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Granata G, Valle G, Di Iorio R, Iodice F, Petrini FM, Strauss I, D'anna E, Iberite F, Lauretti L, Fernandez E, Romanello R, Stieglitz T, Raspopovic S, Calabresi P, Micera S, Rossini PM. Cortical plasticity after hand prostheses use: Is the hypothesis of deafferented cortex "invasion" always true? Clin Neurophysiol 2020; 131:2341-2348. [PMID: 32828036 DOI: 10.1016/j.clinph.2020.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/14/2020] [Accepted: 06/11/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To study motor cortex plasticity after a period of training with a new prototype of bidirectional hand prosthesis in three left trans-radial amputees, correlating these changes with the modification of Phantom Limb Pain (PLP) in the same period. METHODS Each subject underwent a brain motor mapping with Transcranial Magnetic Stimulation (TMS) and PLP evaluation with questionnaires during a six-month training with a prototype of bidirectional hand prosthesis. RESULTS The baseline motor maps showed in all three amputees a smaller area of muscles representation of the amputated side compared to the intact limb. After training, there was a partial reversal of the baseline asymmetry. The two subjects affected by PLP experienced a statistically significant reduction of pain. CONCLUSIONS Two apparently opposite findings, the invasion of the "deafferented" cortex by neighbouring areas and the "persistence" of neural structures after amputation, could vary according to different target used for measurement. Our results do not support a correlation between PLP and motor cortical changes. SIGNIFICANCE The selection of the target and of the task is essential for studies investigating motor brain plasticity. This study boosts against a direct and unique role of motor cortical changes on PLP genesis.
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Affiliation(s)
- G Granata
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - G Valle
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - R Di Iorio
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - F Iodice
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy; Department of Neuroscience, San Raffaele Pisana IRCCS, Rome, Italy
| | - F M Petrini
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - I Strauss
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - E D'anna
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - F Iberite
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - L Lauretti
- Institute of Neurosurgery, Catholic University of The Sacred Heart, Roma, Italy
| | - E Fernandez
- Institute of Neurosurgery, Catholic University of The Sacred Heart, Roma, Italy
| | - R Romanello
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - T Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering-IMTEK, Bernstein Center Freiburg and BrainLinks-BrainTools Center, University of Freiburg, Freiburg, Germany
| | - S Raspopovic
- Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - P Calabresi
- Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - S Micera
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - P M Rossini
- Department of Neuroscience, San Raffaele Pisana IRCCS, Rome, Italy
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