• Clin Neurophysiol · Apr 2001

    Assessment of reorganization in the sensorimotor cortex after upper limb amputation.

    • P Schwenkreis, K Witscher, F Janssen, B Pleger, R Dertwinkel, M Zenz, J P Malin, and M Tegenthoff.
    • Department of Neurology, Ruhr-University Bochum, BG-Kliniken Bergmannsheil, Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany. peter.schwenkreis@ruhr-uni-bochum.de
    • Clin Neurophysiol. 2001 Apr 1;112(4):627-35.

    ObjectiveWe wanted to investigate plastic changes occurring in the motor and somatosensory cortex after upper limb amputation, and their possible relationship to phantom pain.MethodTo assess these plastic changes, we used transcranial magnetic stimulation (TMS) and source localization of somatosensory evoked potentials (SEP). Eleven patients with upper limb amputation were investigated. The phantom pain intensity was assessed by visual analogue scaling (VAS).ResultsUsing TMS mapping, we found a significant lateralization of the amplitude-weighted centre of gravity (P<0.01) and an enlargement of the excitable area (P<0.05) on the hemisphere contralateral to the amputation. SEP mapping showed a significant medialization of the N20 dipole (P<0.05) on this side. None of these changes correlated with the phantom pain intensity.ConclusionsWe conclude that after limb amputation, the relationship between plastic changes occurring in the sensorimotor cortex and phantom pain seems to be more complex than previously believed.

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