08 April 2009

Brain rewires for new hands

Years after loss of hands the brain can reorganise and rewire itself to recognise and connect to a replacement, a team of researchers in France reports.


Years after loss of hands the brain can reorganise and rewire itself to recognise and connect to a replacement, a team of researchers in France reports.

They also found that when patients had both hands transplanted, their brains re-established connections much more quickly with the left hand than the right.

The sample was small, just two patients, but both had been right-handed before losing their hands, and both followed a pattern of reconnection with their brain that was quicker for the left hand.

The study, led by Angela Sirigu of the Centre for Cognitive Neuroscience at the University of Lyon, France, is reported in Tuesday’s edition of Proceedings of the National Academy of Science.

Hands and face transplant
It also came just days after French physicians, in a 30-hour operation, performed the world’s first simultaneous partial-face and double-hand transplant. Paris’ Public Hospital authority described the recipient as a 30-year-old burn victim who was injured in a 2004 accident.

There have been five other face transplants in the world to date, three of them in France. The most recent was completed on March 27 at the same hospital.

But this is the first time that a transplant of both hands and the face have been completed simultaneously.

New hands
Sirigu’s team used magnetic imaging to study the brains of people who had lost both hands and to see how the motor region that controls movement responded after new hands were transplanted.

The first case involved LB, a 20-year-old man injured in 2000, who received the transplants in 2003 after having used artificial hand devices in the meantime.

He was checked periodically and the researchers found his brain re-established nerve connections to control the left hand by 10 months, while it took 26 months to complete the rewiring needed for the right hand.

Hand preference shifted
“Interestingly, despite that LB was right-handed, and that after his amputation he used his prosthetic device mostly with his right hand, hand preference shifted from right to left after he had the graft,” the researchers reported.

The second patient studied, CD, was a 46-year-old man who lost both hands in 1996 and received a dual hand transplant in 2000. He was tested by the researchers in 2004, 51 months after the transplant. Strong connections in the brain were observed for the left hand, but not yet the right.

The researchers said more study is needed to determine the reason that the brain reconnected more efficiently to the left hand in these patients. Possibilities include a basically better connection to the left hand, factors in the way that the brain reorganises itself during the process of the loss of a hand and its later replacement, or perhaps some pre-existing difference in brain organisation.

Right controls left
In general, experiments have shown that the right side of the brain controls the left side of the body and many researchers believe it also dominates in such areas as spatial abilities, face recognition, visual imagery and music.

The left side of the brain controls the right side of the body and is thought to dominate in language, math and logic. However, many traits are shared by both sides, and if one side is damaged the other can take over many of its functions.

The research was supported by the US National Science Foundation, the French National Centre for Scientific Research, the International Brain Organization and other organizations in Brazil, France and Canada. – (Sapa-AFP, April 2009)

Read more:
Face transplant patient discharged
Brain rewires after hand transplant



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