Continuing to look in the mirror: A review of neuroscientific evidence for the broken mirror hypothesis, EP-M model and STORM model of autism spectrum conditions.
Luke Yates, Hannah Hobson
PMID 32668956WHAT IT FOUND
Neuroscientific evidence does not support the 'broken mirror' theory that autism stems from a global mirror neuron deficit.
Instead, findings point to atypical top-down regulation of visual-motor systems. Clinicians should not assume a single broken brain mechanism explains imitation difficulties.
Key findings
01The review found a significant lack of evidence for the Broken Mirror Hypothesis (BMH), which claims a global deficit in the mirror neuron system explains autism symptoms.
02Evidence supports the EP-M and STORM models, which propose that difficulties arise from specific route impairments or reduced top-down regulation of the mirror neuron system, rather than a global deficit.
03Neurofeedback training studies showed improvements in attention but not autism-specific symptoms, and results were confounded by lack of blinding and parental expectation.
STILL TO COME
How it was doneWhat they found
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What it does not show
The review only included studies of autistic people without intellectual disabilities (IQ > 70), so findings may not apply to the broader autistic population. The included studies are heterogeneous in methodology, sample size, and tasks, making direct comparison difficult. The review is a narrative synthesis, not a systematic review with meta-analysis, so it does not provide pooled effect sizes. Neuroscientific measures like mu suppression and TMS may not directly translate to clinical observations of imitation or social communication.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research or publication.
The easy way to misread this
Do not interpret this review as evidence that mirror neuron dysfunction causes autism symptoms in a way that can be directly targeted by therapy. The findings are neuroscientific and theoretical; they do not provide clinical protocols or prove that treating the brain mechanism will improve patient outcomes.