Furthermore, from a neuroscience perspective, rehabilitation

is a challenge, as the neurobiological processes underlying rehabilitation-related recovery have not been fully revealed. A key challenge in neurorehabilitation is to establish optimal training protocols for the given patient. The Rehabilitation Gaming System (RGS) is a virtual reality (VR)-based paradigm for the rehabilitation of motor deficits following brain damage such as stroke (Cameirão et al., 2010). Specifically, subjects engaged in the RGS observe colored balls in a outdoor environment that appear to fly from the far distant horizon towards them. The subject’s task is to grasp the balls with the arms of an animated body, that is an avatar, Vorinostat research buy which are steered by a calibrated motion capture system. The subject controls the arms of the avatar in the VR world, with the goal of intercepting the course of the flying balls. The speed, distribution BMS-354825 purchase and size of the balls can be adjusted to match the individual capacity of the subject in a flexible performance-adjusted manner, providing for individualised training. Thus, the RGS relies on visuomotor processing that includes action observation, object-oriented

action planning, and feedback of the successful action. In this context, so-called mirror neurons, which are primarily found in the inferior frontal gyrus (IFG) and anterior inferior parietal lobule (IPL), have come into the focus of research. As they have been shown to be active not only when a goal-directed action is performed but also when such actions are passively observed or imagined (Grezès & Decety, 2001; Rizzolatti & Craighero, 2004; Iacoboni & Dapretto, 2006), the mirror neuron system might represent the key neural

substrate for relearning or resuming impaired motor functions following focal brain damage such as occurs in stroke (Buccino et al., 2006; Garrison et al., 2010; Sale & Franceschini, 2012). Accordingly, it can be hypothesised that acting in the RGS exploits the notion of mirror mechanisms (Rizzolatti Teicoplanin et al., 2009), combined with a number of considerations on perception, learning, action and motivation stemming from theoretical neuroscience (Verschure et al., 2003; Verschure, 2012). The central assumption behind the RGS is that, in order to drive the learning mechanisms underlying rehabilitation, the sensory aspects of sensorimotor contingencies must be enhanced (Cameirão et al., 2010; Verschure, 2011). Indeed, initial studies in acute and chronic stroke patients who were treated with RGS have shown significant improvements in functional capacities of the paretic arm as assessed by standard clinical scales, including the Motorcity Index, the Fugl–Meyer Assessment Test, the Chedoke Arm and Hand Activity Inventory, and the Barthel Index, as detailed by Cameirão et al. (2011, 2012).