Abstract
This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR). As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1) before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2) 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 329-336 |
| Number of pages | 8 |
| Journal | NeuroImage: Clinical |
| Volume | 8 |
| DOIs | |
| State | Published - Jun 8 2015 |
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Keywords
- Amputation
- Brain reorganization
- Cortical activity
- Electroencephalography
- Motor
- Targeted reinnervation
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Neurology
- Clinical Neurology
- Cognitive Neuroscience
Cite this
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Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation : A case report. / Yao, Jun; Chen, Albert; Kuiken, Todd A; Carmona, Carolina; Dewald, Julius P A.
In: NeuroImage: Clinical, Vol. 8, 08.06.2015, p. 329-336.Research output: Contribution to journal › Article
TY - JOUR
T1 - Sensory cortical re-mapping following upper-limb amputation and subsequent targeted reinnervation
T2 - A case report
AU - Yao, Jun
AU - Chen, Albert
AU - Kuiken, Todd A
AU - Carmona, Carolina
AU - Dewald, Julius P A
PY - 2015/6/8
Y1 - 2015/6/8
N2 - This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR). As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1) before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2) 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR.
AB - This case study demonstrates the change of sensory cortical representations of the residual parts of the arm in an individual who underwent a trans-humeral amputation and subsequent targeted reinnervation (TR). As a relatively new surgical technique, TR restores a direct neural connection from amputated sensorimotor nerves to specific target muscles. This method has been successfully applied to upper-limb and lower-limb amputees, and has shown effectiveness in regaining control signals via the newly re-innervated muscles. Correspondingly, recent study results have shown that motor representations for the missing limb move closer to their original locations following TR. Besides regaining motor control signals, TR also restores the sensation in the re-innervated skin areas. We therefore hypothesize that TR causes analogous cortical sensory remapping that may return closer to their original locations. In order to test this hypothesis, cortical activity in response to sensory-level electrical stimulation in different parts of the arm was studied longitudinally in one amputated individual before and up to 2 years after TR. Our results showed that 1) before TR, the cortical response to sensory electrical stimulation in the residual limb showed a diffuse bilateral pattern without a clear focus in either the time or spatial domain; and 2) 2 years after TR, the sensory map of the reinnervated median nerve reorganized, showing predominant activity over the contralateral S1 hand area as well as moderate activity over the ipsilateral S1. Therefore, this work provides new evidence for long-term sensory cortical plasticity in the human brain after TR.
KW - Amputation
KW - Brain reorganization
KW - Cortical activity
KW - Electroencephalography
KW - Motor
KW - Targeted reinnervation
UR - http://www.scopus.com/inward/record.url?scp=84930616952&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84930616952&partnerID=8YFLogxK
U2 - 10.1016/j.nicl.2015.01.010
DO - 10.1016/j.nicl.2015.01.010
M3 - Article
VL - 8
SP - 329
EP - 336
JO - NeuroImage: Clinical
JF - NeuroImage: Clinical
SN - 2213-1582
ER -