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Imaginary companions, fantasy twins, mirror dreams and depersonalization.

Illustrative case material is presented to demonstrate genetic linkages between the presence of imaginary companions or fantasy twins and extensive mirror play in childhood and early adolescence, and the appearance of mirror dreams and depersonalization in later adolescence and adulthood. The defensive splitting of the self-representations observable in these phenomena is viewed as a means of warding off castration anxiety and anxiety about object loss, anxieties which arise because of conflicts primarily centering on intense aggressive drive derivative wishes. Formulations about depersonalization are discussed.

Adult↗

Resonance behaviors and mirror neurons.

This article is subdivided into two parts. In the first part we review the properties of a particular class of premotor neurons, the "mirror" neurons. With this term we define neurons that discharge both when the monkey makes a particular action and when it observes another individual (monkey or human) making a similar action. The second part is an attempt to give a neurophysiological account of the mechanisms underlying behaviors where an individual reproduces, overtly or internally, movements or actions made by another individual. We will refer to these behaviors as "resonance behaviors". We distinguish two types of resonance behavior. The first type is characterized by imitation, immediate or with delay, of movements made by other individuals. Examples of resonance behavior of this type are the "imitative" behaviors observed in birds, young infants and patients with frontal lesions. The second type of resonance behavior is characterized by the occurrence, at the observation of an action, of a neural pattern, which, when internally generated, determines the making of the observed action. In this type of resonance behavior the observed action is, typically, not repeated (overtly). We argue that resonance behavior of the second type is at the basis of the understanding of actions made by others. At the end of the article we review evidence of mirror mechanisms in humans and discuss their anatomical localizations.

Animals↗

[Cluster analysis of mirror type internal symmetry in amino acid sequences of heterotrimeric G-protein alpha-subunit superfamily].

For the identification of mirror type internal symmetry centers in amino acid sequences (AASs) the new method, named by the method of internal symmetry scanning, was developed. The method, contrary to earlier ones, can be used for analysis of large clusters of primary structures of related proteins. The internal symmetry centres, containing both one and two amino acid residues, can be identified rapidly and effectively by the method. Additionally, the new method allow to estimate quantitatively the homology of AASs, which are antiparallel to relation of the centres. The different modifications of the method can be used for revealing of both high conservative and unequal symmetrical structures in AASs of proteins. Usually the structures coincide with functionally important regions of protein molecules. The method was used for investigation of primary structures of members of heterotrimeric G-protein a a-subunit superfamily. The positive correlation between conservativity of primary structure and distribution of mirror type internal symmetry centres was shown.

Amino Acid Sequence↗

Balloon Mitral and Aortic Valvuloplasty in Mirror-Image Dextrocardia.

Three patients of mirror-image dextrocardia were subjected to balloon valvuloplasty at our institute. One patient had severe pliable rheumatic mitral stenosis (MS), another had severe calcific rheumatic MS and the third had moderate rheumatic MS and severe rheumatic aortic stenosis (AS). Necessary modifications in the standard septal puncture technique, Inoue mitral valvuloplasty technique, and Cribier aortic valvuloplasty technique were done keeping unusual anatomy of mirror-image dextrocardia in account to dilate mitral and aortic stenosis successfully. Acute hemodynamic results were satisfactory and no complications encountered. This report illustrates feasibility and safety of balloon mitral and aortic valvuloplasty in the complex cardiac anatomy of situs inversus totalis.

Journal Article↗

Open tube, proximal illumination mirror and direct laryngeal photography.

Equipment is described for mirror and open tube direct laryngoscopic photography. It consists of specially constructed reflex camera systems that provide adequate exposure and depth of the desired field, sharpness of focus, correct color, and effective composition for meaningful illustrations. The separate cameras for still and motion pictures consist of units that contain the light source, lenses, optic reflex systems, and film chambers. The mirrors for indirect laryngoscopy and the open tube direct laryngoscopes are attached by rigid, easily released clamps for quick interchange. It is stressed that the laryngologist himself must be the photographer. The pictures are adjuncts to case recording, are supportive evidence of investigative work, and may be used as chronologic sequences in study of physiology and in pre- and postoperative evaluation.

Laryngoscopy↗

"On the other hand": a case of hereditary, congenital mirror movement.

We describe a 20-year-old male Singaporean army recruit with hereditary, congenital mirror movements who presented with difficulties in military training because releasing the grip of one hand resulted in a similar release by the other hand. His father has mirror movements with a significant decrease in symptoms with time, a phenomenon that has not been previously described. Both father and son have no associated neurological abnormalities. Bilateral cortical representation for hand muscles and the presence of active ipsilateral corticospinal projections have been postulated as the mechanisms responsible for this condition.

Adult↗

[A case of incomplete endocardial cushion defect with mirror-image dextrocardia, IVC defect and azygos connection].

A case of incomplete endocardial cushion defect associated with mirror-image dextrocardia, IVC defect and azygos connection is reported. Intracardiac defect was corrected under moderate hypothermia with cardiopulmonary bypass. Three venous drainage cannulas were necessary to be indwelled into SVC, hepatic vein and right common iliac vein to maintain adequate venous drainage for extra-corporeal circulation. Thus, anomaly of venous system, which is commonly associated with mirror-image dextrocardia, must be recognized correctly and prepared before intracardiac correction.

Azygos Vein↗

The right aortic arch with mirror-image branching of brachiocephalic arteries and aplasia of the left brachiocephalic trunk: surgically cured rare cause of cerebrovascular insufficiency.

A clinical case with rare anomaly: right aortic arch with mirror-image branching of brachiocephalic arteries and aplasia (isolation) of the left brachiocephalic trunk, causing cerebrovascular insufficiency and left arm claudication is described. Despite the clear neurologic manifestations of cerebrovascular insufficiency and absence of the pulse on the left arm, the pathology was not diagnosed until 35 years of age. The anomaly was diagnosed and surgically cured in the Department of Vascular Surgery of Vilnius University Emergency Hospital. Using transsternal median thoracotomy approach, 12 mm diameter PTFE vascular graft, arising from the ascending aorta and connected to the angle, made of branching left common carotid and left subclavian arteries, was implanted into the position of missing left brachiocephalic trunk. 3 years after surgery patient feels healthy and is working. To our knowledge this is the first reported case of surgical replacement of missing left brachiocephalic trunk in the right-sided aortic arch with mirror-image branching of brachiocephalic arteries.

Adult↗

Congenital mirror movement: report of a case.

We report the case of a 27-year-old woman who has had mirror movements in both hands since childhood. These synkinetic involuntary movements impair her performance in bimanual activities such as buttoning clothes, tying shoes, and washing dishes. Cranial magnetic resonance imaging disclosed only mild diffuse cortical atrophy. Although congenital mirror movements have been well-documented in the English literature, we herein report the first case of a Chinese patient in Taiwan.

Adult↗

Effect of a one-month yoga training program on performance in a mirror-tracing task.

The performance in a mirror star tracing task was assessed in two groups of volunteers (yoga and control) with 26 people in each group, and age range between 18 and 45 years. The star to be traced was six pointed and the outline was made up of 60 circles (4 mm in diameter). At the end of one month the yoga group showed a significant improvement in terms of an increase in the number of circles crossed (P<0.001, Wilcoxon paired signed ranks test) for both hands and a decrease in the number of circles left out for the right hand (P<0.05). The control group showed a significant increase in number of circles crossed for the left hand alone (P<0.05) at the end of a month attributed to re-test. The study suggests that one month of yoga improved reversal ability, eye-hand co-ordination, speed and accuracy which are necessary for mirror star tracing.

Adolescent↗

Embodied simulation: from mirror neuron systems to interpersonal relations.

A direct form of 'experiential understanding' of others is achieved by modelling their behaviours as intentional experiences on the basis of the equivalence between what the others do and feel and what we do and feel. This modelling mechanism is embodied simulation. By means of embodied simulation we do not just 'see' an action, an emotion, or a sensation. Side by side with the sensory description of the observed social stimuli, internal representations of the body states associated with actions, emotions, and sensations are evoked in the observer, as if he/she would be doing a similar action or experiencing a similar emotion or sensation. Mirror neurons are likely the neural correlate of this mechanism. The mirror neuron matching systems map the different intentional relations in a compressed fashion, which is neutral about the specific quality or identity of the agentive/subjective parameter. By means of a shared neural state realized in two different bodies that nevertheless obey to the same functional rules, the 'objectual other' becomes 'another self'.

Animals↗

Topographic maps of human motor cortex in normal and pathological conditions: mirror movements, amputations and spinal cord injuries.

We studied motor evoked potentials to transcranial magnetic stimulation in patients with unilateral upper limb amputations, complete T10-T12 spinal cord transection, and congenital mirror movements and in controls. Different muscles in the trunk and upper and lower extremities were evaluated at rest. In controls, muscles could be activated with stimulation of regions several centimeters wide. These areas overlapped extensively when muscles studied were from the same limb and shifted positions abruptly when muscles were from different limbs. Distal muscles were easier to activate than proximal muscles and normally evidenced exclusively a contralateral representation. Congenital defects in motor control in patients with mirror movements resulted in marked derangement of the map of outputs of distal hand muscles with enlarged and ipsilateral representations. Peripheral lesions, either acquired (amputations) or congenital (congenital absence of a limb), resulted in plastic reorganization of motor outputs targeting muscles immediately proximal to the stump. Central nervous system lesions (i.e., spinal cord injury producing paraplegia) also resulted in enlargement of the map of outputs targeting muscles proximal to the lesion. These results indicate that magnetic stimulation is a useful non-invasive tool for exploring plastic changes in human motor pathways following different types of injury.

Adult↗

Bilateral small-hand-muscle motor evoked responses in a patient with congenital mirror movements.

In a 56 year old patient with congenital mirror movements involving the muscles of the hands and forearms, transcranial electrical stimulation of either the left or right motor-cortex hand area induced bilateral surface electromyographic (EMG) responses in the abductor pollicis brevis (APB) muscles with normal latencies (21 msec). Slight volitional background contraction of the APB muscle contralateral to the stimulated motor cortex enhanced the motor evoked potential (MEP) and shortened the latency of the response by about 3 msec, while no definite facilitation was detected in the ipsilateral APB muscle. Volitional activation of the APB muscle ipsilateral to the stimulated motor cortex failed to enhance the response or shorten the latency of the response in either APB muscle. It is concluded that a fast conducting uncrossed or double crossed corticospinal system plays an important role in the execution of ipsilateral involuntary mirror movements and may be explained by aberrant reorganization of the pyramidal system.

Adult↗

[Mirror movement. Review of 11 cases].

The disturbance of mirror movements is a little known disfunction of the movement in which one extremity reproduces simultaneously the movements carried out by the other extremity. It can have very different etiologies. We have observed the clinical histories of eleven children who suffered from this disturbance, with the aim of contributing to a further knowledge of this subject. The conclusions of our observation are: 1) Clear preference for male sex. 2) Great etiological variety. 3) High incidence of neuropsychological disturbances associated, as well a large variety of them. 4) The most useful complementary exam from the underlying process to the disturbance of mirror movements is the craneal CAT; although the alterations found are not especific and probably not pathogenetically related with the disturbance.

Adolescent↗

[Posterior reinforcement behind hepatic angiomas. Mirror artefact as a possible source of error].

Posterior enhancement beyond liver hemangiomas was retrospectively assessed on 89 hemangiomas of all size and localization with in the liver. This enhancement is seen only beyond big and complex lesions, containing hypoechoic or anechoic zones. Conversely, it seems to be very rare beyond little hyperechoic lesions. It is necessary to distinguish true enhancement and a mirror artefact beyond lesions of all sizes but localized just near the diaphragma. In the lesions of less than 2 cm, no clear posterior enhancement was discovered, but some of them showed a very clear mirror artifact.

Diagnostic Errors↗

Autoradiographic assessment of [3H]proline uptake by neurons of epileptogenic mirror focus.

Epileptogenic mirror focus was produced in the left parietal area of the rat brain by cobalt implantation into the contralateral hemisphere. On the 14th day after cobalt implantation [3H]proline was injected into both experimental and control rats (without cobalt). The incorporation of [3H]proline in neurons of layers III and V of the parietal brain cortex and neurons of the nucleus lateralis thalami was investigated by the autoradiography technique. A statistically reliable increase in [3H]proline uptake was observed in neurons of layer III (31%) and in neurons of layer V (41%) of the epileptogenic mirror focus. The other neuronal types revealed no reliable changes. The morphological and functional aspects of the altered protein metabolism during epileptogenesis are discussed.

Animals↗

[Histone alteration in the nuclei of different types of neurons in a "mirror" epileptiform focus in rat brain].

Total histones estimated after M. Alfred and I. Geschwind were studied cytophotometrically in nuclei of neurons of different types (layers III and V in the frontal-parietal cortex and in the thalamic lateral nucleus) of the "mirror" epileptiform focus in the rat brain on the 11th and 63d day after cobalt implantation. On the 11th day of the experiment, integral optic density of the histones decreased by 33%, 25% and 37%, and the area of the nuclei -- by 27%, 24% and 35% in the neurons of layers II and V in the frontal-parietal cortex and in the thalamic lateral neucleus, respectively. On the 63d, integral optic density of the histones in the neurons mentioned increased respectively by 42%, 52% and 42%, and the area of the nuclei -- by 21%, 43% and 27%. Concentration of the histones in the nuclei decreased by 3--9% on the 11th day and increased, except layer V, by 9--18% on the 63d of the experiment. Interconnection between changes in histone content and total proteins in cytoplasm of functionally different neurons in the "mirror" epileptiform focus is disscussed, with special reference to histones as a regular of genetic activity for protein synthesis.

Animals↗