title: Long-term ongoing cortical remodeling after contralateral C-7 nerve transfer.
abstract: OBJECTIVE
  Contralateral C-7 nerve transfer was developed for the treatment of patients with brachial plexus avulsion injury (BPAI). In the surgical procedure the affected recipient nerve is connected to the ipsilateral motor cortex, and the dramatic peripheral alteration may trigger extensive cortical reorganization. However, little is known about the long-term results after such specific nerve transfers. The purpose of this study was to investigate the long-term cortical adaptive plasticity after BPAI and contralateral C-7 nerve transfer.
  
  
  METHODS
  In this study, 9 healthy male volunteers and 5 male patients who suffered from right-sided BPAI and had undergone contralateral C-7-transfer more than 5 years earlier were included. Functional MRI studies were used for the investigation of long-term cerebral plasticity.
  
  
  RESULTS
  The neuroimaging results suggested that the ongoing cortical remodeling process after contralateral C-7 nerve transfer could last for a long period; at least for 5 years. The motor control of the reinnervated limb may finally transfer from the ipsilateral to the contralateral hemisphere exclusively, instead of the bilateral neural network activation.
  
  
  CONCLUSIONS
  The authors believe that the cortical remodeling may last for a long period after peripheral rearrangement and that the successful cortical transfer is the foundation of the independent motor recovery.
authors: Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.
authors: Xu-Yun
authors: XY
authors: Hua
authors: Bin
authors: B
authors: Liu
authors: Yan-Qun
authors: YQ
authors: Qiu
authors: Wei-Jun
authors: WJ
authors: Tang
authors: Wen-Dong
authors: WD
authors: Xu
authors: Han-Qiu
authors: HQ
authors: Liu
authors: Jian-Guang
authors: JG
authors: Xu
authors: Yu-Dong
authors: YD
authors: Gu
mesh_terms: D000328:Adult; D001917:Brachial Plexus / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology; D016022:Case-Control Studies; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000473:pathology / Q000502:physiology*; D016067:Nerve Transfer / Q000379:methods*; D009473:Neuronal Plasticity / Q000502:physiology*; D059348:Peripheral Nerve Injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity / Q000294:innervation / Q000502:physiology