Area of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
The Biorobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Bertarelli Foundation Chair in Translational Neural Engineering. Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
Clin Neurophysiol. 2020 Oct;131(10):2341-2348. doi: 10.1016/j.clinph.2020.06.023. Epub 2020 Jul 15.
To study motor cortex plasticity after a period of training with a new prototype of bidirectional hand prosthesis in three left trans-radial amputees, correlating these changes with the modification of Phantom Limb Pain (PLP) in the same period.
Each subject underwent a brain motor mapping with Transcranial Magnetic Stimulation (TMS) and PLP evaluation with questionnaires during a six-month training with a prototype of bidirectional hand prosthesis.
The baseline motor maps showed in all three amputees a smaller area of muscles representation of the amputated side compared to the intact limb. After training, there was a partial reversal of the baseline asymmetry. The two subjects affected by PLP experienced a statistically significant reduction of pain.
Two apparently opposite findings, the invasion of the "deafferented" cortex by neighbouring areas and the "persistence" of neural structures after amputation, could vary according to different target used for measurement. Our results do not support a correlation between PLP and motor cortical changes.
The selection of the target and of the task is essential for studies investigating motor brain plasticity. This study boosts against a direct and unique role of motor cortical changes on PLP genesis.
研究 3 名左侧桡骨截断截肢患者在使用新型双向手假肢进行一段时间训练后的运动皮层可塑性，并将这些变化与同期幻肢痛（PLP）的改变相关联。
每位受试者在使用双向手假肢原型进行 6 个月训练期间，均接受经颅磁刺激（TMS）脑运动映射和 PLP 问卷调查评估。
基线运动图显示，所有 3 名截肢者的截肢侧肌肉代表区域均小于健侧。训练后，基线不对称性部分逆转。两名受 PLP 影响的受试者经历了疼痛的统计学显著减轻。
两种看似相反的发现，即“去传入”皮层被相邻区域侵犯和截肢后神经结构的“持续存在”，可能因用于测量的不同目标而有所不同。我们的结果不支持 PLP 与运动皮层变化之间的相关性。
目标和任务的选择对于研究运动大脑可塑性至关重要。本研究反对运动皮层变化对 PLP 发生的直接和独特作用。
