Changes in Sensorimotor Cortical Activation in Children Using Prostheses and Prosthetic Simulators.

Christopher Copeland,Jorge M Zuniga,Mukul Mukherjee,Kaitlin Fraser,Yingying Wang

doi:10.3390/brainsci11080991

Christopher Copeland, Jorge M Zuniga + Show 3 more

Open Access

https://doi.org/10.3390/brainsci11080991

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Abstract

This study aimed to examine the neural responses of children using prostheses and prosthetic simulators to better elucidate the emulation abilities of the simulators. We utilized functional near-infrared spectroscopy (fNIRS) to evaluate the neural response in five children with a congenital upper limb reduction (ULR) using a body-powered prosthesis to complete a 60 s gross motor dexterity task. The ULR group was matched with five typically developing children (TD) using their non-preferred hand and a prosthetic simulator on the same hand. The ULR group had lower activation within the primary motor cortex (M1) and supplementary motor area (SMA) compared to the TD group, but nonsignificant differences in the primary somatosensory area (S1). Compared to using their non-preferred hand, the TD group exhibited significantly higher action in S1 when using the simulator, but nonsignificant differences in M1 and SMA. The non-significant differences in S1 activation between groups and the increased activation evoked by the simulator’s use may suggest rapid changes in feedback prioritization during tool use. We suggest that prosthetic simulators may elicit increased reliance on proprioceptive and tactile feedback during motor tasks. This knowledge may help to develop future prosthesis rehabilitative training or the improvement of tool-based skills.

Highlights

The main finding of this study was that use of prosthetic simulators in typically developing children (TD) children resulted in greater activation in M1 and supplementary motor area (SMA), but similar S1 activation, when compared to prosthesis use in the upper limb reduction (ULR) group, who had not used any prosthetic device within the past six months
The higher M1 and SMA activation in the TD group when compared to the ULR group may be further evidence that the experiential motor repertoires that correspond to gross upper limb dexterity are underdeveloped within children with ULR
These results suggest that simulators cannot emulate the neurophysiological differences seen in the ULR group by mechanically restricting the limbs

Summary

Introduction

1 in 1900 children is born with an impairment known as congenital limb reduction deficiency each year [2], which results in variable levels of amputation, from finger and toe reduction to complete removal of the limb. There is a deficiency in motor research in children with congenital upper limb reduction (ULR) due to the scarce availability of research participants [6,7]. This deficiency in research participants has created a gap in the literature regarding the immediate effects and adaptation of congenital loss or early traumatic loss of a limb on the brain and its body schema [8,9]

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