Neural correlates and clinical application of mirror neuron-based interventions in swallowing function rehabilitation: a scoping review.

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.