Methods of assessment of cortical plasticity in patients following amputation, replantation, and composite tissue allograft transplantation.

Abstract

The brain is always adapting to new inputs from the environment. New noninvasive techniques are available to scrupulously study cortical plasticity. Several studies have proven that these modifications of neural pathways occur because of denervation from injury such as amputation. Changes that occur rapidly are likely because of unmasking of established synapses that are latent, whereas changes that occur over long periods of time are more likely because of establishment of new neural connections. Cortical reorganization that occurs from traumatic amputation has been shown to be reversible with replantation and transplantation. With the new field of composite tissue transplantation, such as hand or face, it is critical to be aware of these changes to choose potential patients and to modify their rehabilitation, on the basis of our understanding of the cortical reorganization that occurs over time.