A new hand -- and signs of sensory recovery

October 9, 2008,
Activation of the left cerebral hemisphere during sensory stimulation of the transplanted right palm as viewed by enhancement of fMRI findings. Credit: Courtesy of Scott Frey

Four months after a successful hand transplant -- 35 years after amputation in an industrial accident at age 19 -- a 54-year-old man's emerging sense of touch is registered in the former "hand area" of the his brain, says a University of Oregon neuroscientist.

The finding, appearing online in advance of regular publication in the Oct. 14 issue of the journal Current Biology, centers only on the man's right palm of a donated hand, which was attached along with major nerves, bones, tendons, and muscle, in a surgery by Kleinert, Kutz and Associates Hand Care Center of Louisville, Ken. A co-author, Dr. Warren C. Breidenbach, also was the lead surgeon of the team that performed the first long-term successful hand transplant in 1999.

Still to be determined, said lead author Scott H. Frey, UO psychology professor and director of the Robert and Beverly Lewis Center for NeuroImaging, is how the brain's map of the individual fingers will evolve with increasing sensation. Just four months post-surgery, initial touch sensations were reported on the thenar eminence -- muscle on the palm just below the thumb -- and on the lateral base of the thumb near the radial nerve.

Functional magnetic resonance imaging was used to record brain activity while sensory stimuli were delivered to the hands and faces of the transplant recipient and four control participants. Results showed that sensory signals from the transplanted hand are being processed in the same brain regions that would have formerly handled sensations from the hand prior to amputation.

"This individual is very unique from a brain standpoint," Frey said. "We know that when someone loses a hand, there are reorganizational changes that take place in areas of the brain that have received sensory input from that hand. Yet, even after 35 years, the restoration of sensory input seems capable of recapturing the former territory of the hand. The capacity of the brain to reverse these changes is all the more striking in light of the fact that his brain was fully mature when the amputation occurred. We believe that this work may have far reaching implications for our understanding of brain plasticity in adulthood and neurorehabilitation."

The patient received the transplant in December 2006. After losing his hand in a machine press accident, he wore a standard cable-hook-prosthetic device, allowing him to continue working.

Reorganization in sensory regions begins within hours of a limb loss. Research on animals has shown that neurons that had been devoted to receiving sensory inputs from the limb take on new duties. Exactly what happens is not entirely clear, nor are we certain how long such changes continue Frey said, "but one way to think about it is that none of the brain's real estate is left vacant for very long." Over time, the injured man reported gradual reductions of phantom sensations and pain often reported by amputees.

Recovery of sensation and the brain's systematic mapping of the hand-to-brain network, in this case, involve only gross hand map zones, referring to activity of major nerves that were reattached, not any peripheral connections to individual digits. "We don't know what that map will look like in the future as the nerves of his fingers regenerate and sensation improves," Frey said.

Physicians at the Hand Care Center have performed four of the almost 30 hand transplants done worldwide. Advances in imaging technology are allowing neuroscientists to map the brain before and after surgeries, opening new insights into brain reorganization and recovery, Frey said.

"What this hand transplant allows us to ask for the very first time in history is: Following reorganizational changes, is it possible to reverse the restoration of sensory input into the brain? The answer, which appears to be yes, extends well beyond the case of hand transplants," he said. "In general, it gives us some ideas about the reorganizational potential of the brain."

Source: University of Oregon

Explore further: For some surgeries, nerve blocks mean better outcomes, fewer opioids

Related Stories

For some surgeries, nerve blocks mean better outcomes, fewer opioids

March 14, 2018
In a room near the operating suites at Yale New Haven Hospital's Saint Raphael Campus, anesthesiologist Jinlei Li, MD, prepares a patient for a total knee replacement. She inserts a hair-thin needle into the skin near where ...

Retraining the brain's vision center to take action

March 1, 2018
Neuroscientists have demonstrated the astounding flexibility of the brain by training neurons that normally process input from the eyes to develop new skills, in this case, to control a computer-generated tone.

Research suggests creative people do not excel in cognitive control

March 6, 2018
A recent study by a University of Arkansas researcher, Darya Zabelina, assistant professor of psychology, takes a new approach to measuring the association between creativity and cognitive control, that is, the mind's ability ...

Birth control pills increase risk of ischemic stroke

March 5, 2018
Oral contraceptives increase the risk of ischemic stroke, but this risk is very small among women who do not have other stroke risk factors, according to a Jan. 3, 2018 paper in the journal MedLink Neurology by Loyola Medicine ...

Feedback enhances brainwave control of a novel hand-exoskeleton

January 22, 2018
An extremely lightweight and portable hand exoskeleton may one day help the physically impaired with daily living. These are the hopes of EPFL scientist Luca Randazzo who is developing the exoskeleton with the Defitech Chair ...

Recording a thought's fleeting trip through the brain

January 17, 2018
University of California, Berkeley neuroscientists have tracked the progress of a thought through the brain, showing clearly how the prefrontal cortex at the front of the brain coordinates activity to help us act in response ...

Recommended for you

Democratizing science: Researchers make neuroscience experiments easier to share, reproduce

March 16, 2018
Over the past few years, scientists have faced a problem: They often cannot reproduce the results of experiments done by themselves or their peers.

Human 'chimeric' cells restore crucial protein in Duchenne muscular dystrophy

March 16, 2018
Cells made by fusing a normal human muscle cell with a muscle cell from a person with Duchenne muscular dystrophy —a rare but fatal form of muscular dystrophy—were able to significantly improve muscle function when implanted ...

Team develops 3-D tissue model of a developing human heart

March 16, 2018
The heart is the first organ to develop in the womb and the first cause of concern for many parents.

Genetic variant discovery to help asthma sufferers

March 16, 2018
Research from the University of Liverpool, published today in Lancet Respiratory Medicine, identifies a genetic variant that could improve the safety and effectiveness of corticosteroids, drugs that are used to treat a range ...

Researchers say use of artificial intelligence in medicine raises ethical questions

March 15, 2018
In a perspective piece, Stanford researchers discuss the ethical implications of using machine-learning tools in making health care decisions for patients.

Study identifies potential drug for treatment of debilitating inherited neurological disease

March 15, 2018
St. Jude Children's Research Hospital scientists have demonstrated in mouse studies that the neurological disease spinal bulbar muscular atrophy (SBMA) can be successfully treated with drugs. The finding paves the way for ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.