Cortical Organization in Allogeneic Hand Transplants or Heterotopic Hand Replants
Technical Report,28 Sep 2010,30 Nov 2013
University of Missouri, Columbia Columbia United States
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This project was a collaboration between two sites The University of Missouri MU and the Christine M. Kleinert InstituteCMKI. The CMKI recruited and performed functional analysis and clinical sensory and motor assessments with theobjective of directly comparing the overall outcomes of the hand transplant or a hand replant procedures. Participants thentraveled to MU for structural and functional MRI and kinematic testing. We report six key accomplishments 1. Functionalrecovery for hand transplantation is equivalent or superior to that for hand replantation. 2. Hand transplantation replantationis associated with substantial reductions, or elimination, of phantom limb pain and pressure. 3. The ability to localize touchwithout vision on the transplanted or replanted hand improves gradually over years and appears unrelated to time sinceamputation. 4. Development of a novel apparatus for assessment of neural activity during manual grasping in functional MRI.5. Grasping with a transplanted or replanted hand recruits the anterior intraparietal and primary sensory cortex. 6. Individual variation in bilateral cortical reorganization of sensorimotor cortices. These have led to the development of a working model consisting of two stages of recovery following hand transplantation or replantation.