Assessment of cortical reorganization and preserved function in phantom limb pain: a methodological perspective

Andoh, Jamila; Milde, Christopher; Diers, Martin; Bekrater-Bodmann, Robin; Trojan, Jörg; Fuchs, Xaver; Becker, Susanne; Desch, Simon; Flor, Herta

doi:10.1038/s41598-020-68206-9

Cited by 24 publications

(12 citation statements)

References 86 publications

(218 reference statements)

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“…This could be attributed to our relatively small sample (further recruitment was prevented due to Covid-19 restrictions), and in particular, the small proportion of amputees experiencing PLP (11 out of 17). However, pain is not a necessary condition for deprivation-triggered remapping [83][84][85] and vice versa, PLP can be experienced in absence of remapping 86 . Moreover, previous studies reporting significant difference between amputees who experienced PLP and those who do not, often employed a similar sample size 20 , indicating that the expected effect of remapping should be substantial.…”

Section: Discussionmentioning

confidence: 99%

Reassessing face topography in primary somatosensory cortex and remapping following hand loss

Root

Muret

Arribas

et al. 2021

Preprint

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Cortical remapping after hand loss in the primary somatosensory cortex (S1) is thought to be predominantly dictated by cortical proximity, with adjacent body parts remapping into the deprived area. Traditionally, this remapping has been characterised by changes in the lip representation, which is assumed to be the immediate neighbour of the hand based on electrophysiological research in non-human primates. However, the orientation of facial somatotopy in humans is debated, with contrasting work reporting both an inverted and upright topography. We aimed to fill this gap in the S1 homunculus by investigating the topographic organisation of the face. Using both univariate and multivariate approaches we examined the extent of face-to-hand remapping in individuals with a congenital and acquired missing hand (hereafter one-handers and amputees, respectively), relative to two-handed controls. Participants were asked to move different facial parts (forehead, nose, lips, tongue) during fMRI scanning. We first report evidence for an upright facial organisation in all three groups, with the upper face and not the lips bordering the hand area. We further found little evidence for remapping of all tested facial parts in amputees, with no significant relationship to the chronicity of their PLP. In contrast, we found converging evidence for a complex pattern of face remapping in congenital one-handers across all facial parts, where the location of the cortical neighbour, the forehead, is shown to shift away from the deprived hand area, which is subsequently activated by the lips and the tongue. Together, our findings demonstrate that the face representation in humans is highly plastic, but that this plasticity is restricted by the developmental stage of input deprivation, rather than cortical proximity.

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Section: Discussionmentioning

confidence: 99%

Reassessing face topography in primary somatosensory cortex and remapping following hand loss

Root

Muret

Arribas

et al. 2021

Preprint

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“…The prevalence and relationship of non-painful phantom phenomena and phantom limb pain in a nationwide survey on 3374 unilateral limb amputees Martin Diers 1,2 , Bertram Krumm 3 , Xaver Fuchs 1,4 , Robin Bekrater-Bodmann 1 , Christopher Milde 1,5 , Jörg Trojan 1 , Jens Foell 1,6 , Susanne Becker 1,7 , Gerhard Rümenapf, ,8 Herta Flor 1,9 A c c e p t e d a u t h o r m a n u s c r i p t…”

Section: Supplementary Materialsmentioning

confidence: 99%

The Prevalence and Characteristics of Phantom Limb Pain and Non-Painful Phantom Phenomena in a Nationwide Survey of 3,374 Unilateral Limb Amputees

Diers

Krumm

Fuchs

et al. 2022

The Journal of Pain

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“…It is also necessary that cognitive control accurately direct the actions of the donor hand in a fashion like that of the native hand, highlighting the essential role of cortical regeneration. Early concerns regarding the limited capacity for functional recovery due to reorganization of cortical sensory and motor areas were informed by studies with mature primate brains following injuries or amputations (for review see Gunduz et al, 2020 andAndoh et al, 2020 andreferences within). Studies in both humans and animals have found that areas of the brain dedicated to the neural representation of the hand respond to sensory stimulation of the face after upper limb loss (Ramachandran and Rogers-Ramachandran, 2000).…”

Section: The Ramifications Of Hand Lossmentioning

confidence: 99%

Hand Transplants, Daily Functioning, and the Human Capacity for Limb Regeneration

Fitzpatrick

Brogan

Grover

2022

Front. Cell Dev. Biol.

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Unlike some of our invertebrate and vertebrate cousins with the capacity to regenerate limbs after traumatic loss, humans do not have the ability to regrow arms or legs lost to injury or disease. For the millions of people worldwide who have lost a limb after birth, the primary route to regaining function and minimizing future complications is via rehabilitation, prosthetic devices, assistive aids, health system robustness, and social safety net structures. The majority of limbs lost are lower limbs (legs), with diabetes and vascular disorders being significant causal contributors. Upper limbs (arms) are lost primarily because of trauma; digits and hands are the most common levels of loss. Even if much of the arm remains intact, upper limb amputation significantly impacts function, largely due to the loss of the hand. Human hands are marvels of evolution and permit a dexterity that enables a wide variety of function not readily replaced by devices. It is not surprising, therefore, for some individuals, dissatisfaction with available prosthetic options coupled with remarkable advances in hand surgery techniques is resulting in patients undertaking the rigors of a hand transplantation. While not “regeneration” in the sense of the enviable ability with which Axolotls can replace a lost limb, hand transplants do require significant regeneration of tissues and nerves. Regaining sophisticated hand functions also depends on “reconnecting” the donated hand with the areas of the human brain responsible for the sensory and motor processing required for complex actions. Human hand transplants are not without controversy and raise interesting challenges regarding the human regenerative capacity and the status of transplants for enabling function. More investigation is needed to address medical and ethical questions prior to expansion of hand transplants to a wider patient population.

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Assessment of cortical reorganization and preserved function in phantom limb pain: a methodological perspective

Cited by 24 publications

References 86 publications

Reassessing face topography in primary somatosensory cortex and remapping following hand loss

Reassessing face topography in primary somatosensory cortex and remapping following hand loss

The Prevalence and Characteristics of Phantom Limb Pain and Non-Painful Phantom Phenomena in a Nationwide Survey of 3,374 Unilateral Limb Amputees

Hand Transplants, Daily Functioning, and the Human Capacity for Limb Regeneration

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