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Mirror neurons and their clinical relevance


One of the most exciting events in neurosciences over the past few years has been the discovery of a mechanism that unifies action perception and action execution. The essence of this 'mirror' mechanism is as follows: whenever individuals observe an action being done by someone else, a set of neurons that code for that action is activated in the observers' motor system. Since the observers are aware of the outcome of their motor acts, they also understand what the other individual is doing without the need for intermediate cognitive mediation. In this Review, after discussing the most pertinent data concerning the mirror mechanism, we examine the clinical relevance of this mechanism. We first discuss the relationship between mirror mechanism impairment and some core symptoms of autism. We then outline the theoretical principles of neurorehabilitation strategies based on the mirror mechanism. We conclude by examining the relationship between the mirror mechanism and some features of the environmental dependency syndromes.

Key Points

  • The mirror mechanism is a neural system that unifies action perception and action execution

  • The mirror mechanism is organized into two main cortical networks, the first being formed by the parietal lobe and premotor cortices, and the second by the insula and anterior cingulate cortex

  • The role of the mirror mechanism is to provide a direct understanding of the actions and emotions of others without higher order cognitive mediation

  • Limited development of the mirror mechanism seems to determine some of the core aspects of autism spectrum disorders

  • The recently demonstrated link between limited development of the mirror mechanism and that of some aspects of the motor system suggests that rehabilitation in children with austism spectrum disorder should take into account both motor and cognitive strategies

  • The use of action-observation-based protocols could represent a new rehabilitation strategy to treat motor deficits after stroke

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Figure 1: A cytoarchitectonic map of the monkey cortex and an example of a mirror neuron.
Figure 2: Action-constrained neurons in the monkey IPL.
Figure 3: The parietofrontal mirror system in humans.
Figure 4: Absence of mirror EEG responses in autism.
Figure 5: Motor behavior in typically developing children and children with ASD.


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This study was supported by European Union Contract 012738, Neurocom, by PRIN 2006 to GR and by Fondazione Monte Parma. MF-D was supported by Fondazione Cassa di Risparmio di Ferrara.

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Correspondence to Giacomo Rizzolatti.

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The authors declare no competing financial interests.

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Rizzolatti, G., Fabbri-Destro, M. & Cattaneo, L. Mirror neurons and their clinical relevance. Nat Rev Neurol 5, 24–34 (2009).

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