Methods of Assessment of Cortical Plasticity in Patients Following Amputation, Replantation, and Composite Tissue Allograft Transplantation

Abstract

The brain is constantly adapting to new inputs from the environment. New noninvasive techniques are available to scrupulously study cortical plasticity. Several studies have proven that changes in neural pathways occur due to denervation from injury such as amputation. Changes that occur rapidly are likely due to unmasking of established synapses that are latent, while changes that occur over long periods of time are more likely due to 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 in order to choose potential patients and to modify their rehabilitation based on our understanding of the cortical reorganization that occurs over time.