Cerebellar grey matter modifications in lower limb amputees not using prosthesis

Abstract

Plastic brain changes following peripheral deafferentation, in particular those following limb amputations, are well-documented, with significant reduction of grey matter (GM) in the sensory-motor cerebral areas representing the amputated limb. However, few studies have investigated the role played by the use of a prosthesis in these structural brain modifications. Here we hypothesized that using a functional prosthesis that allows individuals to perform actions may reduce grey matter reduction. We investigated the brain structural reorganization following lower limb amputation by using a Voxel Based Morphometry (VBM) analysis of structural magnetic resonance imaging (MRI) in 8 right-handed individuals with lower limb amputation (LLA) fitted with prostheses (LLAwp), compared to 6 LLA who had never used a prosthesis (LLAnp). 14 age-matched healthy controls were also enrolled (HC). We did not find any significant effect when comparing LLAwp and HC. However we found a decreased GM volume in the bilateral cerebellum in LLAnp compared with HC. These results suggest that prosthesis use prevents GM decrease in the cerebellum after lower limb amputation.

Neuroplasticity Modifications Following a Lower‐Limb Amputation: A Systematic Review

“…[Correction added on December 3, 2019, after first online publication: 31 number was changed to 32 in the Results section.] Finally, 11 articles were included in this review and 21 were excluded because they did not meet the inclusion criteria (Figure ). The excluded articles are shown in Table …”

“…The 11 studies included a total of 204 people with unilateral transfemoral or transtibial amputation. The studies included people with amputations of different origins: traumatic and oncological in five studies; traumatic, vascular, and oncological etiologies in three; traumatic in one; and not specified in two …”

“…Regarding the use of prostheses, in four studies all participants used a prosthesis . Three studies made a distinction between participants who used a prosthesis and those who did not . Three of the studies did not specify whether prostheses were used .…”

“…In three studies participants presented with neither phantom sensation nor painful sensation of a phantom limb . In three studies, participants had phantom limb sensations, but no pain . Four articles included participants with phantom limb pain, residual limb pain, or without pain/sensation .…”

“…The studies included in this review analyzed different structures and functions of the CNS: cerebellum, corpus callosum white matter, connectivity and tracts of white matter within the hemispheres and between them, morphological aspects of the cerebral cortex, mapping of the cerebral cortex, and intracortical excitability . One study analyzed the association between behavioral tests (non‐action‐oriented body representations and body schema) and the gray matter volume .…”