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J Hand Ther. 1993 Apr-Jun;6(2):89-104.

Reorganization of cortical representations of the hand following alterations of skin inputs induced by nerve injury, skin island transfers, and experience.

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W. M. Keck Center for Integrative Neurosciences & Coleman Laboratory, University of California, San Francisco 94143-0732.


Tactile experiences remodel the central nervous system representations of the body surface. The results of assessments of ten peripheral manipulations that reveal different aspects of representational plasticity are reviewed: (1) chronic peripheral denervation; (2) surgical amputation; (3) digital syndactyly and its natural behavioral equivalents; (4) peripheral nerve crush with reinnervation; (5) peripheral nerve transection and repair, with reinnervation; (6) denervation of very large skin surfaces, for very long times; (7) electrical stimulation of large-fiber afferents in the median nerve, simulating electroacupuncture; (8) implantation of always-innervated island pedicle flaps; (9) behavioral training with locationally invariant stimuli; and (10) behavioral training with moving stimuli. Focus is on the changes recorded in a primary somatosensory cortical field, area 3b, following these ten manipulations, in adult monkeys. On the basis of these findings, the following are discussed: (1) how altered schedules of activity from the skin contribute to cortical representational remodeling; (2) other factors that influence the representational remodeling; (3) where the remodeling actually occurs; and (4) some implications of these findings for sensory rehabilitation.

[Indexed for MEDLINE]

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