of 10 healthy volunteers aged 23-42 years attended the experiment. The electrical brain activity was detected via scalp EEG. First, we registered the brain activity during resting state with open and with closed eyes, each for 5 min. Afterwards, the subjects were seated at a table with a mirror reflecting their left hand and occluding their right hand. The EEG was then recorded in 2 min sequencies during four modifications of the experiment (haptic contact on both hands, stimulation of the left hand only, right hand only and without any tactile stimuli). We randomized the order of the modifications for each participant. The obtained EEG data were converted into the sLORETA program and evaluated statistically at the significance level of p ≤ 0.05. The subjective experience of all the participants was registered using a survey. A statistically significant difference in source brain activity occurred during all four modifications of our experiment in the beta-2, beta-3 and delta frequency bands, resulting in the activation of 10 different Brodmann areas varying by modification. The results suggest that the summation of stimuli secured by interpersonal haptic contact modified by mirror illusion can activate the brain areas integrating motor, sensory and cognitive functions and further areas related to communication and understanding processes, including the mirror neuron system. We believe these findings may have potential for therapy.

Beyond passive observation: feedback anticipation and observation activate the mirror system in virtual finger movement control via P300-BCI.

Action observation (AO) is widely used as a post-stroke therapy to activate sensorimotor circuits through the mirror neuron system. However, passive observation is often considered to be less effective and less interactive than goal-directed movement observation, leading to the suggestion that observation of goal-directed actions may have stronger therapeutic potential, as goal-directed AO has been shown to activate mechanisms for monitoring action errors. Some studies have also suggested the use of AO as a form of Brain-computer interface (BCI) feedback. In this study, we investigated the potential for observation of virtual hand movements within a P300-based BCI as a feedback system to activate the mirror neuron system. We also explored the role of feedback anticipation and estimation mechanisms during movement observation. Twenty healthy subjects participated in the study. We analyzed event-related desynchronization and synchronization (ERD/S) of sensorimotor EEG rhythms and Error-related potentials (ErrPs) during observation of virtual hand finger flexion presented as feedback in the P300-BCI loop and compared the dynamics of ERD/S and ErrPs during observation of correct feedback and errors. We also analyzed these EEG markers during passive AO under two conditions: when subjects anticipated the action demonstration and when the action was unexpected. A pre-action mu-ERD was found both before passive AO and during action anticipation within the BCI loop. Furthermore, a significant increase in beta-ERS was found during AO within incorrect BCI feedback trials. We suggest that the BCI feedback may exaggerate the passive-AO effect, as it engages feedback anticipation and estimation mechanisms as well as movement error monitoring simultaneously. The results of this study provide insights into the potential of P300-BCI with AO-feedback as a tool for neurorehabilitation.

Effectiveness of a Program Based on Action-Observation Training (AOT) on Motor, Functional and Cognitive Aspects in Patients with Cognitive Impairment: A Non-Randomized Controlled Trial.

Cognitive impairment is frequent in elderly subjects. It is associated with motor impairment, a limitation in quality of life and frequently, institutionalization. The aim of this work is to test the efficacy of a therapeutic group program based on action-observation learning. METHODS: a non-randomized controlled trial study was conducted. We included 40 patients with cognitive impairment from a nursing home who were categorized into mild and moderate cognitive impairment and divided separately into a control and experimental group. Experimental group performed a 4-week group work, in which each patient with mild cognitive impairment was paired with a patient with moderate cognitive impairment. Thus, patients with mild cognitive impairment observed a series of functional exercises performed by their peers and replicated them. Simultaneously, the patients with moderate cognitive impairment replicated the movement after observing it performed by a patient with mild cognitive impairment. The control group continued to receive their usual care at the center. The upper limb function, cognitive level and function in basic activities of human daily life were measured before and after the intervention and compared with the control group. RESULTS: statistically significant differences were found in the functionality of basic activities of daily living, in the functionality of the upper limb and in the cognitive level in all patients in the experimental group regardless of the initial cognitive level. No statistically significant differences were found in the control group. CONCLUSIONS: the implementation of a group, peer-based, action-observation learning therapeutic program is effective in improving the basic activities of human daily life, cognitive level and upper limb functionality in patients with mild and moderate dementia.