Is Cortical Reorganization Following Limb Amputation Functionally Relevant and Reversible?

截肢后的皮质重组在功能上相关且可逆吗？

基本信息

批准号：
9339873
负责人：
SCOTT H FREY
金额：
$ 34.67万
依托单位：
UNIVERSITY OF MISSOURI-COLUMBIA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-01 至 2019-04-30
项目状态：
已结题

项目摘要

DESCRIPTION (provided by applicant): In modern neuroscience, the notion that the functional organization of sensory and motor cortex is dynamic-- changing in response either to increases or decreases in stimulation, is axiomatic. This has become a guiding principle of neurorehabilitation. Some of the earliest and most influential evidence for this plasticity comes from demonstrations of dramatic reorganization within the sensory and motor cortices of non-human primates following amputations (or other injuries to the peripheral nerves or spinal cord) that disrupt communications between the hand and brain. These findings are complimented by non-invasive neuroimaging demonstrations of extensive reorganization in human amputees. Together these observations are foundational to the prevailing view that cortical representations are activity-dependent, with their organization maintained through competitive interactions. Data indicating that increased stimulation (practice) induces functionally relevant changes in cortical organization are plentiful. By contrast, it remains unclear whether the reorganizational changes that follow injury-related decreases in activity in the intact brain are adaptive, maladaptive, or functionally irrelevant. Our overarching goal is to address this fundamental scientific, and broadly clinically relevant, issue in current and former hand amputees who have received hand replants. Our approach combines functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) to determine changes occurring within the former hand territory, and behavioral testing to establish their functional relevance. Aim 1: Evaluate the functional relevance of cortical map reorganization within amputees' former hand territories. Issue A) What is the relationship between the expansion of the face map into the former hand territory and neuropathic ("phantom") pain? Issue B) What is the relationship between the expansion of maps of the face, residual limb and intact hand into the former hand territory and sensibility? Issue C) Does cortical reorganization underlie non-painful tactile sensations referred from touch on other body regions to the missing limb? Aim 2: Establish the functional relevance of reorganizational changes in the cortical representation of amputees' intact hands following chronic forced use. Issue A) How does chronic forced use of the non-dominant hand affect performance? Issue B) What is the relationship between recruitment of the former hand territory during use of the intact hand and performance? Issue C) Is increased activity within the former hand territory causally involved in performances of the intact non-dominant hand? Aim 3: Determine the extent to which amputation-related cortical reorganization is reversed following hand replantation and elucidate the relevance of these changes to recovery of function. Issue A): Is recovery of function associated with re-establishing the hand map within the former hand territory? Issue B) Is the reversal of reorganizational changes within the former hand territory related to recovery?

描述（由申请人提供）：在现代神经科学中，感官和运动皮层的功能组织是动态的 - 响应刺激的增加或减少的响应是公理的。这已成为神经康复的指导原则。这种可塑性的一些最早，最有影响力的证据来自于截肢后非人类灵长类动物的感觉和运动皮层中发生戏剧性重组的证明（或其他损伤对外围神经或脊髓造成的伤害）破坏了手和大脑之间的交流。这些发现得到了人类截肢者广泛重组的非侵入性神经影像学的表现。这些观察结果共同是基本的观点，即皮质表示是活动依赖性的，其组织通过竞争性互动维护。数据表明增加刺激（实践）会导致皮质组织功能相关的变化很多。相比之下，尚不清楚完整大脑中与损伤相关的活性下降的重组变化是适应性，适应不良还是功能无关。我们的总体目标是在当前和以前的手动截肢者中解决这个基本的科学科学且在临床上具有广泛相关的问题，这些问题已收到手动补充物。我们的方法结合了功能性磁共振成像（fMRI）和经颅磁刺激（TMS），以确定以前手部区域内发生的变化，并进行行为测试以建立其功能相关性。 AIM 1：评估Amputees以前的手部领土内皮质图重组的功能相关性。问题a）面部图向前手区域的扩展与神经性疗法（“幻影”）疼痛之间有什么关系？问题b）脸部地图的扩展，残留的肢体和完整的手之间的关系是什么关系？问题c）皮质重组是指非触觉感觉的基础从触摸其他身体区域到缺失的肢体？ AIM 2：在长期强迫使用后，建立重组变化的功能相关性。问题a）慢性强迫使用非主导手段如何影响性能？问题b）在使用完整的手和性能期间，以前的手部招募招募之间有什么关系？问题c）在以前的手部区域内有因果关系中参与完整的非主导手的表现的活动增加吗？ AIM 3：确定在手动补给后逆转与截肢相关的皮质重组的程度，并阐明了这些变化与功能恢复的相关性。问题a）：恢复功能是否与重新建立以前的手部区域内的手图关联的恢复？问题b）在前手领域内的重组变化是否与恢复有关？

项目成果

期刊论文数量（13）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Changes in Primary Somatosensory Cortex Following Allogeneic Hand Transplantation or Autogenic Hand Replantation.

同种异体手移植或自体手再植后初级体感皮层的变化。

DOI：
10.3389/fnimg.2022.919694
发表时间：
2022
期刊：
Frontiers in neuroimaging
影响因子：
0
作者：
Philip,BA;Valyear,KF;Cirstea,CM;Baune,NA;Kaufman,C;Frey,SH
通讯作者：
Frey,SH

Maturation and experience in action representation: Bilateral deficits in unilateral congenital amelia.

DOI：
10.1016/j.neuropsychologia.2015.05.018
发表时间：
2015-08
期刊：
Neuropsychologia
影响因子：
2.6
作者：
Philip BA;Buckon C;Sienko S;Aiona M;Ross S;Frey SH
通讯作者：
Frey SH

Cortical Neurochemical Profile Depends on the Origin and the Site of the Central Nervous System Injury.

皮质神经化学特征取决于中枢神经系统损伤的起源和部位。

DOI：
10.1016/j.pmrj.2016.07.035
发表时间：
2016
期刊：
PM & R : the journal of injury, function, and rehabilitation
影响因子：
0
作者：
Cirstea,CarmenM;Burris,JosephE;Peng,Huiling;Nanda,Ashish;Singh,Niranjan;Craciunas,SorinC
通讯作者：
Craciunas,SorinC

Microstructural integrity of corticospinal and medial lemniscus tracts: insights from diffusion tensor tractography of right-hand amputees.

皮质脊髓和内侧丘系束的微观结构完整性：来自右手截肢者扩散张量束成像的见解。