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Rehabilitation after free gracilis muscle transfer (smile surgery, SS) is crucial for a functional recovery of the smiling skill, mitigating social and psychological problems resulting from facial paralysis. We compared two post-SS rehabilitation treatments: the traditional based on teeth clenching exercises and the FIT-SAT (facial imitation and synergistic activity treatment). FIT-SAT, based on observation/imitation therapy and on hand-mouth motor synergies would facilitate neuronal activity in the facial motor cortex avoiding unwanted contractions of the jaw, implementing muscle control. We measured the smile symmetry on 30 patients, half of whom after SS underwent traditional treatment (control group, CG meanage = 20 ± 9) while the other half FIT-SAT (experimental group, EG meanage= 21 ± 14). We compared pictures of participants while holding two postures: maximum and gentle smile. The former corresponds to the maximal muscle contraction, whereas the latter is strongly linked to the control of muscle strength during voluntary movements. No differences were observed between the two groups in the maximum smile, whereas in the gentle smile the EG obtained a better symmetry than the CG. These results support the efficacy of FIT-SAT in modulating the smile allowing patients to adapt their smile to the various social contexts, aspect which is crucial during reciprocal interactions.

There is a debate about whether abstract semantics could be represented in a motor domain as concrete language. A contextual association with a motor schema (action or gesture) seems crucial to highlighting the motor system involvement. The present study with transcranial magnetic stimulation aimed to assess motor cortex excitability changes during abstract word comprehension after conditioning word reading to a gesture execution with congruent or incongruent meaning. Twelve healthy volunteers were engaged in a lexical-decision task responding to abstract words or meaningless verbal stimuli. Motor cortex (M1) excitability was measured at different after-stimulus intervals (100, 250, or 500 ms) before and after an associative-learning training where the execution of the gesture followed word processing. Results showed a significant post-training decrease in hand motor evoked potentials at an early processing stage (100 ms) in correspondence to words congruent with the gestures presented during the training. We hypothesized that traces of individual semantic memory, combined with training effects, induced M1 inhibition due to the redundancy of evoked motor representation. No modulation of cortical excitability was found for meaningless or incongruent words. We discuss data considering the possible implications in research to understand the neural basis of language development and language rehabilitation protocols.

Temporal dynamics of behavior, particularly facial expressions, are fundamental for communication between individuals from very early in development. Facial expression processing has been widely demonstrated to involve embodied simulative processes mediated by the motor system. Such processes may be impaired in patients with congenital facial palsy, including those affected by Moebius syndrome (MBS). The aims of this study were to investigate (a) the role of motor mechanisms in the processing of dynamic facial expression timing by testing patients affected by congenital facial palsy and (b) age-dependent effects on such processing. Accordingly, we recruited 38 typically developing individuals and 15 individuals with MBS, ranging in age from childhood to adulthood. We used a time comparison task where participants were asked to identify which one of two dynamic facial expressions was faster. Results showed that MBS individuals performed worse than controls in correctly estimating the duration of facial expressions. Interestingly, we did not find any performance differences in relation to age. These findings provide further evidence for the involvement of the motor system in processing facial expression duration and suggest that a sensorimotor matching mechanism may contribute to such timing perception from childhood.