Brain, Vol 121, Issue 9 1785-1794, Copyright © 1998 by Oxford University Press
M Tinazzi, G Zanette, D Volpato, R Testoni, C Bonato, P Manganotti, C Miniussi and A Fiaschi
The human somatosensory cortex (S1) is capable of modification after
partial peripheral deafferentation, but it is not known whether spinal and
brainstem changes contribute to this process. We recorded spinal, brainstem
and cortical somatosensory evoked potentials following ulnar nerve
stimulation in patients affected by unilateral carpal tunnel syndrome with
EMG evidence of chronic alterations in median nerve sensorimotor conduction
at the wrist lasting at least 4 weeks, and compared them with those from
the unaffected hand and with those obtained in a control group. Amplitudes
of spinal N13 and brainstem P14 potentials following stimulation of the
ulnar nerve ipsilateral to the deafferented median nerve were greater than
those following stimulation of the contralateral ulnar nerve. Side-to-side
amplitude differences in N13 and P14 were greater in patients than in the
control group. Parietal N20 and P27 potentials, supposedly generated in S1,
were also significantly increased. The present results suggest that a
chronic pathological modification of peripheral sensorimotor inputs is
associated with changes in neural activity at multiple sites of the
somatosensory system. Changes in spinal and brainstem structures could
contribute to the mechanisms subserving changes in the S1. Changes in
synaptic strength and unmasking inputs secondary to disconnection of the
normally dominant inputs to the 'median nerve' cortex may be the mechanisms
underlying ulnar nerve SEP changes.
ARTICLES
Neurophysiological evidence of neuroplasticity at multiple levels of the somatosensory system in patients with carpal tunnel syndrome
Dipartimento di Scienze Neurologiche e della Visione, Universita di Verona, Italy.
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