Accepted for/Published in: JMIR Mental Health
Date Submitted: Jun 30, 2022
Open Peer Review Period: Jun 30, 2022 - Aug 25, 2022
Date Accepted: Aug 3, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Comparing Motor Resonance to Virtual and Real Actions using Transcranial Magnetic Stimulation: Relevance to Virtual Clinical Consultations
ABSTRACT
Background:
Virtual clinical interactions have increased tremendously since the onset of the pandemic. While they certainly have their advantages, there also exist potential limitations, e.g., in establishing a therapeutic alliance, discussing complex clinical scenarios, and so on. This may be due to possible disruptions in the accurate activation of the human mirror neuron system - a posited physiological template of effective social communication.
Objective:
To compare motor resonance - a putative marker of mirror neuron system (MNS) activity estimated using transcranial magnetic stimulation elicited while viewing virtual (video-based) and actual or real (enacted by a person) actions in healthy individuals. We hypothesized that motor resonance will be greater during real as compared to virtual action observation.
Methods:
Motor resonance or motor evoked potential (MEP) facilitation during action observation relative to rest states, is an indirect measurement of MNS activity in humans. We compared MEP facilitation during the observation of virtual (presented via videos) and real (enacted in person) actions, relative to static image observation in healthy individuals (N=64) using transcranial magnetic stimulation. The MEP recordings were obtained by two single-pulse (neuronal membrane excitability-driven) TMS paradigms of different intensities and two paired-pulse (cortical GABA-interneuron driven) TMS paradigms.
Results:
On RMANOVA we observed a significant time effect for MEP facilitation from static to virtual and real observation states when recorded using three of the four TMS paradigms. Post-hoc pairwise comparisons with Benjamini–Hochberg false discovery rate correction revealed a significant MEP facilitation in both virtual and real observation states relative to static image observation; however, we also observed a significant time effect between the two observation states (real > virtual) with two TMS paradigms.
Conclusions:
Our results indicate that social cues expressed via both virtual (video) or real (in person) modes elicit physiological responses within the putative MNS, but this effect is more pronounced for actions presented in person. This has relevance to the appropriate implementation of digital health solutions, especially those pertaining to mental health. Clinical Trial: -
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.