title: Cortical motor activation patterns following hand transplantation and replantation.
abstract: We studied cortical activation patterns by functional MRI in a patient who received bilateral hand transplantation after amputation 6 years ago and in a patient who had received unilateral hand replantation within 2 hours after amputation. In the early postoperative period, the patient who had had the hand transplantation revealed strong activation of a higher motor area, only weak activation of the primary sensorimotor motor cortex and no activation of the primary somatosensory cortex. At 1-year follow-up, a small increase in primary sensorimotor motor cortex activation was observed. Activation of the primary somatosensory cortex was only seen at the 2 year follow-up. By contrast, after hand replantation, the activation pattern was similar to that of the uninjured hand within 6 weeks. This included activation of the primary sensorimotor motor cortex, higher motor areas and primary somatosensory cortex. Transplantation after long-standing amputation results in cortical reorganization occurring over a 2-year period. In contrast, hand replantation within a few hours preserves a normal activation pattern.
authors.affiliation: Clinical Department of Neurology, Innsbruck Medical University, Austria. christian.brenneis@uibk.ac.at
authors.forename: C
authors.initials: C
authors.lastname: Brenneis
authors.forename: W N
authors.initials: WN
authors.lastname: Löscher
authors.forename: K E
authors.initials: KE
authors.lastname: Egger
authors.forename: T
authors.initials: T
authors.lastname: Benke
authors.forename: M
authors.initials: M
authors.lastname: Schocke
authors.forename: M F
authors.initials: MF
authors.lastname: Gabl
authors.forename: G
authors.initials: G
authors.lastname: Wechselberger
authors.forename: S
authors.initials: S
authors.lastname: Felber
authors.forename: S
authors.initials: S
authors.lastname: Pechlaner
authors.forename: R
authors.initials: R
authors.lastname: Margreiter
authors.forename: H
authors.initials: H
authors.lastname: Piza-Katzer
authors.forename: W
authors.initials: W
authors.lastname: Poewe
mesh_terms: D000328:Adult; D005260:Female; D006225:Hand / Q000502:physiology / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology*; D009068:Movement / Q000502:physiology; D012092:Replantation; D014184:Transplantation, Homologous