Gray Matter Volume Loss after Upper Limb Amputation

Gaser, Christian; Nenadić, Igor; Weiß, Thomas; Miltner, Wolfgang H. R.; Sauer, Hans R.

doi:10.1055/s-2004-831981

Cited by 5 publications

(7 citation statements)

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“…The changes reported by Dettmers et al (1999) also indicate a loss of gray matter. Our results are also in line with Gaser et al (2004) demonstrating loss of gray matter in the hand representation of M1 in a subject with upper limb amputation. Furthermore, a study with patients after complete spinal cord injury reported loss of axons and dendrites in the deafferented area in M1 (Wrigley et al 2009).…”

Section: Neural Alterations In the Precentral Gyrussupporting

confidence: 92%

“…Studies focusing on neural alterations caused by amputation are rare and the results are not uniform. A single case study reports a continuous loss of gray matter in the primary somatosensory cortex (S1), superior parietal cortex, supplementary motor area, primary motor cortex (M1), and cerebellum covering a 21-week period after upper limb amputation (Gaser et al 2004). Neural alterations in S1 are in line with previous studies focusing on the underlying central mechanisms of PLP.…”

Section: Introductionsupporting

confidence: 82%

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Gray Matter Changes Following Limb Amputation with High and Low Intensities of Phantom Limb Pain

Preißler¹,

Feiler²,

Dietrich³

et al. 2012

Cerebral Cortex

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Limb amputation and chronic phantom limb pain (PLP) are both associated with neural alterations at all levels of the neuraxis. We investigated gray matter volume of 21 upper limb amputees and 14 healthy control subjects. Results demonstrate that amputation is associated with reduced gray matter in areas in the motor cortex representing the amputated limb. Additionally, patients show an increase in gray matter in brain regions that belong to the dorsal and ventral visual stream. We subdivided the patient group into patients with medium to high PLP (HPLP; N = 11) and those with slight PLP (SPLP; N = 10). HPLP patients showed reduced gray matter in brain areas involved in pain processing. SPLP patients showed a significant gray matter increase in regions of the visual stream. Results indicate that all patients may have an enhanced need for visual control to compensate the lack of sensory feedback of the missing limb. As we found these alterations primarily in the SPLP patient group, successful compensation may have an impact on PLP development. Therefore, we hypothesize that visual adaptation mechanisms may compensate for the lack of sensorimotor feedback and may therefore function as a protection mechanism against high PLP development.

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Section: Neural Alterations In the Precentral Gyrussupporting

confidence: 92%

Section: Introductionsupporting

confidence: 82%

Gray Matter Changes Following Limb Amputation with High and Low Intensities of Phantom Limb Pain

Preißler¹,

Feiler²,

Dietrich³

et al. 2012

Cerebral Cortex

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show abstract

“…For the first time, our work demonstrates in a group study the involvement of cerebellar alteration in amputees, linked to the prosthesis use, which is likely due to the different alterations of somatosensory inputs between those who do not use the prosthesis and those who do use it. Indeed, according to the literature review described above, only the Gaser, Nenadic, Weiss, Miltner & Sauer’s 13 single case study documented a continuous grey matter loss in the first 21 weeks after amputation also in the cerebellum. Accordingly, Mizelle, Oparah &Wheaton 14 highlighted a downregulation of cerebellar activity when somatosensory feedback was altered without an adaptation period in a study investigating the role of visual and somatosensory feedback in skilled movements (i.e.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar grey matter modifications in lower limb amputees not using prosthesis

Vita

Boccia

Palermo

et al. 2018

Sci Rep

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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.

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“…Both training and changes in chronic pain are known to provoke structural changes (Gaser et al, 2004; May, 2011b). On the one hand, amputation might be accompanied with a loss of cortical volume in different regions (Draganski et al, 2006; Preißler et al, 2013b).…”

Section: Discussionmentioning

confidence: 99%

“…Draganski et al ( 2006 ) showed additional decrease in gray matter within the thalamus contralateral to the amputated side. Gaser et al ( 2004 ) found decreased gray matter in primary motor cortex (MI), SI, superior parietal cortex contralateral to the amputated limb. Additional decrease in gray matter was found in the supplementary motor area (SMA), and the ipsilateral primary motor cortex and bilaterally in the cerebellum and the brain stem.…”

Section: Introductionmentioning

confidence: 99%

Preliminary Evidence for Training-Induced Changes of Morphology and Phantom Limb Pain

Preißler

Thielemann

Dietrich

et al. 2017

Front. Hum. Neurosci.

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The aim of this study was to investigate whether a special prosthetic training in phantom limb pain patients aimed at increasing the functional use of the prosthesis leads to neural morphological plasticity of brain structures and a reduction in phantom limb pain. For chronic pain disorders, it was shown that morphological alterations due to pain might become at least partially reversed by pain therapies. Phantom limb pain is a chronic pain disorder that is frequently followed by neural plasticity of anatomical brain structures. In our study, 10 patients with amputation of the upper limb participated in a two-week training with a myoelectric prosthesis with somatosensory feedback. Grip strength was fed back with electrocutaneous stimulus patterns applied to the stump. Phantom limb pain was assessed before and after the two-week training. Similarly, two T1 weighted MRI scans were conducted for longitudinal thickness analyses of cortical brain structures. As result of this treatment, patients experienced a reduction in phantom limb pain and a gain in prosthesis functionality. Furthermore, we found a change of cortical thickness in small brain areas in the visual stream and the post-central gyrus ipsilateral to the amputation indicating morphological alterations in brain areas involved in vision and pain processing.

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Gray Matter Volume Loss after Upper Limb Amputation

Cited by 5 publications

References 0 publications

Gray Matter Changes Following Limb Amputation with High and Low Intensities of Phantom Limb Pain

Gray Matter Changes Following Limb Amputation with High and Low Intensities of Phantom Limb Pain

Cerebellar grey matter modifications in lower limb amputees not using prosthesis

Preliminary Evidence for Training-Induced Changes of Morphology and Phantom Limb Pain

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