Cortical remapping in amputees and dysmelic patients: a functional MRI study.
OBJECTIVE
To investigate motor cortex function in upper and lower limb amputees and dysmelic patients using fMRI.


METHODS
Five amputees and two dysmelic patients were examined. Motor and imagery tasks were defined according to each patient limb deficiency. Cortical activation patterns were analysed for each patient and compared between groups, integrating patients clinical data.


RESULTS
There is a consistent pattern of cortical reorganization in all amputees: predominance of activation in the ipsilateral motor cortex and extension to premotor and sensory areas of the contralateral cortex. On the contrary, cortical maps of dysmelic patients were similar to those of healthy volunteers, predominantly with activation of contralateral primary motor cortex areas.


CONCLUSIONS
fMRI discloses specific patterns of cortical reorganization on amputees and dysmelic patients, suggesting influence by prosthesis adaptation or stump use with dexterity. These findings could be further applied in influencing neurorehabilitation and development of prosthetic devices.
Cruz
Vitor Tedim
VT
Neurology Department, Hospital de S. Sebastião, R. Dr Cândido de Pinho, 4520-211 Santa Maria da Feira, Portugal. vcruz@hospitalfeira.min-saude.pt
Nunes
Belina
B
Reis
Ana Mafalda
AM
Pereira
Jorge Resende
JR
D000368:Aged; D000673:Amputation, Traumatic / Q000503:physiopathology*; D001931:Brain Mapping; D002648:Child; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000293:injuries / Q000503:physiopathology; D038061:Lower Extremity Deformities, Congenital / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009044:Motor Cortex / Q000473:pathology* / Q000503:physiopathology*; D034941:Upper Extremity / Q000293:injuries / Q000503:physiopathology; D038062:Upper Extremity Deformities, Congenital / Q000503:physiopathology*