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Mao L, Lu X, Yu C, Yin K. Physiological and Neural Changes with Rehabilitation Training in a 53-Year Amputee: A Case Study. Brain Sci 2022; 12:brainsci12070832. [PMID: 35884639 PMCID: PMC9313058 DOI: 10.3390/brainsci12070832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023] Open
Abstract
Many people who received amputation wear sEMG prostheses to assist in their daily lives. How these prostheses promote muscle growth and change neural activity remains elusive. We recruited a subject who had his left hand amputated for over 53 years to participate in a six-week rehabilitation training using an sEMG prosthesis. We tracked the muscle growth of his left forearm and changes in neural activity over six weeks. The subject showed an increase in fast muscle fiber in his left forearm during the training period. In an analysis of complex networks of neural activity, we observed that the α-band network decreased in efficiency but increased in its capability to integrate information. This could be due to an expansion of the network to accommodate new movements enabled by rehabilitation training. Differently, we found that in the β-band network, a band frequency related to motor functions, the efficiency of the network initially decreased but started to increase after approximately three weeks. The ability to integrate network information showed an opposite trend compared with its efficiency. rMT values, a measure that negatively correlates with cortical excitability, showed a sharp decrease in the first three weeks, suggesting an increase in cortical excitability. In the last three weeks, there was little to no change. These data indicate that rehabilitation training promoted fast muscle fiber growth and introduced neural activity changes in the subject during the first three weeks of training. Our study gave insights into how rehabilitation training with an sEMG prosthesis could lead to physiological and neural changes in amputees.
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Affiliation(s)
- Lin Mao
- Nanjing Research Institute of Electronic Technology, Nanjing 210019, China; (L.M.); (C.Y.)
| | - Xiao Lu
- Department of Rehabilitation Medicine, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China;
| | - Chao Yu
- Nanjing Research Institute of Electronic Technology, Nanjing 210019, China; (L.M.); (C.Y.)
| | - Kuiying Yin
- Nanjing Research Institute of Electronic Technology, Nanjing 210019, China; (L.M.); (C.Y.)
- Correspondence:
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2
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Neural Plasticity in a French Horn Player with Bilateral Amelia. Neural Plast 2021; 2021:4570135. [PMID: 34373687 PMCID: PMC8349270 DOI: 10.1155/2021/4570135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/01/2021] [Accepted: 07/19/2021] [Indexed: 11/26/2022] Open
Abstract
Precise control of movement and timing play a key role in musical performance. This motor skill requires coordination across multiple joints, muscles, and limbs, which is acquired through extensive musical training from childhood on. Thus, making music can be a strong driver for neuroplasticity. We here present the rare case of a professional french horn player with a congenital bilateral amelia of the upper limbs. We were able to show a unique cerebral and cerebellar somatotopic representation of his toe and feet, that do not follow the characteristic patterns of contralateral cortical and ipsilateral cerebellar layout. Although being a professional horn player who trained his embouchure muscles, including tongue, pharyngeal, and facial muscle usage excessively, there were no obvious signs for an expanded somatosensory representation in this part of the classic homunculus. Compared to the literature and in contrast to control subjects, the musicians' foot movement-related activations occurred in cerebellar areas that are typically more related to hand than to foot activation.
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Dempsey-Jones H, Wesselink DB, Friedman J, Makin TR. Organized Toe Maps in Extreme Foot Users. Cell Rep 2020; 28:2748-2756.e4. [PMID: 31509738 PMCID: PMC6899508 DOI: 10.1016/j.celrep.2019.08.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 03/28/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022] Open
Abstract
Although the fine-grained features of topographic maps in the somatosensory cortex can be shaped by everyday experience, it is unknown whether behavior can support the expression of somatotopic maps where they do not typically occur. Unlike the fingers, represented in all primates, individuated toe maps have only been found in non-human primates. Using 1-mm resolution fMRI, we identify organized toe maps in two individuals born without either upper limb who use their feet to substitute missing hand function and even support their profession as foot artists. We demonstrate that the ordering and structure of the artists’ toe representation mimics typical hand representation. We further reveal “hand-like” features of activity patterns, not only in the foot area but also similarly in the missing hand area. We suggest humans may have an innate capacity for forming additional topographic maps that can be expressed with appropriate experience. We ask if extreme behavior can cause the (re)emergence of somatotopic maps We investigated two foot artists, born without arms 7T fMRI shows individuated maps of up to 5 toes in the artists but not controls Activity in artists’ foot and hand areas was more “hand-like” than in controls
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Affiliation(s)
| | - Daan B Wesselink
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX3 9DU, UK.
| | - Jason Friedman
- Physical Therapy Department, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 699 7801, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 699 7801, Israel
| | - Tamar R Makin
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK
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Nakagawa K, Takemi M, Nakanishi T, Sasaki A, Nakazawa K. Cortical reorganization of lower-limb motor representations in an elite archery athlete with congenital amputation of both arms. NEUROIMAGE-CLINICAL 2019; 25:102144. [PMID: 31958685 PMCID: PMC6970184 DOI: 10.1016/j.nicl.2019.102144] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/13/2019] [Accepted: 12/21/2019] [Indexed: 02/07/2023]
Abstract
We investigated cortical reorganization in an amputated archer who used his feet. Lower-limb motor representations were examined using fMRI and TMS mapping. M1 areas innervating lower-limb muscles were larger in the amputated athlete. The toe and knee representations were expanded towards the lateral part of the M1. Paralympic athletes have a unique and dynamic M1 plasticity.
Despite their disabilities, top Paralympic athletes have better motor skills than able-bodied athletes. However, the neural underpinnings of these better motor skills remain unclear. We investigated the reorganization of the primary motor cortex (M1) in a Paralympic athlete with congenital amputation of both arms who holds the world record for the farthest accurate shot in archery (Amputee Archer: AA). We recorded brain activity during contraction of right toe, ankle, knee, and hip joint muscles in the AA and 12 able-bodied control subjects using functional magnetic resonance imaging. The results revealed that M1 activation was more widespread in the AA compared with control subjects during all tasks, and shifted towards the lateral part of the M1 during contraction of toe and knee muscles. We also conducted a motor mapping experiment using navigated transcranial magnetic stimulation. The M1 area receiving stimulation elicited motor-evoked potentials from the toe, lower-leg, and thigh muscles, which were larger in the AA compared with 12 control subjects. Furthermore, the AA's motor maps were shifted towards the lateral side of M1. These results suggest an expansion of lower-limb M1 representation towards the lateral side of M1, including the trunk and upper-limb representations, and an expansion of the area of corticomotor neurons innervating the lower limb muscles in the AA. This unique M1 reorganization could underpin the AA's excellent archery performance in the absence of upper limbs. The current results suggest that Paralympic athletes may exhibit extreme M1 plasticity, which could arise through a combination of rigorous long-term motor training and compensatory M1 reorganization for missing body parts.
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Affiliation(s)
- Kento Nakagawa
- Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan; The Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan; Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Mitsuaki Takemi
- Division of Physical and Health Education, Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan; Japan Science and Technology Agency, PRESTO, 4-1-8 Honmachi, Kawaguchi, Saitama, 332-0012, Japan
| | - Tomoya Nakanishi
- Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan; The Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - Atsushi Sasaki
- Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan; The Japan Society for the Promotion of Science, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - Kimitaka Nakazawa
- Graduate School of Arts and Sciences, The University of Tokyo, 3-8-1 Komaba, Meguro-ku, Tokyo, 153-8902, Japan.
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Vannuscorps G, F Wurm M, Striem-Amit E, Caramazza A. Large-Scale Organization of the Hand Action Observation Network in Individuals Born Without Hands. Cereb Cortex 2018; 29:3434-3444. [DOI: 10.1093/cercor/bhy212] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/12/2018] [Accepted: 08/08/2018] [Indexed: 01/09/2023] Open
Abstract
Abstract
The human high-level visual cortex comprises regions specialized for the processing of distinct types of stimuli, such as objects, animals, and human actions. How does this specialization emerge? Here, we investigated the role of effector-specific visuomotor coupling experience in shaping the organization of the action observation network (AON) as a window on this question. Observed body movements are frequently coupled with corresponding motor codes, e.g., during monitoring one’s own movements and imitation, resulting in bidirectionally connected circuits between areas involved in body movements observation (e.g., of the hand) and the motor codes involved in their execution. If the organization of the AON is shaped by this effector-specific visuomotor coupling, then, it should not form for body movements that do not belong to individuals’ motor repertoire. To test this prediction, we used fMRI to investigate the spatial arrangement and functional properties of the hand and foot action observation circuits in individuals born without upper limbs. Multivoxel pattern decoding, pattern similarity, and univariate analyses revealed an intact hand AON in the individuals born without upper limbs. This suggests that the organization of the AON does not require effector-specific visuomotor coupling.
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Affiliation(s)
- Gilles Vannuscorps
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Center for Mind/Brain Sciences (CIMeC), Università degli Studi di Trento, Rovereto, Italy
- Faculty of Psychology and Educational Sciences, Psychological Sciences Research Institute and Institute of Neuroscience, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Moritz F Wurm
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Center for Mind/Brain Sciences (CIMeC), Università degli Studi di Trento, Rovereto, Italy
| | - Ella Striem-Amit
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Alfonso Caramazza
- Department of Psychology, Harvard University, Cambridge, MA, USA
- Center for Mind/Brain Sciences (CIMeC), Università degli Studi di Trento, Rovereto, Italy
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Abstract
Cortex plasticity after hand amputation is considered harmful, causing phantom limb pain. A new study shows that cortical overtake can occur instead in a compensatory manner in people born with one hand, for multiple body parts used to overcome disability.
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Hahamy A, Macdonald SN, van den Heiligenberg F, Kieliba P, Emir U, Malach R, Johansen-Berg H, Brugger P, Culham JC, Makin TR. Representation of Multiple Body Parts in the Missing-Hand Territory of Congenital One-Handers. Curr Biol 2017; 27:1350-1355. [PMID: 28434861 PMCID: PMC5434257 DOI: 10.1016/j.cub.2017.03.053] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 01/30/2017] [Accepted: 03/22/2017] [Indexed: 12/19/2022]
Abstract
Individuals born without one hand (congenital one-handers) provide a unique model for understanding the relationship between focal reorganization in the sensorimotor cortex and everyday behavior. We previously reported that the missing hand’s territory of one-handers becomes utilized by its cortical neighbor (residual arm representation), depending on residual arm usage in daily life to substitute for the missing hand’s function [1, 2]. However, the repertoire of compensatory behaviors may involve utilization of other body parts that do not cortically neighbor the hand territory. Accordingly, the pattern of brain reorganization may be more extensive [3]. Here we studied unconstrained compensatory strategies under ecological conditions in one-handers, as well as changes in activation, connectivity, and neurochemical profile in their missing hand’s cortical territory. We found that compensatory behaviors in one-handers involved multiple body parts (residual arm, lips, and feet). This diversified compensatory profile was associated with large-scale cortical reorganization, regardless of cortical proximity to the hand territory. Representations of those body parts used to substitute hand function all mapped onto the cortical territory of the missing hand, as evidenced by task-based and resting-state fMRI. The missing-hand territory also exhibited reduced GABA levels, suggesting a reduction in connectional selectivity to enable the expression of diverse cortical inputs. Because the same body parts used for compensatory purposes are those showing increased representation in the missing hand’s territory, we suggest that the typical hand territory may not necessarily represent the hand per se, but rather any other body part that shares the functionality of the missing hand [4]. Compensatory behavior in one-handers involves utilization of multiple body parts Multiple body parts benefit from increased representation in the missing-hand area The missing-hand area showed reduced connectional selectivity (lower GABA levels)
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Affiliation(s)
- Avital Hahamy
- Department of Neurobiology, Weizmann Institute of Science, Herzl Street, Rehovot 7610001, Israel
| | - Scott N Macdonald
- Graduate Program in Neuroscience, University of Western Ontario, London, Ontario N6A 5B7, Canada; Brain and Mind Institute, University of Western Ontario, London, Ontario N6A 5B7, Canada
| | - Fiona van den Heiligenberg
- FMRIB Centre, Nuffield Department of Clinical Neuroscience, University of Oxford, Headington, Oxford OX3 9DU, UK
| | - Paullina Kieliba
- FMRIB Centre, Nuffield Department of Clinical Neuroscience, University of Oxford, Headington, Oxford OX3 9DU, UK
| | - Uzay Emir
- FMRIB Centre, Nuffield Department of Clinical Neuroscience, University of Oxford, Headington, Oxford OX3 9DU, UK
| | - Rafael Malach
- Department of Neurobiology, Weizmann Institute of Science, Herzl Street, Rehovot 7610001, Israel
| | - Heidi Johansen-Berg
- FMRIB Centre, Nuffield Department of Clinical Neuroscience, University of Oxford, Headington, Oxford OX3 9DU, UK
| | - Peter Brugger
- Department of Neurology, Neuropsychology Unit, University Hospital Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland
| | - Jody C Culham
- Graduate Program in Neuroscience, University of Western Ontario, London, Ontario N6A 5B7, Canada; Brain and Mind Institute, University of Western Ontario, London, Ontario N6A 5B7, Canada; Department of Psychology, University of Western Ontario, London, Ontario N6A 5B7, Canada
| | - Tamar R Makin
- FMRIB Centre, Nuffield Department of Clinical Neuroscience, University of Oxford, Headington, Oxford OX3 9DU, UK; Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK.
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Hahamy A, Sotiropoulos SN, Henderson Slater D, Malach R, Johansen-Berg H, Makin TR. Normalisation of brain connectivity through compensatory behaviour, despite congenital hand absence. eLife 2015; 4. [PMID: 25562885 PMCID: PMC4281879 DOI: 10.7554/elife.04605] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 11/20/2014] [Indexed: 11/25/2022] Open
Abstract
Previously we showed, using task-evoked fMRI, that compensatory intact hand usage after amputation facilitates remapping of limb representations in the cortical territory of the missing hand (Makin et al., 2013a). Here we show that compensatory arm usage in individuals born without a hand (one-handers) reflects functional connectivity of spontaneous brain activity in the cortical hand region. Compared with two-handed controls, one-handers showed reduced symmetry of hand region inter-hemispheric resting-state functional connectivity and corticospinal white matter microstructure. Nevertheless, those one-handers who more frequently use their residual (handless) arm for typically bimanual daily tasks also showed more symmetrical functional connectivity of the hand region, demonstrating that adaptive behaviour drives long-range brain organisation. We therefore suggest that compensatory arm usage maintains symmetrical sensorimotor functional connectivity in one-handers. Since variability in spontaneous functional connectivity in our study reflects ecological behaviour, we propose that inter-hemispheric symmetry, typically observed in resting sensorimotor networks, depends on coordinated motor behaviour in daily life. DOI:http://dx.doi.org/10.7554/eLife.04605.001
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Affiliation(s)
- Avital Hahamy
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Stamatios N Sotiropoulos
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | | | - Rafael Malach
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Heidi Johansen-Berg
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Tamar R Makin
- FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Yu XJ, He HJ, Zhang QW, Zhao F, Zee CS, Zhang SZ, Gong XY. Somatotopic reorganization of hand representation in bilateral arm amputees with or without special foot movement skill. Brain Res 2014; 1546:9-17. [DOI: 10.1016/j.brainres.2013.12.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 12/11/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022]
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Stoeckel MC, Seitz RJ, Buetefisch CM. Congenitally altered motor experience alters somatotopic organization of human primary motor cortex. Proc Natl Acad Sci U S A 2009; 106:2395-400. [PMID: 19164537 PMCID: PMC2650167 DOI: 10.1073/pnas.0803733106] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2008] [Indexed: 12/14/2022] Open
Abstract
Human motor development is thought to result from a complex interaction between genes and experience. The well-known somatotopic organization of the primate primary motor cortex (M1) emerges postnatally. Although adaptive changes in response to learning and use occur throughout life, somatotopy is maintained as reorganization is restricted to modifications within major body part representations. We report of a unique opportunity to evaluate the influence of experience on the genetically determined somatotopic organization of motor cortex in humans. We examined the motor "foot" representation in subjects with congenitally compromised hand function and compensatory skillful foot use. Functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) of M1 revealed that the foot was represented in the classical medial foot area of M1 and was several centimetres away in nonadjacent cortex in the vicinity of the lateral "hand" area. Both areas had direct output to the spinal motor neurons innervating foot muscles and were behaviorally relevant because experimental disruption of either area by TMS altered reaction times. We demonstrate a unique, nonsomatotopically organized M1 in humans, which emerged as a function of grossly altered motor behavior from the earliest stages of development. Our results imply that during early motor development experience may play a more critical role in the shaping of genetically determined neural networks than previously assumed.
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Affiliation(s)
- M Cornelia Stoeckel
- Department of Neurology, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany
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