Abstract
The right parietal lobe plays an important role in body image, and disorders of body image emerge after lesions in the parietal lobe or with parietal lobe epilepsy. Body image disorder also often accompanies upper-limb amputation, in which the patient misperceives that their missing limb is still part of their body. Cortical reorganization is known to occur after upper-limb amputation, but it is not clear how widespread and to what degree functional connectivity (FC) is reorganized post-amputation, nor whether such changes might be related to misperceptions of body image. Twenty-four subjects who had a traumatically upper-limb amputees (ULAs) and 24 age-matched healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans. Regions of interest (ROIs) in the right superior parietal gyrus (SPG_R) and right inferior parietal lobule (IPL_R) were defined using BrainNet Viewer. We calculated the amplitude of low-frequency fluctuations (ALFF) in ROIs and correlated the ROI mean amplitude of low-frequency fluctuations (mALFF) and mean scores on the phantom limb sensation (PLS) scale and beck depression index (BDI). We also calculated ROIs and whole-brain FC. Compared to the HC group, we observed significantly increased activation (mALFF) in ROIs of the ULA group. Moreover, correlation analyses revealed a significant positive correlation between ROI mALFF and scores on the PLS. There was a significant negative correlation between the SPG_R mALFF and BDI scores. Seed-based, whole-brain FC analysis revealed that FC in the ULA group significantly decreased in many brain regions across the entire brain. The right parietal lobe appears to be involved in some aspect of body awareness and depression in amputation patients. Upper-limb amputation results not only in reorganization in the local brain area formerly representing the missing limb, but also results in more widespread reorganization through FC changes in whole brain.
Highlights
Limb amputation is an important health issue affecting the quality of life of untold numbers of people worldwide (Pomares et al, 2018)
The analyses identified a significant negative correlation between the mean amplitude of low-frequency fluctuations (mALFF) values of superior parietal gyrus (SPG_R) and beck depression index (BDI) scores of the upper-limb amputees (ULAs)
This condition can be considered to be a type of body image disorder, since a coherent body image is absent (Casale et al, 2009)
Summary
Limb amputation is an important health issue affecting the quality of life of untold numbers of people worldwide (Pomares et al, 2018). In the United States, for example, the number of limb amputees continues to increase, mostly due to increases in the number of traumatic injuries resulting from traffic accidents and natural disasters, and amputations related to diabetes and malignant tumors of limbs (Varma et al, 2014). This increasing trend can be seen worldwide, with 1.5 amputations being performed per 1000 people. Amputation can save lives, the risk of many types of medical complications remains. Phantom limb pain (PLP), residual limb pain (RLP), and phantom limb sensation (PLS) are the most common clinical complications of amputations
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