基于镜像神经元的吞咽功能康复干预的神经相关性与临床应用：范围综述

文献信息

中文摘要

背景： 吞咽困难在全球范围内常见。基于镜像神经元的吞咽干预提供重复性、神经调控训练，可增强治疗可及性和疗效。
目的： 本综述系统综合基于镜像神经元的方法在吞咽困难康复中的神经相关性和临床应用，特别关注吞咽镜像疗法的概念定义、神经相关性和干预特征。
方法： 检索了五个数据库（PubMed、Web of Science、Cochrane Library、Scopus和Embase），从建库至2026年3月31日。纳入标准为涉及成人（≥18岁）、基于镜像神经元理论检查吞咽功能、并以英文发表的研究。两名评价者独立进行研究选择和数据提取。数据采用叙述性综合。
结果： 共纳入19项研究，涵盖445名参与者（年龄18-80岁）。九项研究从干预、机制和结局三个领域概念化了基于镜像神经元的吞咽困难干预。十三项研究报告了神经相关性，表明吞咽的动作观察、运动想象和观察诱导的想象激活与真实吞咽时参与的脑网络重叠。六项干预研究表明，两至六周的动作观察、运动想象或其组合改善了吞咽功能，并增强了前运动区和感觉运动区的皮层激活。
结论： 基于镜像神经元的吞咽困难干预是一种以镜像神经元机制为基础的康复技术。神经生理学证据表明吞咽相关神经网络的激活，干预性研究显示其积极效果，尤其是在卒中后吞咽困难中。
系统综述注册： https://osf.io/yvqt5。

英文摘要

BACKGROUND: Dysphagia is common worldwide. Mirror neuron-based swallowing interventions provide repetitive, neuromodulatory training that enhances both therapeutic accessibility and efficacy.
OBJECTIVES: This review systematically synthesizes the neural correlates and clinical applications of mirror neuron-based approaches in dysphagia rehabilitation, with a specific focus on the conceptual definition, neural correlates, and intervention characteristics of mirror therapy for swallowing.
METHODS: Five databases (PubMed, Web of Science, Cochrane Library, Scopus, and Embase) were searched from inception to March 31, 2026. Studies were included if they involved adults (≥ 18 years), examined swallowing function based on mirror neuron theory, and were published in English. Two reviewers independently performed study selection and data extraction. Data were synthesized narratively.
RESULTS: Nineteen studies encompassing 445 participants (aged 18-80 years) were included. Nine studies conceptualized mirror neuron-based interventions for dysphagia across three domains: interventions, mechanisms, and outcomes. Thirteen studies reported neural correlates, demonstrating that action observation, motor imagery, and observation-induced imagery of swallowing activate overlapping brain networks with those engaged during actual swallowing. Six intervention studies showed that two to six weeks of action observation, motor imagery, or their combination improved swallowing function and enhanced cortical activation in premotor and sensorimotor areas.
CONCLUSIONS: Mirror neuron-based intervention for dysphagia is a rehabilitation technique grounded in mirror neuron mechanisms. Neurophysiological evidence suggests the activation of swallowing-related neural networks, and interventional studies indicate its positive effects, particularly in post-stroke dysphagia.
SYSTEMATIC REVIEW REGISTRATION: https://osf.io/yvqt5.