Having a limb amputated can be an absolutely devastating experience, luckily, clinicians today have been able to alleviate some of the effects of amputation through prosthetics, rehabilitative therapy, and allogenic transplantation. Allogenic transplantation is the process of connecting a non-genetically matched donor limb to an amputee patient. As of 2018, there have been 75 successful allogenic hand transplants. These transplants have given patients the ability to perform complex functions, such as grasping and object manipulation, but resulted in limited ability for basic sensory and motor function. This juxtaposition of functionality puzzled researches at the University of Missouri, and therefore motivated them to undertake an analysis of the relationship between hand function and brain activity. The analysis surrounded a 36 year old patient who was recently given an allogenic hand transplant 13 years after his original amputation. During the 13 years the patient lived without his left arm, the specific connections in his brain corresponding to hand motility and sensitivity became significantly reduced. However, adjacent regions of his brain seemed to expand directly into these regions, possibly affecting his ability to regain original functionality once the peripheral nerves in the hand are reattached. In fact, previous studies revealed that patients who receive hand transplants normally sustain these organizational changes in primary sensory and motor cortices long after their surgery. However, despite the reorganization of these once necessary connections, transplant patients, including the one analyzed in this study, show remarkable capability for higher hand functions, such as grasping and object manipulation. The results of this study reveal that the brains of transplant patients seems to compensate for this lost connectivity by increasing the activity of the premotor and cerebellar cortices; regions primarily responsible for higher level motor function. The authors hypothesize that the “re-assigning” of brain function therefore compensates for amputation related brain structure reorganization. The results of this study predict that upstream brain functions may compensate for the loss of downstream connections in other neurological conditions and may be targeted to increase the efficacy of neuro-rehabilitation in the future.
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