“…The primary motor cortex (M1) ipsilateral to the active (reflected) hand, that is, M1 projecting to the unseen hand behind the mirror, is considered the final common pathway for the beneficial effect of MVF according to various studies. A complete reversal of lateralization when moving a limb that is reflected by a mirror (ie, the ipsilateral side taking over control), as put forward by some, 53,56,59 is unlikely; however, there is accumulating evidence that MVF decreases the motor threshold and enhances corticospinal output of the ipsilesional M1 in stroke patients. 55,63,[65][66][67][68] This is probably mediated through a reduction in interhemispheric inhibition (from contralateral/lesional to ipsilateral/lesional) 63 and/or a reduction of intracortical inhibition.…”