EEG-Based Evidence of Mirror Neuron Activity from App-Mediated Stroke Patient Observation

Background and Objectives: The mirror neuron system in the sensorimotor region of the cerebral cortex is equally activated during both action observation and execution. Action observation training mimics the functioning of the mirror neuron system, requiring patients to watch and imitate the actions necessary to perform activities of daily living. StrokeCare is a user-friendly application based on the principles of action observation training, designed to assist people recovering from stroke. Therefore, when observing the daily life behavior provided in the StrokeCare app, whether the MNS is activated and mu inhibition appears. Materials and Methods: We performed electroencephalography (EEG) on 24 patients with chronic stroke (infarction: 11, hemorrhage: 13) during tasks closely related to daily activities, such as dressing, undressing, and walking. The StrokeCare app provided action videos for patients to watch. Landscape imagery observation facilitated comparison among tasks. We analyzed the mu rhythm from the C3, CZ, and C4 regions and calculated the mean log ratios for comparison of mu suppression values. Results: The EEG mu power log ratios were significantly suppressed during action observation in dressing, undressing, walking, and landscape conditions, in decreasing order. However, there were no significant activity differences in the C3, C4 and CZ regions. The dressing task showed maximum suppression after a color spectrum was used to map the relative power values of the mu rhythm for each task. Conclusions: These findings reveal that the human mirror neuron system was more strongly activated during observation of actions closely related to daily life activities than landscape images.