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Cécile Galléa (Centre de Neuro-imagerie de Recherche, Hôpital Pitié-Salpêtrière, Paris)

Congenital mirror movements : a novel clue to understanding bimanual motor control.

Congenital mirror movement disorder is a rare disease which is inherited in an autosomal dominant manner. Individuals with mirror movements are unable to perform complex bimanual movements requiring independent hand actions . In humans, the motor system is crossed : the left cortical motor area controls the movement of the right hand, and vice-versa with the right cortical motor area and the left hand. The crossing occurs at the level of the brainstem, with the decussation of the motor pathways. Using a complementary approach that combines multimodal magnetic resonance imaging and neurophysiological techniques, we show that the presence of the crossing and a good communication between the two brain hemispheres during the movement are key factors conditioning the ability to perform the intended lateralized hand action. Additionally, the movement has to be correctly planned in specific brain areas. These findings allow a better understanding of the brain mechanisms involved in controlling unimanual and bimanual movements. This work is the starting point to investigate the development of the motor system and will help to shed light on the brain dysfunction in movement disorders with impairments of fine hand actions.

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