Introduction
Stroke is the second leading cause for death worldwide (after ischemic heart disease) as per WHO and one of the leading causes for disability at advanced age (Feigin et al., 2014). Stroke is not limited to industrial countries how recent analysis demonstrated, but is a global problem, indeed stroke mortality and stroke burden measured by the disability-adjusted life years (DALY) is highest in low-income countries (Johnston, Mendis, & Mathers, 2009). If the observed trend from 1990 to 2010 in incidence, mortality, and DALYs continues, by 2030 there will be almost “12 million stroke deaths, 70 million stroke survivors, and more than 200 million DALYs” burden worldwide (Feigin et al., 2014). About one third of all stroke patients suffer from severe hemiparesis (disability to move one body side) of the upper limb (Jorgensen et al., 1995). In one study about first-ever unilateral stroke patients in the area of the middle cerebral artery (MCA) with following severe hemiparesis, even after intensive rehabilitation procedure 62% remained without any function and only about 38% regained some dexterity of the affected arm (complete recovery: 11.6%) (Kwakkel, Kollen, van der Grond, & Prevo, 2003). With regard to the individual suffering as well as to the raising costs that are caused by these low recovery rates, it is socially relevant to promote research in the field of neurological rehabilitation of severe hemiparesis and to search for alternatives to the conventional rehabilitation procedures. The thesis at hand aims for a better understanding of the underlying neurophysiological mechanisms of one alternative therapy, the so-called mirror therapy (MT). Although a lot of research on MT has been done in the past years, many questions about the underlying cerebral mechanism and about potential determinants of the efficacy of MT remain open.
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TBI Rehabilitation 