Kikkert, S; Root, V; Makin, TR; (2019) Cortical reorganisation in the primary sensorimotor cortex following hand loss. In: The Oxford Handbook of Cortical Plasticity. Oxford University Press: Oxford, UK. (In press).

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Abstract

Limb loss provides a key model for studying brain reorganisation as it combines two main drivers of brain plasticity - sensory input loss and altered behaviour. Here we explore how the highly structured and consistent hand representation in the primary somatosensory cortex (S1) changes following hand loss. We review classical findings demonstrating that following amputation, the neighbouring body part representations ‘invade’ the deprived hand area. We review potential perceptual consequences of such reorganisation, both maladaptive (e.g. phantom limb pain) and adaptive (e.g. compensatory strategies). We highlight recent evidence demonstrating that the functional organisation in the deprived cortex is preserved even decades after amputation, consistent with the view that S1 reorganisation reflects plasticity occurring at the brainstem level. We finally highlight alternative models of deprivation-driven S1 plasticity (hand transplantation, temporary deafferentation, congenital handlessness and neuroprostheses), providing further insights into the scope and functional consequences of S1 reorganisation.

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