title: Changes in the corticospinal tract after wearing prosthesis in bilateral transtibial amputation.
abstract: BACKGROUND
  After amputation, the brain is known to be reorganized especially in the primary motor cortex. We report a case to show changes in the corticospinal tract in a patient with serial bilateral transtibial amputations using diffusion tensor imaging. Case Description and Methods: A 78-year-old man had a transtibial amputation on his left side in 2008 and he underwent a right transtibial amputation in 2011. An initial brain magnetic resonance imaging with a diffusion tensor imaging was performed before starting rehabilitation on his right transtibial prosthesis, and a follow-up magnetic resonance imaging with diffusion tensor imaging was performed 2 years after this. Findings and Outcomes: In the initial diffusion tensor imaging, the number of fiber lines in his right corticospinal tract was larger than that in his left corticospinal tract. At follow-up diffusion tensor imaging, there was no definite difference in the number of fiber lines between both corticospinal tracts.
  
  
  CONCLUSIONS
  We found that side-to-side corticospinal tract differences were equalized after using bilateral prostheses. Clinical relevance This case report suggests that diffusion tensor imaging tractography could be a useful method to understand corticomotor reorganization after using prosthesis in transtibial amputation.
authors.affiliation: 1 Department of Physical Medicine & Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: 1 Department of Physical Medicine & Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Si Hyun
authors.initials: SH
authors.lastname: Kang
authors.affiliation: 1 Department of Physical Medicine & Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Don-Kyu
authors.initials: DK
authors.lastname: Kim
authors.affiliation: 1 Department of Physical Medicine & Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Kyung Mook
authors.initials: KM
authors.lastname: Seo
authors.affiliation: 1 Department of Physical Medicine & Rehabilitation, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Hee Joon
authors.initials: HJ
authors.lastname: Ro
authors.affiliation: 2 Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Jae Kyun
authors.initials: JK
authors.lastname: Kim
mesh_terms: D000222:Adaptation, Physiological; D000368:Aged; D000671:Amputation, Surgical / Q000379:methods* / Q000534:rehabilitation; D001186:Artificial Limbs; D056324:Diffusion Tensor Imaging / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D017755:Prosthesis Fitting / Q000379:methods; D011712:Pyramidal Tracts / Q000000981:diagnostic imaging* / Q000503:physiopathology; D056910:Republic of Korea; D013647:Task Performance and Analysis; D013977:Tibia / Q000601:surgery
keywords: Prosthetics; corticospinal tract; diffusion tensor imaging; rehabilitation of prostheses