title: Dominance of ipsilateral corticospinal pathway in congenital mirror movements.
abstract: OBJECTIVE
  To clarify the mechanism of congenital mirror movements.
  
  
  METHODS
  The triple stimulation technique (TST) and the silent period were used to investigate a patient with congenital mirror movements. The TST was used to calculate the ratio of ipsilateral to contralateral corticospinal tracts from the two hemispheres to the spinal motor neurones.
  
  
  RESULTS
  Transcranial magnetic stimulation over unilateral M1 induced larger ipsilateral than contralateral motor evoked potentials on both sides. Only 9% of spinal motor neurones innervating the abductor digitorum minimi were excited by contralateral primary motor cortex (M1) stimulation, while 94% were excited by the ipsilateral M1 stimulation. The silent period was examined during mirror movements and with voluntary contraction of the right first dorsal interosseus mimicking mirror movements. Left M1 stimulation (through the crossed corticospinal tract) did not show any difference in silent period between the two conditions, while right M1 stimulation (through the uncrossed tract) caused a longer silent period during mirror movements than during voluntary contractions.
  
  
  CONCLUSIONS
  The results suggest that mirror movements may be caused by a strong connection between ipsilateral M1 and the mirror movements conveyed through a dominant ipsilateral corticospinal pathway.
authors.affiliation: Human Brain Research Centre, Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ueki
authors.forename: T
authors.initials: T
authors.lastname: Mima
authors.forename: T
authors.initials: T
authors.lastname: Oga
authors.forename: A
authors.initials: A
authors.lastname: Ikeda
authors.forename: T
authors.initials: T
authors.lastname: Hitomi
authors.forename: H
authors.initials: H
authors.lastname: Fukuyama
authors.forename: T
authors.initials: T
authors.lastname: Nagamine
authors.forename: H
authors.initials: H
authors.lastname: Shibasaki
mesh_terms: D000328:Adult; D019054:Evoked Potentials, Motor / Q000502:physiology*; D007839:Functional Laterality; D006225:Hand; D006801:Humans; D008280:Magnetics; D008297:Male; D011712:Pyramidal Tracts / Q000502:physiology*; D046608:Synkinesis / Q000151:congenital* / Q000503:physiopathology*