Aberrant central plasticity underlying synchronous sensory phenomena in brachial plexus injuries after contralateral cervical seventh nerve transfer

Abstract

Backgrounds: Contralateral cervical seventh (C7) nerve transfer aids motor and sensory recovery in total brachial plexus avulsion injuries (TBPI), but synchronous sensation often persists postoperatively. The mechanism underlying synchronous sensory phenomena remain largely unknown. Objective: To investigate the role of central plasticity in sensory recovery after contralateral C7 nerve transfer. Methods: Sixteen right TBPI patients who received contralateral C7 nerve transfer for more than 2 years were included. Sensory evaluations included Semmes–Weinstein monofilament assessment (SWM), synchronous sensation test, and sensory evoked action potential (SNAP) test. Smaller value in the SWM assessment and larger amplitude of SNAP indicates better tactile sensory. Functional magnetic resonance imaging was performed while stimulations delivered to each hand separately in block-design trials for central plasticity analysis. Results: The SWM value of the injured right hand was increased compared with the healthy left side (difference: 1.76, 95% confidence interval: 1.37–2.15, p