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Related Experiment Video

Updated: Jan 11, 2026

Corticospinal Excitability Modulation During Action Observation
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Altered Motor Resonance Effects during Action Observation in Functional Weakness: A Transcranial Magnetic Stimulation

Gloria P Mingolla1, Elena Antelmi2,3, Angela Sandri1,3

  • 1Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Movement Disorders Clinical Practice
|November 18, 2025
PubMed
Summary

Patients with functional weakness show altered motor resonance, impacting their ability to internally simulate actions. This suggests a disrupted motor system, particularly for strong contractions, which could guide new rehabilitation approaches.

Keywords:
action observationfunctional motor disordersmotor resonancetranscranial magnetic stimulation

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Area of Science:

  • Neuroscience
  • Motor Control
  • Clinical Neurology

Background:

  • Motor resonance, mediated by the mirror neuron system, involves brain activation during action observation similar to execution.
  • While motor resonance patterns are known in Parkinson's disease and dystonia, they are unexamined in functional weakness, a common functional motor disorder.
  • Functional weakness is characterized by a loss of motor function without a clear neurological cause.

Purpose of the Study:

  • To investigate motor resonance in functional weakness by assessing corticospinal excitability.
  • To compare motor resonance during observation of familiar versus non-executable actions in patients with functional weakness.
  • To explore the role of the motor repertoire in motor resonance in functional neurological disorders.

Main Methods:

  • Exploratory study involving 19 adult patients with functional weakness and 21 healthy controls.
  • Participants observed videos of hand movements (index finger abduction, power grip) performed with varying force.
  • Corticospinal excitability was measured using single-pulse transcranial magnetic stimulation of the primary motor cortex, recording motor-evoked potentials from FDI and ADM muscles.

Main Results:

  • Healthy controls exhibited significant corticospinal excitability modulation during strong abduction and power grips compared to baseline and weak conditions.
  • Patients with functional weakness showed no significant modulation of corticospinal excitability across any observed action condition.
  • Compared to controls, patients displayed reduced corticospinal excitability during strong abduction and power grip observations.

Conclusions:

  • Functional weakness is associated with altered force-dependent motor resonance, indicating impaired internal simulation of actions.
  • The findings suggest a disruption in the motor system's ability to simulate actions, especially those requiring significant muscular effort.
  • These results may inform the development of novel rehabilitation strategies that utilize action observation for functional motor disorders.