TY - JOUR
T1 - Motor cortex reorganization in limb amputation: A systematic review of TMS motor mapping studies
AU - Gunduz, Muhammed Enes
AU - Pinto, Camila Bonin
AU - Velez, Faddi Ghassan Saleh
AU - Duarte, Dante
AU - Pacheco-Barrios, Kevin
AU - Lopes, Fernanda
AU - Fregni, Felipe
N1 - Funding Information:
This study was supported grant (1R01HD082302-01A1).
PY - 2020/4/21
Y1 - 2020/4/21
N2 - Purpose: The purpose of this systematic review is to evaluate motor cortex reorganization in amputees as indexed by transcranial magnetic stimulation (TMS) cortical mapping and its relationship with phantom limb pain (PLP). Methods: Pubmed database were systematically searched. Three independent researchers screened the relevant articles, and the data of motor output maps, including the number of effective stimulation sites, center of gravity (CoG) shift, and their clinical correlations were extracted. We calculated a pooled CoG shift for motor cortex TMS mapping. Results: The search yielded 468 articles, 11 were included. Three studies performed correlation between the cortical changes and PLP intensity, and only one study compared cortical mapping changes between amputees with pain and without pain. Results showed (i) enlarged excitable area and a shift of CoG of neighboring areas toward the deafferented limb area; (ii) no correlation betweenmotor cortex reorganization and level of pain and (iii) greater cortical reorganization in patients with PLP compared to amputation without pain. Conclusion: Our review supports the evidence for cortical reorganization in the affected hemisphere following an amputation. The motor cortex reorganization could be a potential clinical target for prevention and treatment response of PLP.
AB - Purpose: The purpose of this systematic review is to evaluate motor cortex reorganization in amputees as indexed by transcranial magnetic stimulation (TMS) cortical mapping and its relationship with phantom limb pain (PLP). Methods: Pubmed database were systematically searched. Three independent researchers screened the relevant articles, and the data of motor output maps, including the number of effective stimulation sites, center of gravity (CoG) shift, and their clinical correlations were extracted. We calculated a pooled CoG shift for motor cortex TMS mapping. Results: The search yielded 468 articles, 11 were included. Three studies performed correlation between the cortical changes and PLP intensity, and only one study compared cortical mapping changes between amputees with pain and without pain. Results showed (i) enlarged excitable area and a shift of CoG of neighboring areas toward the deafferented limb area; (ii) no correlation betweenmotor cortex reorganization and level of pain and (iii) greater cortical reorganization in patients with PLP compared to amputation without pain. Conclusion: Our review supports the evidence for cortical reorganization in the affected hemisphere following an amputation. The motor cortex reorganization could be a potential clinical target for prevention and treatment response of PLP.
KW - Amputation
KW - Cortical mapping
KW - Motor cortex reorganization
KW - Phantom limb pain
KW - Transcranial magnetic stimulation
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UR - https://www.mendeley.com/catalogue/dc91962f-145b-3da5-919a-55705683e8ec/
U2 - 10.3389/fnins.2020.00314
DO - 10.3389/fnins.2020.00314
M3 - Article
C2 - 32372907
VL - 14
SP - 314
JO - Frontiers in Neuroscience
JF - Frontiers in Neuroscience
SN - 1662-4548
M1 - 314
ER -