Abstract
The aim of this thesis was to investigate the effects of cortical reorganisational changes following experimental deafferentation and peripheral nerve injury and apply the concept of brain plasticity to enhance sensory re-education following peripheral nerve injury and repair in the hand.
In the first two papers the effects on hand function of contralateral deafferentation was investigated. Tourniquet induced anaesthesia (paper I) resulted in significant improvement in perception of touch, tactile discrimination, and grip strength in the opposite hand during anaesthesia. In order to investigate the effects of contralateral deafferentation with the pain factor eliminated, 100 patients, operated on in axillary plexus anaesthesia, were investigated (paper II). Axillary plexus anaesthesia also resulted in rapid, significant improvement in sensibility in the contralateral hand.
In paper III selective ipsilateral cutaneous anaesthesia of the forearm resulted in rapid significant improvement in ipsilateral hand function.
In the last two studies previous findings were applied on patients with median or ulnar nerve injuries. Tourniquet induced anaesthesia (paper IV) of the healthy hand results in significant rapid improvement in sensibility in nerve-injured hands. Repeated ipsilateral cutaneous anaesthesia (paper V) in combination with intensive sensory re-education resulted in improved hand function in nerve injured hands lasting at least 4 weeks after the last episode of anaesthesia.
In conclusion, hand function in both healthy persons and patients with median or ulnar nerve injuries can be improved by using the concept of brain plasticity. These findings have a potential clinical application in sensory re-education following nerve repair in the hand.
In the first two papers the effects on hand function of contralateral deafferentation was investigated. Tourniquet induced anaesthesia (paper I) resulted in significant improvement in perception of touch, tactile discrimination, and grip strength in the opposite hand during anaesthesia. In order to investigate the effects of contralateral deafferentation with the pain factor eliminated, 100 patients, operated on in axillary plexus anaesthesia, were investigated (paper II). Axillary plexus anaesthesia also resulted in rapid, significant improvement in sensibility in the contralateral hand.
In paper III selective ipsilateral cutaneous anaesthesia of the forearm resulted in rapid significant improvement in ipsilateral hand function.
In the last two studies previous findings were applied on patients with median or ulnar nerve injuries. Tourniquet induced anaesthesia (paper IV) of the healthy hand results in significant rapid improvement in sensibility in nerve-injured hands. Repeated ipsilateral cutaneous anaesthesia (paper V) in combination with intensive sensory re-education resulted in improved hand function in nerve injured hands lasting at least 4 weeks after the last episode of anaesthesia.
In conclusion, hand function in both healthy persons and patients with median or ulnar nerve injuries can be improved by using the concept of brain plasticity. These findings have a potential clinical application in sensory re-education following nerve repair in the hand.
| Original language | English |
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| Qualification | Doctor |
| Awarding Institution |
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| Supervisors/Advisors |
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| Award date | 2005 Oct 28 |
| Publisher | |
| ISBN (Print) | 91-85439-89-4 |
| Publication status | Published - 2005 |
Bibliographical note
Defence detailsDate: 2005-10-28
Time: 13:00
Place: Lilla aulan Medicinskt forskningscentrum Universitetssjukhuset MAS Malmö
External reviewer(s)
Name: Carlstedt, Thomas
Title: Professor
Affiliation: The Royal National Orthopeadic Hospital, Brockley Hill, Stanmore, Middlesex, England
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<div class="article_info">A Björkman, B Rosén, D van Westen, E-M Larsson and G Lundborg. <span class="article_issue_date">2004</span>. <span class="article_title">Acute improvement of contralateral hand function after deafferentation.</span> <span class="journal_series_title">NeuroReport</span>, <span class="journal_volume">vol 15</span> <span class="journal_pages">pp 1861-1865</span>.</div>
<div class="article_info">A Björkman, B Rosén and G Lundborg. <span class="article_issue_date">2005</span>. <span class="article_title">Anaesthesia of the axillary plexus induces rapid improvement of sensory function in the contralateral hand: an effect of interhemispheric plasticity.</span> <span class="journal_series_title">Scand J Plast Reconstr Surg Hand Surg</span>, <span class="journal_volume">vol 39</span> <span class="journal_pages">pp 234-237</span>.</div>
<div class="article_info">A Björkman, B Rosén and G Lundborg. <span class="article_issue_date">2004</span>. <span class="article_title">Acute improvement of hand sensibility after selective ipsilateral cutaneous forearm anaesthesia.</span> <span class="journal_series_title">Eur J Neurosci</span>, <span class="journal_volume">vol 20</span> <span class="journal_pages">pp 2733-2736</span>.</div>
<div class="article_info">A Björkman, B Rosén and G Lundborg. <span class="article_issue_date">2005</span>. <span class="article_title">Enhanced function in nerve-injured hands after contralateral deafferentation.</span> <span class="journal_series_title">NeuroReport</span>, <span class="journal_volume">vol 16</span> <span class="journal_pages">pp 517-519</span>.</div>
<div class="article_info">B Rosén, A Björkman and G Lundborg. <span class="article_issue_date">2005</span>. <span class="article_title">Improved sensory relearning after nerve repair induced by selective temporary anaesthesia – a new concept in hand rehabilitation.</span> <span class="journal_series_title">J Hand Surg (Br.)</span>, (submitted)</div>
Subject classification (UKÄ)
- Surgery
Free keywords
- traumatologi
- Neurology
- neuropsychology
- neurophysiology
- Neurologi
- neuropsykologi
- neurofysiologi
- Kirurgi
- ortopedi
- traumatology
- Surgery
- Medicin (människa och djur)
- Medicine (human and vertebrates)
- hand function
- nerve injury
- brain plasticity
- orthopaedics
