1000 Section - Unilateral vs. Bilateral Mirror Therapy for Post-Stroke Upper Limb Dysfunction: A Functional Near-Infrared Spectroscopy Study of Brain Network Changes

Design: A total of 46 patients were enrolled and randomly assigned to either the unilateral mirror therapy group (n=23) or the bilateral mirror therapy group (n=23). Functional near-infrared spectroscopy (fNIRS) data were collected before the intervention(T0) and after three weeks of treatment(T1). The assessment tasks included resting-state and upper limb motor tasks (finger-to-nose, wrist dorsiflexion, and fist clenching). Regions of interest (ROIs) comprised the primary motor cortex (M1), premotor cortex (PMC), supplementary motor area (SMA), dorsolateral prefrontal cortex (DLPFC), primary somatosensory cortex (S1), and somatosensory association cortex (SAC).

Results:

Results: After three weeks of intervention, the activations of right M1, right PMC and SMA, and left DLPFC in the UMT group were significantly enhanced. left DLPFC-left M1, left DLPFC-right DLPFC, left DLPFC-right PMC&SMA, right DLPFC-right SAC, the functional connectivity of right S1-right SAC was significantly enhanced. The activation and functional connectivity of some brain regions in the BMT group were enhanced, but there was no statistically significant difference.

Conclusion:

Conclusions:  The study found that BMT induces widespread bilateral brain activation, whereas UMT primarily facilitates sensorimotor integration by modulating the right hemisphere’s action observation–motor imagery–executive control network. Although both are forms of mirror therapy, they promote recovery of the affected upper limb motor function through activation of distinct neural pathways to varying degrees.