title: Central Adaptation following Brachial Plexus Injury.
abstract: Brachial plexus trauma (BPT) often affects young patients and may result in lasting functional deficits. Standard care following BPT involves monitoring for clinical and electrophysiological evidence of muscle reinnervation, with surgical treatment decisions based on the presence or absence of spontaneous recovery. Data are emerging to suggest that central and peripheral adaptation may play a role in recovery following BPT. The present review highlights adaptive and maladaptive mechanisms of central and peripheral nervous system changes following BPT that may contribute to functional outcomes. Rehabilitation and other treatment strategies that harness or modulate these intrinsic adaptive mechanisms may improve functional outcomes following BPT.
authors.affiliation: St. Vincent's Clinical School, University of New South Wales, Australia.
authors.forename: Neil G
authors.initials: NG
authors.lastname: Simon
authors.affiliation: Department of Physical Medicine and Rehabilitation, Northwestern University, Illinois, USA; Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Illinois, USA.
authors.forename: Colin K
authors.initials: CK
authors.lastname: Franz
authors.affiliation: Departments of Neurological Surgery and Pediatrics, University of California, San Francisco, California, USA.
authors.forename: Nalin
authors.initials: N
authors.lastname: Gupta
authors.affiliation: Division of Neurosurgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA; Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Tord
authors.initials: T
authors.lastname: Alden
authors.affiliation: Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Electronic address: michelkliot@gmail.com.
authors.forename: Michel
authors.initials: M
authors.lastname: Kliot
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D000328:Adult; D001072:Apraxias / Q000503:physiopathology; D001132:Arm / Q000294:innervation*; D001720:Birth Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery; D001917:Brachial Plexus / Q000293:injuries* / Q000503:physiopathology* / Q000601:surgery; D020516:Brachial Plexus Neuropathies / Q000503:physiopathology / Q000601:surgery; D001921:Brain / Q000503:physiopathology*; D003131:Combined Modality Therapy; D004576:Electromyography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation*; D009416:Nerve Regeneration / Q000502:physiology*; D011247:Pregnancy; D004561:Transcutaneous Electric Nerve Stimulation
keywords: Apraxia; Brachial plexus injury; Central adaptation; Nerve trauma; Neuroplasticity