リハビリテーションにおけるミラーニューロンの臨床応用

The Mirror Neuron System in Motor and Sensory Rehabilitation

ミラーニューロンシステムは，主に視覚入力された他者の運動から運動情報を抽出し，それと同様の運動プログラムをつくりだす働きがある。この他者の運動からつくりだされた運動プログラムを実行することにより，観察している運動と同じ運動が出力することが可能となる。この模倣運動を利用し，中枢神経障害後の運動障害と四肢切断などの身体の変化により生じる幻肢痛という2つの病態に対する観察・模倣運動の臨床的応用を紹介する。

Abstract

The discovery of the mirror neuron system has dramatically changed the study of motor control in neuroscience. The mirror neuron system provides a conceptual framework covering the aspects of motor as well as sensory functions in motor control. Previous studies of motor control can be classified as studies of motor or sensory functions, and these two classes of studies appear to have advanced independently. In rehabilitation requiring motor learning, such as relearning movement after limb paresis, however, sensory information of feedback for motor output as well as motor command are essential. During rehabilitation from chronic pain, motor exercise is one of the most effective treatments for pain caused by dysfunction in the sensory system. In rehabilitation where total intervention unifying the motor and sensory aspects of motor control is important, learning through imitation, which is associated with the mirror neuron system can be effective and suitable. In this paper, we introduce the clinical applications of imitated movement in rehabilitation from motor impairment after brain damage and phantom limb pain after limb amputation.