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Changes in Sensorimotor Cortical Activation in Children Using Prostheses and Prosthetic Simulators. Brain Sci 2021; 11:brainsci11080991. [PMID: 34439610 PMCID: PMC8392534 DOI: 10.3390/brainsci11080991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to examine the neural responses of children using prostheses and prosthetic simulators to better elucidate the emulation abilities of the simulators. We utilized functional near-infrared spectroscopy (fNIRS) to evaluate the neural response in five children with a congenital upper limb reduction (ULR) using a body-powered prosthesis to complete a 60 s gross motor dexterity task. The ULR group was matched with five typically developing children (TD) using their non-preferred hand and a prosthetic simulator on the same hand. The ULR group had lower activation within the primary motor cortex (M1) and supplementary motor area (SMA) compared to the TD group, but nonsignificant differences in the primary somatosensory area (S1). Compared to using their non-preferred hand, the TD group exhibited significantly higher action in S1 when using the simulator, but nonsignificant differences in M1 and SMA. The non-significant differences in S1 activation between groups and the increased activation evoked by the simulator's use may suggest rapid changes in feedback prioritization during tool use. We suggest that prosthetic simulators may elicit increased reliance on proprioceptive and tactile feedback during motor tasks. This knowledge may help to develop future prosthesis rehabilitative training or the improvement of tool-based skills.
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Guo X, Liu R, Lu J, Wu C, Lyu Y, Wang Z, Xiang J, Pan C, Tong S. Alterations in Brain Structural Connectivity After Unilateral Upper-Limb Amputation. IEEE Trans Neural Syst Rehabil Eng 2019; 27:2196-2204. [PMID: 31443033 DOI: 10.1109/tnsre.2019.2936615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous studies have indicated that amputation induces reorganization of functional brain network. However, the influence of amputation on structural brain network remains unclear. In this study, using diffusion tensor imaging (DTI), we aimed to investigate the alterations in fractional anisotropy (FA) network after unilateral upper-limb amputation. We acquired DTI from twenty-two upper-limb amputees (15 dominant-side and 7 nondominant-side amputees) as well as fifteen healthy controls. Using DTI tractography and graph theoretical approaches, we examined the topological changes in FA network of amputees. Compared with healthy controls, dominant-side amputees showed reduced global mean strength, increased characteristic path length, and decreased nodal strength in the contralateral sensorimotor system and visual areas. In particular, the nodal strength of the contralateral postcentral gyrus was negatively correlated with residual limb usage, representing a use-dependent reorganization. In addition, the nodal strength of the contralateral middle temporal gyrus was positively correlated with the magnitude of phantom limb sensation. Our results suggested a degeneration of FA network after dominant-side upper-limb amputation.
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Di Vita A, Boccia M, Palermo L, Nemmi F, Traballesi M, Brunelli S, De Giorgi R, Galati G, Guariglia C. Cerebellar grey matter modifications in lower limb amputees not using prosthesis. Sci Rep 2018; 8:370. [PMID: 29321625 PMCID: PMC5762812 DOI: 10.1038/s41598-017-18772-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 12/18/2017] [Indexed: 11/09/2022] Open
Abstract
Plastic brain changes following peripheral deafferentation, in particular those following limb amputations, are well-documented, with significant reduction of grey matter (GM) in the sensory-motor cerebral areas representing the amputated limb. However, few studies have investigated the role played by the use of a prosthesis in these structural brain modifications. Here we hypothesized that using a functional prosthesis that allows individuals to perform actions may reduce grey matter reduction. We investigated the brain structural reorganization following lower limb amputation by using a Voxel Based Morphometry (VBM) analysis of structural magnetic resonance imaging (MRI) in 8 right-handed individuals with lower limb amputation (LLA) fitted with prostheses (LLAwp), compared to 6 LLA who had never used a prosthesis (LLAnp). 14 age-matched healthy controls were also enrolled (HC). We did not find any significant effect when comparing LLAwp and HC. However we found a decreased GM volume in the bilateral cerebellum in LLAnp compared with HC. These results suggest that prosthesis use prevents GM decrease in the cerebellum after lower limb amputation.
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Affiliation(s)
- Antonella Di Vita
- PhD program in Behavioural Neuroscience, "Sapienza" University of Rome, Rome, Italy. .,I.R.C.C.S. Santa Lucia Foundation, Rome, Italy. .,Department of Psychology, "Sapienza" University of Rome, Rome, Italy.
| | - Maddalena Boccia
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy.,Department of Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Liana Palermo
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy.,Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Federico Nemmi
- Klingberg Lab, Neuroscience Department, Karolinska Institute, Stockholm, Sweden
| | | | | | | | - Gaspare Galati
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy.,Department of Psychology, "Sapienza" University of Rome, Rome, Italy.,Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Cecilia Guariglia
- I.R.C.C.S. Santa Lucia Foundation, Rome, Italy.,Department of Psychology, "Sapienza" University of Rome, Rome, Italy
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Preißler S, Thielemann D, Dietrich C, Hofmann GO, Miltner WHR, Weiss T. Preliminary Evidence for Training-Induced Changes of Morphology and Phantom Limb Pain. Front Hum Neurosci 2017; 11:319. [PMID: 28676749 PMCID: PMC5476738 DOI: 10.3389/fnhum.2017.00319] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 06/02/2017] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to investigate whether a special prosthetic training in phantom limb pain patients aimed at increasing the functional use of the prosthesis leads to neural morphological plasticity of brain structures and a reduction in phantom limb pain. For chronic pain disorders, it was shown that morphological alterations due to pain might become at least partially reversed by pain therapies. Phantom limb pain is a chronic pain disorder that is frequently followed by neural plasticity of anatomical brain structures. In our study, 10 patients with amputation of the upper limb participated in a two-week training with a myoelectric prosthesis with somatosensory feedback. Grip strength was fed back with electrocutaneous stimulus patterns applied to the stump. Phantom limb pain was assessed before and after the two-week training. Similarly, two T1 weighted MRI scans were conducted for longitudinal thickness analyses of cortical brain structures. As result of this treatment, patients experienced a reduction in phantom limb pain and a gain in prosthesis functionality. Furthermore, we found a change of cortical thickness in small brain areas in the visual stream and the post-central gyrus ipsilateral to the amputation indicating morphological alterations in brain areas involved in vision and pain processing.
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Affiliation(s)
- Sandra Preißler
- Department of Biological and Clinical Psychology, Friedrich Schiller UniversityJena, Germany
| | - Désirée Thielemann
- Department of Biological and Clinical Psychology, Friedrich Schiller UniversityJena, Germany
| | - Caroline Dietrich
- Department of Biological and Clinical Psychology, Friedrich Schiller UniversityJena, Germany
| | - Gunther O Hofmann
- Clinic for Trauma and Reconstructive Surgery, Berufsgenossenschaftliche Kliniken Bergmannstrost HalleHalle, Germany.,Department of Trauma, Hand and Reconstructive Surgery, University Hospital JenaJena, Germany
| | - Wolfgang H R Miltner
- Department of Biological and Clinical Psychology, Friedrich Schiller UniversityJena, Germany
| | - Thomas Weiss
- Department of Biological and Clinical Psychology, Friedrich Schiller UniversityJena, Germany
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Preißler S, Feiler J, Dietrich C, Hofmann GO, Miltner WHR, Weiss T. Gray Matter Changes Following Limb Amputation with High and Low Intensities of Phantom Limb Pain. Cereb Cortex 2012; 23:1038-48. [DOI: 10.1093/cercor/bhs063] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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