title: Somatotrophic reorganization in the brain after extremity replantation, revascularization and amputations: investigated by SPECT analysis.
abstract: BACKGROUND
  We wanted to investigate the somatotropic reorganization occurring in the motor and somatosensory cortex by using 99mTc-HMPAO SPECT analyses, after the extremity revascularization, replantation or amputation.
  
  
  METHODS
  Twelve patients (11 men, 1 female; mean age 38.9+/-14.7 years) and controls (5 men, mean age 32.2+/-7.9 years) were enrolled in this study. After reconstruction, lower, middle and upper orbitomeatal slices with precentral and postcentral slices were obtained. All images were visually and semi-quantitatively evaluated. Mann-Whitney U-test was used for statistical analysis.
  
  
  RESULTS
  In the revascularization and replantation patients, postcentral and precentral hypoperfusions were seen at dominant hemisphere. In the amputated patients, postcentral (in 3 of 4 cases) and precentral hypoperfusions were seen at non-dominant hemisphere and postcentral hypoperfusion (in 1 of 4 cases) was seen at dominant hemisphere. In our patients, most significant difference in regional cerebral blood flow was found in posterior parietal cortex (somatic associated area).
  
  
  CONCLUSIONS
  Changes that take place in precentral and postcentral cortical areas subsequent to the extremity replantation-revascularization of the organ is a good indicator of somatotrophic reorganization.
authors: Department of Orthopedics and Traumatology, Medicine Faculty of Inönü University, Turgut Ozal Medical Center, Malatya, Turkey. kertem@inonu.edu.tr
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