Brain Remaps Itself in a Child with Double Hand Transplant

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CHOP/Penn Medicine Team Is First to Show Massive Cortical Reorganization Is Reversible in a Child

The first child to undergo a successful hand transplant also is the first child in whom scientists have detected massive changes in how sensations from the hands are represented in the brain. The brain reorganization is thought to have begun six years before the transplant, when the child had both hands amputated because of a severe infection during infancy. Notably, after he received transplanted hands, the patient’s brain reverted toward a more typical pattern.

Each area of the body that receives nerve sensations sends signals to a corresponding site in the brain. The spatial pattern in which those signals activate the brain’s neurons is called somatosensory representation—particular parts of the brain reflect specific parts of the body.

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“We know from research in nonhuman primates and from brain imaging studies in adult patients that, following amputation, the brain remaps itself when it no longer receives input from the hands,” said first author William Gaetz, PhD, a radiology researcher in the Biomagnetic Imaging Laboratory at Children’s Hospital of Philadelphia (CHOP). “The brain area representing sensations from the lips shifts as much as 2 centimeters to the area formerly representing the hands.”

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