Acute improvement of hand sensibility after selective ipsilateral cutaneous forearm anaesthesia

被引:56
作者
Björkman, A [1 ]
Rosén, B [1 ]
Lundborg, G [1 ]
机构
[1] Malmo Univ Hosp, Dept Hand Surg, SE-20502 Malmo, Sweden
关键词
cortical reorganization; deafferentation; EMLA (R); hand function; human;
D O I
10.1111/j.1460-9568.2004.03742.x
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
The cortical representation of body parts is constantly modulated in response to the afferent input, and acute deafferentation of a body part results in bilateral cortical reorganization. To study the effects on hand function of right forearm anaesthesia, we investigated ten human subjects (group 1) for perception of touch, tactile discrimination and grip strength in the right (ipsilateral) and left (contralateral) hand before, during and 24 h after forearm skin anaesthesia with a local anaesthetic cream (EMLA(R)). Ten age-matched controls (group 2) were investigated in the same way but received placebo. In group 1 a significant improvement was seen in tactile discrimination in the ipsilateral hand compared to base line (P = 0.009) and compared to group 2 (P = 0.006). The improvement in tactile discrimination remained for at least 24 h after anaesthesia. Perception of touch, was improved during anaesthesia compared to baseline values in group 1 (P = 0.046) and remained for at least 24 h. Grip strength did not change. These findings suggest that transient selective deafferentation of an extremity results in enhanced sensory functions of the functionally preserved parts of the same extremity, presumably as a result of expansion of adjacent cortical territories. Such rapid functional changes suggest unmasking of pre-existing synaptic connections as the mechanism underlying the acute modulation of sensory functions in the hand. Our findings open new perspectives for sensory re-education and rehabilitation following injury to the peripheral and central nervous system.
引用
收藏
页码:2733 / 2736
页数:4
相关论文
共 36 条
[11]   Sensory deprivation without competition yields modest alterations of short-term synaptic dynamics [J].
Finnerty, GT ;
Connors, BW .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2000, 97 (23) :12864-12868
[12]   Associative pairing of tactile stimulation induces somatosensory cortical reorganization in rats and humans [J].
Godde, B ;
Spengler, F ;
Dinse, HR .
NEUROREPORT, 1996, 8 (01) :281-285
[13]   FUNCTIONAL REORGANIZATION OF PRIMARY SOMATOSENSORY CORTEX IN ADULT OWL MONKEYS AFTER BEHAVIORALLY CONTROLLED TACTILE STIMULATION [J].
JENKINS, WM ;
MERZENICH, MM ;
OCHS, MT ;
ALLARD, T ;
GUICROBLES, E .
JOURNAL OF NEUROPHYSIOLOGY, 1990, 63 (01) :82-104
[14]   THE REORGANIZATION OF SOMATOSENSORY CORTEX FOLLOWING PERIPHERAL-NERVE DAMAGE IN ADULT AND DEVELOPING MAMMALS [J].
KAAS, JH ;
MERZENICH, MM ;
KILLACKEY, HP .
ANNUAL REVIEW OF NEUROSCIENCE, 1983, 6 :325-356
[15]   PLASTICITY OF SENSORY AND MOTOR MAPS IN ADULT MAMMALS [J].
KAAS, JH .
ANNUAL REVIEW OF NEUROSCIENCE, 1991, 14 :137-167
[16]   FUNCTIONAL REORGANIZATION OF ADULT RACCOON SOMATOSENSORY CEREBRAL-CORTEX FOLLOWING NEONATAL DIGIT AMPUTATION [J].
KELAHAN, AM ;
RAY, RH ;
CARSON, LV ;
MASSEY, CE ;
DOETSCH, GS .
BRAIN RESEARCH, 1981, 223 (01) :151-159
[17]   Changes of cortical motor area size during immobilization [J].
Liepert, J ;
Tegenthoff, M ;
Malin, JP .
ELECTROMYOGRAPHY AND MOTOR CONTROL-ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY, 1995, 97 (06) :382-386
[18]   Nerve injury and repair - a challenge to the plastic brain [J].
Lundborg, G .
JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, 2003, 8 (04) :209-226
[19]   Brain plasticity and hand surgery: An overview [J].
Lundborg, G .
JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME, 2000, 25B (03) :242-252
[20]  
Merzenich M M, 1993, J Hand Ther, V6, P89