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Cortical motor activation patterns following hand transplantation and replantation
BRENNEIS C; LOSCHER WN; EGGER KE; BENKE T; SCHOCKE M; GABL MF; WECHSELBERGER G; FELBER S; PECHLANER S; MARGREITER R; PIZAKATZER H; POEWE W
J HAND SURG BR , 2005, vol. 30, n° 5, p. 530-533 Doc n°: 122510 Localisation : Documentation IRR Descripteurs : DD861 - TRAITEMENT CHIRURGICAL - MAIN-DOIGTS We studied cortical activation patterns by functional MRI in a patient who received bilateral hand transplantation after amputation 6 years ago and in a patient who had received unilateral hand replantation within 2 hours after amputation. In the early postoperative period, the patient who had had the hand transplantation revealed strong activation of a higher motor area, only weak activation of the primary sensorimotor motor cortex and no activation of the primary somatosensory cortex. At 1-year follow-up, a small increase in primary sensorimotor motor cortex activation was observed. Activation of the primary somatosensory cortex was only seen at the 2 year follow-up. By contrast, after hand replantation, the activation pattern was similar to that of the uninjured hand within 6 weeks. This included activation of the primary sensorimotor motor cortex, higher motor areas and primary somatosensory cortex. Transplantation after long-standing amputation results in cortical reorganization occurring over a 2-year period. In contrast, hand replantation within a few hours preserves a normal activation pattern. Langue : ANGLAIS Tiré à part : OUI |
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