Medical Hypotheses 76 (2011) 646–647
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Medical Hypotheses
journal homepage: www.elsevier .com/locate /mehy
Mirror neural training induced by virtual reality in brain–computer interfacesmay provide a promising approach for the autism therapy
Huaping Zhu, Yaoru Sun ⇑, Jinhua Zeng, Hongyu SunDepartment of Computer Science and Technology, Tongji University, CaoAn Road 4800, Shanghai, China
a r t i c l e i n f o a b s t r a c t
Article history:Received 28 May 2010Accepted 13 January 2011
0306-9877/$ - see front matter � 2011 Elsevier Ltd. Adoi:10.1016/j.mehy.2011.01.022
⇑ Corresponding author. Tel.: +86 02169589864; faE-mail addresses: [email protected] (H
(Y. Sun), [email protected] (J. Zeng), 6hongyusu
Previous studies have suggested that the dysfunction of the human mirror neuron system (hMNS) playsan important role in the autism spectrum disorder (ASD). In this work, we propose a novel training pro-gram from our interdisciplinary research to improve mirror neuron functions of autistic individuals byusing a BCI system with virtual reality technology. It is a promising approach for the autism to learnand develop social communications in a VR environment. A test method for this hypothesis is alsoprovided.
� 2011 Elsevier Ltd. All rights reserved.
Introduction
The human mirror neuron system (hMNS) can be activated notonly when one person performs an action but also when one ob-serves the identical action performed by another individual [1,2].By directly mapping observed actions of others to the observer’s in-ner representation of the same action, the hMNS facilitates the ob-server to understand the goals and intentions behind actions with afirst-person point view [3–5]. Autism spectrum disorders (ASD) arelargely characterized by deficits in imitation, pragmatic language,theory of mind, and empathy. Previous studies have suggested thata developmental hMNS dysfunction, the so-called ‘‘the brokenmirror theory’’ may lead to the disordered social cognition inhumans observed in ASD and could represent the neural substrateof the social communication deficits of this clinical population[6–10]. Although autism spectrum disorder (ASD) is a neurobiologi-cal disorder, the behavioral interventions are currently the primarytreatments for individuals with ASD [11]. Altschuler [12] suggesteda feasible method to improve mirror neuron functioning in autisticchildren by playing with online virtual pets. Most of the previousstudies in ASD therapy have been focused on behavior treatmentsfrom the perspective of medical research. A new method for ASDdiagnosis and therapy from interdisciplinary research may be feasi-ble. We here describe a novel interdisciplinary study program toimprove mirror neuron functioning in autistic individuals by usinga BCI system with virtual reality technology.
A brain–computer interface (BCI) can integrate different soft-ware and hardware to take the electrophysiological measures ofbrain function and help a subject to communicate with the exter-
ll rights reserved.
x: +86 02169589478.. Zhu), [email protected]@tongji.edu.cn (H. Sun).
nal world. Recently, Daly and Wolpaw [13] suggested that non-invasive, electroencephalogram (EEG)-based BCI technologieswould help to increase the efficacy of a rehabilitation protocoland thus improve muscle control for a patient with severe motordisabilities. The BCI system can give a real-time view of the relativesuppression of the mu rhythm (8–13 Hz) which is considered as anindex of the mirror neuron activity. The non-invasion EEG equip-ment used to measure the relative suppression of the mu rhythmcan be employed for a subject at any age [9,14,15]. The mu rhythmsuppression is suggested to be involved only in the high-functionautism but not in the low-function autism. We therefore believethat whether the mu rhythm is suppressed or not during an ASDindividual observing human actions can be considered as a crite-rion for estimating the grade of autistic symptom.
Playing the therapeutic computer games are of special interestfor autism children. These rules-based environments can providechildren with easy, safe and fun vehicle for interventions to im-prove their mirror neuron mechanism. Mineo et al. [16] investi-gated the impact of a variety of video-based electronic screenmedia (ESM) on the engagement of students with autism by utiliz-ing virtual reality (VR) technology. By measuring the gaze durationand vocalization to estimate the degree of the engagement, theyfound that students preferred watching themselves on the screenas well as watching the VR scenarios. Although it is suggested thatplaying online video games is an accessible and enjoyable therapyfor mental health (for a recent review, see [17]), real systems forASD therapy are rare. Many previous studies suggested that some‘‘impoverished motions’’ depicting biological motions (e.g., shadowanimations or point-light biological motions) are sufficient totrigger a strong activity in the observer’s MNS [18,19]. Sinigagliaand Sparaci [20] recently proposed that the hMNS may be inducedby a wider range of visual stimuli and there may be a ‘‘broadcongruity’’ between the effectively observed motor actions and
H. Zhu et al. / Medical Hypotheses 76 (2011) 646–647 647
the effectively executed ones. By presenting realistic visual stimulito the ASD patients, the real-time degree of the mu rhythmsuppression across the sensorimotor cortex can be transformedto the index of mirror neuron activity so as to be utilized as amethod to facilitate the autism identification and diagnoses. TheBCI system allows real-time transformation of the mu rhythm toan index of mirror neuron activity. Because a BCI system can pro-duce vivid feedback for mu rhythm suppression, it is easy to obtainthe effect of hMNS activity in every stage of mental rehabilitation.It would be a promising approach to improving the human mirrormechanism of the autism by learning social communication in ahuman–computer interaction (HCI) environment.
Hypothesis
The hypotheses in this proposal are: (1) Through the real-timemeasure of the mu rhythm suppression degree during subjectsobserving vivid or ‘‘impoverished’’ motions, the BCI system can pro-vide a rapid diagnosable neural-feedback of ASD; (2) It is a promis-ing approach for improving the human mirror mechanism of theautism by learning social communications in a VR environment.
Testing the hypothesis
We propose the following approach for the above hypothesistest:
Firstly, a series of vivid visual stimuli for activating the hMNSwill be created in a BCI system by using the VR technology, includ-ing some ‘‘impoverished’’ motion stimuli (e.g., shadow motion orpoint-light motion) for a comparison.
Secondly, electrodes will be placed across the sensorimotor cor-tex (e.g., C3, Cz and C4 poles), EEG data will be collected and ana-lyzed. By comparing with the rest condition, the mu rhythmsuppression can be easily calculated.
Finally, the autism patients should be randomized in this kindof BCI based treatments of improving mirror neuron mechanismand the treatment effect should be estimated after each period ofcontrolled treatment. It would be proved that this proposed BCIsystem is useful to improve the mirror mechanism and benefitsthe therapy of autism.
Conflicts of interest statement
None declared.
Acknowledgments
This work was supported by the Grants from the NationalNatural Science Foundation of China (60775019 and 60970062);the Shanghai Pujiang Program (09PJ1410200) and the Science andTechnology Commission of Shanghai Municipality (09511502500).
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