Upper limb cortical maps in amputees with targeted muscle and sensory reinnervation.

Autor:	Serino A; Center for Neuroprosthetics, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Laboratory of Cognitive Neuroscience, Faculty of Life Science, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Switzerland., Akselrod M; Center for Neuroprosthetics, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Laboratory of Cognitive Neuroscience, Faculty of Life Science, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Department of Clinical Neurosciences, University Hospital Lausanne (CHUV), Switzerland., Salomon R; Center for Neuroprosthetics, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Laboratory of Cognitive Neuroscience, Faculty of Life Science, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel., Martuzzi R; Center for Neuroprosthetics, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Laboratory of Cognitive Neuroscience, Faculty of Life Science, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Campus Biotech Geneva, Geneva, Switzerland., Blefari ML; Center for Neuroprosthetics, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Laboratory of Cognitive Neuroscience, Faculty of Life Science, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland., Canzoneri E; Center for Neuroprosthetics, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Laboratory of Cognitive Neuroscience, Faculty of Life Science, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland., Rognini G; Center for Neuroprosthetics, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Laboratory of Cognitive Neuroscience, Faculty of Life Science, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland., van der Zwaag W; Biomedical Imaging Research Center, Swiss Federal Institute of Technology of Lausanne (EPFL), Lausanne, Switzerland.; Spinoza Centre for Neuroimaging, Amsterdam, The Netherlands., Iakova M; Département de l'appareil locomoteur, Clinique Romande de Réadaptation SUVA Care, Sion, Switzerland., Luthi F; Département de l'appareil locomoteur, Clinique Romande de Réadaptation SUVA Care, Sion, Switzerland., Amoresano A; Centro Protesi INAIL, Vigorso di Budrio, Bologna, Italy., Kuiken T; Center for Bionic Medicine, Rehabilitation Institute of Chicago, Chicago, IL, USA., Blanke O; Center for Neuroprosthetics, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Laboratory of Cognitive Neuroscience, Faculty of Life Science, Swiss Federal Institute of Technology of Lausanne (EPFL), chemin des mines 9, 1202 Geneva, Switzerland.; Department of Neurology, University Hospital, Geneva, Switzerland.
Jazyk:	angličtina
Zdroj:	Brain : a journal of neurology [Brain] 2017 Nov 01; Vol. 140 (11), pp. 2993-3011.
DOI:	10.1093/brain/awx242
Abstrakt:	Neuroprosthetics research in amputee patients aims at developing new prostheses that move and feel like real limbs. Targeted muscle and sensory reinnervation (TMSR) is such an approach and consists of rerouting motor and sensory nerves from the residual limb towards intact muscles and skin regions. Movement of the myoelectric prosthesis is enabled via decoded electromyography activity from reinnervated muscles and touch sensation on the missing limb is enabled by stimulation of the reinnervated skin areas. Here we ask whether and how motor control and redirected somatosensory stimulation provided via TMSR affected the maps of the upper limb in primary motor (M1) and primary somatosensory (S1) cortex, as well as their functional connections. To this aim, we tested three TMSR patients and investigated the extent, strength, and topographical organization of the missing limb and several control body regions in M1 and S1 at ultra high-field (7 T) functional magnetic resonance imaging. Additionally, we analysed the functional connectivity between M1 and S1 and of both these regions with fronto-parietal regions, known to be important for multisensory upper limb processing. These data were compared with those of control amputee patients (n = 6) and healthy controls (n = 12). We found that M1 maps of the amputated limb in TMSR patients were similar in terms of extent, strength, and topography to healthy controls and different from non-TMSR patients. S1 maps of TMSR patients were also more similar to normal conditions in terms of topographical organization and extent, as compared to non-targeted muscle and sensory reinnervation patients, but weaker in activation strength compared to healthy controls. Functional connectivity in TMSR patients between upper limb maps in M1 and S1 was comparable with healthy controls, while being reduced in non-TMSR patients. However, connectivity was reduced between S1 and fronto-parietal regions, in both the TMSR and non-TMSR patients with respect to healthy controls. This was associated with the absence of a well-established multisensory effect (visual enhancement of touch) in TMSR patients. Collectively, these results show how M1 and S1 process signals related to movement and touch are enabled by targeted muscle and sensory reinnervation. Moreover, they suggest that TMSR may counteract maladaptive cortical plasticity typically found after limb loss, in M1, partially in S1, and in their mutual connectivity. The lack of multisensory interaction in the present data suggests that further engineering advances are necessary (e.g. the integration of somatosensory feedback into current prostheses) to enable prostheses that move and feel as real limbs. (© The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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