P293 Assessment of primary motor cortex plastic changes following the use of a new prosthetic system able to provide somatosensory feedback from the missing hand in an amputee patient: A TMS study
The cortical representation of a muscle can be significantly modified by plastic reorganization following a limb amputation. These plastic changes are not immutable and can be further modified restoring by the use of prosthesis like new bionic anthropomorphic prosthesis connected to the peripheral n...
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| Vydané v: | Clinical neurophysiology Ročník 128; číslo 3; s. e153 - e154 |
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| Hlavní autori: | , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Elsevier B.V
01.03.2017
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| ISSN: | 1388-2457, 1872-8952 |
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| Abstract | The cortical representation of a muscle can be significantly modified by plastic reorganization following a limb amputation. These plastic changes are not immutable and can be further modified restoring by the use of prosthesis like new bionic anthropomorphic prosthesis connected to the peripheral nervous system via bidirectional neural interfaces. Transcranial magnetic stimulation (TMS) is a non-invasive technique commonly used to assess topographical reorganization of motor brain areas.
The aim of this study is to evaluate the motor cortical reorganization of primary motor cortex with the TMS mapping technique in a left trans-radial amputee patient following the use of a novel prosthetic system able to provide somatosensory feed-back from the lost hand of the user.
Cortical motor output was mapped via TMS (intensity 10% above standardized excitability motor Threshold) for each hemisphere at the beginning, after 1month and 2month of training with the new prosthetic system. Peripheral responses were recorded from forearm flexor and extensor carpi ulnaris muscles of both limbs. Resting and Active motor threshold were also collected during separate mapping of right and left hemispheres.
No significant differences were found in the motor thresholds between the two hemispheres before and after implantation. Pre-surgical TMS motor maps showed a slight abnormal interhemispheric asymmetry of motor cortex topography, resulted in a smaller area of representation of muscles governing the stump compared to the area for the intact limb. Following training, post-surgical maps, showed a reduction and a partial reversal of this asymmetry because of an enlargement of the excitable area on the right hemisphere contralateral to the stump, leading towards a more symmetrical muscle representation in the two hemispheres, as in control subjects.
Our experiment provides a direct and unique evidence of brain plasticity changes occurring in the motor cortex following the use of a prosthetic system able to restore a somatosensory feedback from the missing limb after amputation. [Display omitted] [Display omitted] |
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| AbstractList | IntroductionThe cortical representation of a muscle can be significantly modified by plastic reorganization following a limb amputation. These plastic changes are not immutable and can be further modified restoring by the use of prosthesis like new bionic anthropomorphic prosthesis connected to the peripheral nervous system via bidirectional neural interfaces. Transcranial magnetic stimulation (TMS) is a non-invasive technique commonly used to assess topographical reorganization of motor brain areas. ObjectiveThe aim of this study is to evaluate the motor cortical reorganization of primary motor cortex with the TMS mapping technique in a left trans-radial amputee patient following the use of a novel prosthetic system able to provide somatosensory feed-back from the lost hand of the user. Materials and methodsCortical motor output was mapped via TMS (intensity 10% above standardized excitability motor Threshold) for each hemisphere at the beginning, after 1 month and 2 month of training with the new prosthetic system. Peripheral responses were recorded from forearm flexor and extensor carpi ulnaris muscles of both limbs. Resting and Active motor threshold were also collected during separate mapping of right and left hemispheres. ResultsNo significant differences were found in the motor thresholds between the two hemispheres before and after implantation. Pre-surgical TMS motor maps showed a slight abnormal interhemispheric asymmetry of motor cortex topography, resulted in a smaller area of representation of muscles governing the stump compared to the area for the intact limb. Following training, post-surgical maps, showed a reduction and a partial reversal of this asymmetry because of an enlargement of the excitable area on the right hemisphere contralateral to the stump, leading towards a more symmetrical muscle representation in the two hemispheres, as in control subjects. ConclusionsOur experiment provides a direct and unique evidence of brain plasticity changes occurring in the motor cortex following the use of a prosthetic system able to restore a somatosensory feedback from the missing limb after amputation. The cortical representation of a muscle can be significantly modified by plastic reorganization following a limb amputation. These plastic changes are not immutable and can be further modified restoring by the use of prosthesis like new bionic anthropomorphic prosthesis connected to the peripheral nervous system via bidirectional neural interfaces. Transcranial magnetic stimulation (TMS) is a non-invasive technique commonly used to assess topographical reorganization of motor brain areas. The aim of this study is to evaluate the motor cortical reorganization of primary motor cortex with the TMS mapping technique in a left trans-radial amputee patient following the use of a novel prosthetic system able to provide somatosensory feed-back from the lost hand of the user. Cortical motor output was mapped via TMS (intensity 10% above standardized excitability motor Threshold) for each hemisphere at the beginning, after 1month and 2month of training with the new prosthetic system. Peripheral responses were recorded from forearm flexor and extensor carpi ulnaris muscles of both limbs. Resting and Active motor threshold were also collected during separate mapping of right and left hemispheres. No significant differences were found in the motor thresholds between the two hemispheres before and after implantation. Pre-surgical TMS motor maps showed a slight abnormal interhemispheric asymmetry of motor cortex topography, resulted in a smaller area of representation of muscles governing the stump compared to the area for the intact limb. Following training, post-surgical maps, showed a reduction and a partial reversal of this asymmetry because of an enlargement of the excitable area on the right hemisphere contralateral to the stump, leading towards a more symmetrical muscle representation in the two hemispheres, as in control subjects. Our experiment provides a direct and unique evidence of brain plasticity changes occurring in the motor cortex following the use of a prosthetic system able to restore a somatosensory feedback from the missing limb after amputation. [Display omitted] [Display omitted] |
| Author | Granata, G. Iorio, R. Di Miraglia, F. Vecchio, F. Rossini, P.M. |
| Author_xml | – sequence: 1 givenname: R. Di surname: Iorio fullname: Iorio, R. Di organization: Catholic University of Sacred Heart – Policlinico Gemelli Foundation, Institute of Neurology, Rome, Italy – sequence: 2 givenname: G. surname: Granata fullname: Granata, G. organization: Catholic University of Sacred Heart – Policlinico Gemelli Foundation, Institute of Neurology, Rome, Italy – sequence: 3 givenname: F. surname: Vecchio fullname: Vecchio, F. organization: IRCCS San Raffaele Pisana, Brain Connectivity Laboratory, Rome, Italy – sequence: 4 givenname: F. surname: Miraglia fullname: Miraglia, F. organization: IRCCS San Raffaele Pisana, Brain Connectivity Laboratory, Rome, Italy – sequence: 5 givenname: P.M. surname: Rossini fullname: Rossini, P.M. organization: Catholic University of Sacred Heart – Policlinico Gemelli Foundation, Institute of Neurology, Rome, Italy |
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| Snippet | The cortical representation of a muscle can be significantly modified by plastic reorganization following a limb amputation. These plastic changes are not... IntroductionThe cortical representation of a muscle can be significantly modified by plastic reorganization following a limb amputation. These plastic changes... |
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| Title | P293 Assessment of primary motor cortex plastic changes following the use of a new prosthetic system able to provide somatosensory feedback from the missing hand in an amputee patient: A TMS study |
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