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Cortical reintegration of a replanted hand and an osseointegrated thumb prosthesis

Bjorkman, A; Waites, A; Rosén, Birgitta LU ; Larsson, E M and Lundborg, Göran LU (2007) In Acta Neurochirurgica. Supplementum 100. p.109-112
Abstract
BACKGROUND: Following a peripheral nerve repair the injured nerve has to re-innervate its original cortical area, a process, which is poorly understood. Errors in this cortical re-innervation have been suggested as one key reason for the generally poor clinical outcome following nerve injuries in the hand. METHOD: Functional magnetic resonance imaging (fMRI) was used to assess cortical reintegration following amputation and reattachment of bodyparts in two different situations: a patient with a hand amputation followed by immediate surgical replantation and a patient with an osseointegrated thumb prosthesis. FINDINGS: The primary motor cortex rapidly returns to a normal activation pattern after amputation followed by replantation or... (More)
BACKGROUND: Following a peripheral nerve repair the injured nerve has to re-innervate its original cortical area, a process, which is poorly understood. Errors in this cortical re-innervation have been suggested as one key reason for the generally poor clinical outcome following nerve injuries in the hand. METHOD: Functional magnetic resonance imaging (fMRI) was used to assess cortical reintegration following amputation and reattachment of bodyparts in two different situations: a patient with a hand amputation followed by immediate surgical replantation and a patient with an osseointegrated thumb prosthesis. FINDINGS: The primary motor cortex rapidly returns to a normal activation pattern after amputation followed by replantation or application of an osseointegrated prosthesis. The primary somatosenory cortex changes from an initial ipsilateral to a bilateral activation pattern. Sensory stimulation of an osseointegrated prosthesis also shows a bilateral activation pattern in the primary somatosenory cortex. CONCLUSIONS: The primary motor cortex shows a more normal activation pattern possibly because most muscles controlling the hand are proximal to the injury and can be activated after an amputation. The primary somatosensory cortex reorganises more and the activation pattern is more bilateral compared to a healthy hand. This bilateral activation pattern could represent a compensatory mechanism for the inferior tactile function in the replanted hand and the osseointegrated prosthesis. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Neurochirurgica. Supplementum
volume
100
pages
109 - 112
publisher
Springer
external identifiers
  • PMID:17985557
  • Scopus:38449094530
ISSN
0065-1419
language
English
LU publication?
yes
id
0fe84bb6-f34a-4a06-a76e-4770efd8adcd (old id 1140985)
date added to LUP
2008-08-14 09:56:46
date last changed
2016-10-13 04:35:20
@misc{0fe84bb6-f34a-4a06-a76e-4770efd8adcd,
  abstract     = {BACKGROUND: Following a peripheral nerve repair the injured nerve has to re-innervate its original cortical area, a process, which is poorly understood. Errors in this cortical re-innervation have been suggested as one key reason for the generally poor clinical outcome following nerve injuries in the hand. METHOD: Functional magnetic resonance imaging (fMRI) was used to assess cortical reintegration following amputation and reattachment of bodyparts in two different situations: a patient with a hand amputation followed by immediate surgical replantation and a patient with an osseointegrated thumb prosthesis. FINDINGS: The primary motor cortex rapidly returns to a normal activation pattern after amputation followed by replantation or application of an osseointegrated prosthesis. The primary somatosenory cortex changes from an initial ipsilateral to a bilateral activation pattern. Sensory stimulation of an osseointegrated prosthesis also shows a bilateral activation pattern in the primary somatosenory cortex. CONCLUSIONS: The primary motor cortex shows a more normal activation pattern possibly because most muscles controlling the hand are proximal to the injury and can be activated after an amputation. The primary somatosensory cortex reorganises more and the activation pattern is more bilateral compared to a healthy hand. This bilateral activation pattern could represent a compensatory mechanism for the inferior tactile function in the replanted hand and the osseointegrated prosthesis.},
  author       = {Bjorkman, A and Waites, A and Rosén, Birgitta and Larsson, E M and Lundborg, Göran},
  issn         = {0065-1419},
  language     = {eng},
  pages        = {109--112},
  publisher    = {ARRAY(0x8eb4748)},
  series       = {Acta Neurochirurgica. Supplementum},
  title        = {Cortical reintegration of a replanted hand and an osseointegrated thumb prosthesis},
  volume       = {100},
  year         = {2007},
}