title: Neonatal oral imitation in patients with severe brain damage.
abstract: BACKGROUND
  Neonates reproduce facial movements in response to an adult model just after birth. This neonatal oral imitation usually disappears at about 2- to 3-months of age following the development of cortical control. There is controversy relating to the nature and neural basis of such neonatal imitation. To address this issue, we studied the relationship between oral imitation, primitive reflexes, and residual voluntary movement in patients with severe brain damage.
  
  
  METHODS
  Six male and six female patients with cerebral palsy, from 4 to 39 years, were included in this study. Oral imitation was examined when they were awake and looked at the experimenter. Patients were evaluated as performing oral imitation when they opened their mouth repeatedly without visual feedback regarding their own behavior in response to the experimenter's oral movement. Tongue or lip protrusion was not examined because none of patients were able to do those behaviors due to their physical disability. Rooting and sucking reflexes were also investigated as representatives of primitive reflexes.
  
  
  RESULTS
  Six patients (50%) performed oral imitation. Mouth opening was not observed repeatedly in response to other facial expression without opening the mouth such as surprise or smile, excluding the possibility of nonspecific oral reaction. They exhibited little voluntary movement of their extremities. Half of them also manifested at least one primitive reflex. No patients exhibiting residual voluntary movements of their extremities performed oral imitation or primitive reflexes.
  
  
  CONCLUSIONS
  Oral imitation reappears in a similar way to primitive reflexes in patients showing severely impaired cortical function and little voluntary movement of their extremities due to severe brain damage, suggesting that neonatal oral imitation is mainly controlled by the subcortical brain region.
authors.affiliation: Department of Infants' Brain & Cognitive Development, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan. go-go@umin.ac.jp
authors.forename: Tohshin
authors.initials: T
authors.lastname: Go
authors.forename: Yukuo
authors.initials: Y
authors.lastname: Konishi
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology; D001925:Brain Damage, Chronic / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005149:Facial Expression; D005260:Female; D006801:Humans; D007100:Imitative Behavior / Q000502:physiology*; D007231:Infant, Newborn; D008297:Male