Knecht S, Henningsen H, Höhling C, Elbert T, Flor H, Pantev C, Taub E
Department of Neurology, University of Münster, Germany.
Brain. 1998 Apr;121 ( Pt 4):717-24. doi: 10.1093/brain/121.4.717.
We report a follow-up study on seven arm amputees in whom magnetic source imaging had originally revealed a strong correlation between the amount of cortical invasion of the deafferented cortex and the amount of pain evoked sensation mislocalized to the phantom limb. This re-examination was performed in order to corroborate the phenomenon of mislocalization. On follow-up examination for mislocalization 4 weeks later, a close correlation had remained between the original amount of cortical representational reorganization of the amputation zone (at the first examination) and the number of sites from where painful stimuli evoked sensations referred to the phantom limb, i.e. the amount of perceptual mislocalization, at the second examination. However, contrary to our expectation, the topography of referred sensation had completely changed in every patient. These results suggest that while the overall extent of reorganization is a rather stable phenomenon, the concomitant changes in the pattern of sensory processing are not. This may be due to the fact that alterations of sensory processing are not hardwired, but are rather mediated by an extensive and interconnected neural network with fluctuating synaptic strengths. This mechanism may be of importance for neurological rehabilitation.
我们报告了一项对七名手臂截肢者的随访研究，最初的磁源成像显示，去传入皮层的皮质侵犯量与幻肢疼痛诱发感觉的定位错误量之间存在很强的相关性。进行这项重新检查是为了证实定位错误现象。在4周后对定位错误进行的随访检查中，截肢区最初的皮质表征重组量（在第一次检查时）与第二次检查时疼痛刺激诱发的感觉被指认为幻肢的部位数量，即感知定位错误量之间，仍然存在密切的相关性。然而，与我们的预期相反，每位患者的牵涉感觉地形图都完全改变了。这些结果表明，虽然重组的总体程度是一个相当稳定的现象，但感觉处理模式的伴随变化并非如此。这可能是由于感觉处理的改变并非固定不变，而是由一个具有波动突触强度的广泛且相互连接的神经网络介导的。这种机制可能对神经康复具有重要意义。
