American Society for Peripheral Nerve

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Long-term Ongoing Cortical Remodeling after Contralateral C7 Nerve Transfer
Xu-Yun Hua, PhD, MD; Wen-Dong Xu; Jian-Guang Xu ; Yu-Dong Gu
Department of Hand Surgery, Huashan Hospital, Shanghai, China

Background: Contralateral C7 nerve transfer is developed for the treatment of brachial plexus injury patients. In the surgical procedure, the affected recipient nerve would connect to the ipsilateral motor cortex and the dramatic peripheral alteration may trigger extensive cortical reorganization. But little is known about the long term results after such specific nerve transfer. The purpose of this study is to investigate the long term cortical adaptive plasticity after brachial plexus injury and contralateral C7 nerve transfer.

Methods: In this study, nine healthy male volunteers and five male patients who suffered from right BPAI and underwent contralateral C7 transfer for more than 5 years were involved. fMRI was used for the investigation of the long-term cerebral plasticity.

Results: The neuroimaging results suggested that the ongoing cortical remodeling procedure after contralateral C7 nerve transfer could last for a long period, at least for 5 years. The motor control of the reconstructed limb may finally transfer from the ipsilateral hemisphere to the contralateral hemisphere solely instead of the bilateral neural network activation.

Conclusions: It was believed that the cortical remodeling may last for a long period after peripheral rearrangement and the successful cortical transfer is the foundation of the independent motor recovery.

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