Stimulation of peroneal nerves reveals maintained somatosensory representation in transtibial amputees

Frontiers in Human Neuroscience

Human Neuroscience

Gunther O. Hofmann¹  Wolfgang H. R. Miltner²  Thomas Weiss²  Hanna Koehler³  Maria Geisler⁴  Sandra Nehrdich⁴  Caroline Ritter⁴  Kathrin R. Blume⁵ 

[1] Berufsgenossenschaftliche Kliniken Bergmannstrost Halle/Saale, Halle, Germany;Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany;Department of Clinical Psychology, Institute of Psychology, Friedrich Schiller University Jena, Jena, Germany;Department of Clinical Psychology, Institute of Psychology, Friedrich Schiller University Jena, Jena, Germany;Biomagnetic Center, Department of Neurology, University Hospital Jena, Jena, Germany;Department of Clinical Psychology, Institute of Psychology, Friedrich Schiller University Jena, Jena, Germany;Clinic for Psychosomatics and Psychotherapy, Jena University Hospital, Jena, Germany;Department of Clinical Psychology, Institute of Psychology, Friedrich Schiller University Jena, Jena, Germany;Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany;

关键词: phantom limb pain (PLP);    somatosensory cortex (SI);    peroneal nerve stimulation;    somatosensory evoked fields (SEF);    MEG;    transtibial amputation;   

DOI  :  10.3389/fnhum.2023.1240937

 received in 2023-06-20, accepted in 2023-08-18,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionSeveral studies have found changes in the organization of the primary somatosensory cortex (SI) after amputation. This SI reorganization was mainly investigated by stimulating neighboring areas to amputation. Unexpectedly, the somatosensory representation of the deafferented limb has rarely been directly tested.MethodsWe stimulated the truncated peroneal nerve in 24 unilateral transtibial amputees and 15 healthy controls. The stimulation intensity was adjusted to make the elicited percept comparable between both stimulation sides. Neural sources of the somatosensory-evoked magnetic fields (SEFs) to peroneal stimulation were localized in the contralateral foot/leg areas of SI in 19 patients and 14 healthy controls.ResultsWe demonstrated the activation of functionally preserved cortical representations of amputated lower limbs. None of the patients reported evoked phantom limb pain (PLP) during stimulation. Stimulation that evoked perceptions in the foot required stronger intensities on the amputated side than on the intact side. In addition to this, stronger stimulation intensities were required for amputees than for healthy controls. Exploratorily, PLP intensity was neither associated with stimulation intensity nor dipole strength nor with differences in Euclidean distances (between SEF sources of the healthy peroneus and mirrored SEF sources of the truncated peroneus).DiscussionOur results provide hope that the truncated nerve may be used to establish both motor control and somatosensory feedback via the nerve trunk when a permanently functional connection between the nerve trunk and the prosthesis becomes available.

【 授权许可】

Unknown   
Copyright © 2023 Ritter, Geisler, Blume, Nehrdich, Hofmann, Koehler, Miltner and Weiss.