2011 - 10th Meeting - IHCTAS


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Concurrent Sessions. Session 5: Functional Assessment

11.1 - Neuroplasticity in the Context of Vascularized Composite Allotransplantation

Presenter: Scott, Frey, Eugene, OR, USA
Authors: Scott Frey

Scott Frey, University of Oregon, Eugene, OR, USA.

Functional recovery following hand or face transplantation depends, in part, on adaptive changes in regions of the central nervous system involved in sensory and motor processing. Longstanding evidence from animal models indicates extensive functional and even structural reorganization in sensory and motor cortices following injuries that disrupt afferent and/or efferent signals. The extent to which these changes can be reversed is a fundamental, and clinically significant, question that can be addressed in humans through use of non-invasive functional neuroimaging techniques. In this talk, I will present evidence from functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) studies concerning the effects of unilateral upper extremity amputation on cortical organization. This work suggests that hand loss impacts both cerebral hemispheres during sensorimotor behavior and at rest. We will then consider evidence regarding the potential reversibility of these reorganization changes through hand transplantation, and implications for recovery of function.

At the end of the presentations attendees will:

  1. be familiar with the basic methods of fMRI and TMS, and how they can be used to evaluate cortical organization non-invasively in humans.
  2. understand the basic factors influencing activity-dependent reorganizational changes following peripheral nerve injury or amputation.
  3. appreciate the potential for measures of brain function to contribute to patient selection, prognosis and monitoring the response to rehabilitative interventions.

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