Mirror Neurones

Starting a wee
Just when we thought we were getting a hold on neurobiology and tricky things like central sensitisation, science produces mirror neurones. For 10 years or more we have been aware that approximately 25% of neurones in pre motor areas are mirror neurones, that is they fire when you watch or imagine an activity (25% that is a lot of neurones!). Some even act as predictive text, that is if the brain expects you to straighten your knee or turn right, the mirror neurones will set it up for you (Iacoboni and al. 2005).
It’s time to contemplate what this may be for rehabilitation practice. But first….why does water splashing seem to initiate urination, why are lip readers so fast, why can some sports stars read a game so well, why can group therapy be so effective, why does injury seem to spread though teams? Mirror neurones probably play a part.

Is pain contagious?
In Palma in Italy, in 1996, a monkey had some electrodes inserted into neurones in motor areas in its brain. These neurones fired when the monkey fed itself, i.e. hand to face activity. However, it was noticed that the same neurones fired when the monkey observed a person eating (legend has it that a person walked into the lab eating an icecream!). These neurones were called “mirror neurones” i.e. they reflected acts performed by another person (Gallese, Fadiga et al. 1996).

A similar situation occurs in humans. In conscious patients undergoing cingulotomy, cortical neurones responsive to noxious mechanical input (pin prick) have been noted firing when the person observed an experimenter pricking their finger. They will also fire if they think the person is about to prick their finger. (Hutchison, Davis et al. 1999)

These neurones also respond to sounds of an action such as splashing in the bowl and the sound of eating

Emotional mirror
If you watch someone vomiting you are likely to run a vomit in your own brain. There are emotional mirror neurones as well.

If you know that a person you love is in pain, then similar pain circuits in your brain will fire, much more than if the person in pain is unknown to you. (Singer, Seymour et al. 2006).

It is thought that dysfunctions in the emotional mirroring system may be a component of autism, perhaps related to empathy deficits due to failure of the mirror system

So…
The suggestion is that these mirror neurones “encode templates for specific action” allowing basic motor procedures without thinking about them and comprehension of an act without thinking too hard, i.e. you can grasp what is going on because you are running the same action in your own brain. (Rizzolatti, Fogassi et al. 2006). 

So the sports star who can read the game brilliantly is actually running the opponents moves in his/her brain simultaneously; when you learn the guitar from Eric Clapton, your mirror neurones are beginning to play like Eric Clapton; the lip reader is perhaps almost entirely reliant on mirror neurones – instead of playing sounds back, its kind of playing movement back.

What do mirror neurones mean for clinical practice?
Its all a bit new. Help us out here. Here are my seven initial thoughts:
1.  The most obvious thing is not to hang around with idiots all the time

2.  If you are going to learn something like guitar, try and learn from the best

3. If you are demonstrating exercises, do it well and realise that the patient is actually “running a movie” of you doing the exercise in their brain

4. In the clinic, you can observe a person’s emotional state and form a cognitive assessment of it without feeling emotion. But sometimes the cognitive assessment will activate your emotional mirror system and you feel emotional as well ie the patient “gets you”. There are issues for your own health here.

5. If production and perception of motor action involves similar neruones in the brain, then it is quite understandable when a person says “it hurts when I think of moving.”

6. Working successfully in groups involves mirroring each other so humans perform complementary actions to achieve common goals.

7. These neurones are some of the targets of graded motor imagery (laterality recognition, motor imagery, mirror therapy). For those interested and also those currently using our “Recognise” laterality CD, we have just finished building an online streamed version of “Recognise™” including hands, feet, necks, shoulders and backs with video clips for hands to come.  Contact Tom for the codes for a free 2-week trial before the official release at the end of June.

Your turn
Sorry about the long NOI notes this month it ended up being quite a mouthful!

How do you think mirror neurones could be related to modern rehabilitation practice? Send in your most pressing thought to be in the winning for a full 6 months of unlimited access to “Recognise™” online.

And in honour of the discovery of mirror neurones tell us about your favourite ice-cream and why it is so! The most salivating answer will also win 6 months unlimited access to “Recognise™” online.

NOI notes from last month: FRED AND HALF A SHEEP

Thanks for the dozens of replies. Not everyone was fascinated by the sheep story, some wanted more science (yet the story of placebo remains a science issue up there with consciousness). The New Zealanders sent the story out to all their manual therapists (New Zealanders and sheep??) and the story was used in many therapy classes. But it is all about placebo something Pat Wall wrote about in 1992 “Placebo – an unpopular topic” (Pain 57:1-3).

Its still unpopular but the humour of some of the stories sent in suggests we are getting there. There were some toughen up and be brave stories, prescribing of B6 supplements, and the good old forget-to-turn-on-the-ultrasound-trick but the biggest congratulations goes to Janet Stevens from Great Britain who “…once told a farmer (like Fred) to continue wearing bailing twine around his waist for his low back pain because he believed it had worked for 30 years”!!! If it works – use it!

As for the gifts such as Fred’s half sheep, we are in awe here at NOI by the thought of a 6ft tall plastic apple tree and a bit weirded out by plastic cased kidney stones but the girls decided that definitely Sue Pritt had received the best gift whilst she was working in a private hospital in London a few years ago. The lady that she was seeing post THR noticed her shoes. Admittedly they were not flash as who has flash shoes when on your OE! The patient was horrified at how worn they were and asked if she had any others – Sue told her they were her only shoes apart from a pair of ‘flip flops’. The lovely woman gave her 1000 pounds to buy some ‘decent’ shoes. Sue had to take her the receipt for them to prove she spent the money on shoes! Man – you can get a lot of shoes for 1000 pounds!

Well done both of you – a set of shiny red posters are coming your way!

Recognise.noigroup.com
NOI is happy to announce the arrival of our new online streamed Recognise programme. It has been in development now for some months. We’ve taken on your feedback, resolved some issues from the CD version, and created new features only online can provide. This new online edition will provide a better Recognise experience as it doesn’t limit you to one computer, there are more tests available, it is quick and cost effective, everyone receives any upgrade all at once and you can choose to be involved in the front line research. As mentioned earlier, if you would like a 2-week sample of the programme, just send Tom an email and he’ll send you the access codes.

References
Gallese, V., L. Fadiga, et al. (1996). “Action recognition in the premotor cortex.” Brain 119: 593-609.

Hutchison, W. D., K. D. Davis, et al. (1999). “Pain-related neurons in the human cingulate cortex.” Nature Neuroscience 2: 403-405.

Iacoboni, B. and e. al. (2005). “Grasping the intentions of others with one’s own mirror system.” PLos Biology 3: 529-535.

Rizzolatti, G., L. Fogassi, et al. (2006). “Mirrors in the mind.” Scientific American 295: 30-37.

Singer, T., B. Seymour, et al. (2006). “Empathic neurall responses are modulated by the perceived fairness of others.” Nature 439: 466-469.

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One Response to “Mirror Neurones”

  1. Lori Says:

    The reason one wants to vomit when they see another vomiting is an evolutionary thing. In primitive days all the people in the tribe would share food and partake of the same meal. If the meal was tainted, everyone in the tribe would then eat the tainted food (whether it be roots, berries, meat, etc.). When one person vomited, the chances were it was because of the tainted meal that everyone had participated in and everyone then needed to get that food out of their system and EVERYONE needed to vomit to get the harmful toxins out their systems.

    Over time, this became an evolutionary self-defense mechanism. Although today we don’t live in close proximity to each other and our food is sourced from many places, when we see someone vomit we want to as well based on what happened with our ancestors-we think that person has been food poisoned and so we want to expel that ‘poisonous food’ from our systems as well because that primitive part of our brains still thinks we’ve partaken of the same meal as that sick person.

    I’m not a medical student or anything like that but this is my theory and I’m sticking to it!.

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