Neuroplasticity Modifications Following a Lower-Limb Amputation: A Systematic Review

Area of Science:

• Neuroscience
• Neuroimaging
• Neuroplasticity

Background:

• Limited understanding of brain changes following lower-limb amputation compared to upper-limb amputation.
• Neuroplasticity research has primarily focused on upper-limb amputation.
• Need for comprehensive review of brain modifications in lower-limb amputees.

Purpose of the Study:

• To investigate and synthesize findings on brain modifications after lower-limb amputation.
• To understand neuroplastic changes in the central nervous system.
• To consolidate current knowledge on brain structural and functional alterations.

Main Methods:

• Systematic literature search across major databases (MEDLINE, CINAHL, Web of Science, Scopus, Cochrane).
• Inclusion of case-control studies utilizing neuroimaging techniques.
• Analysis of eleven articles involving 204 individuals with unilateral lower-limb amputation.

Main Results:

• Observed increase in cerebellar gray matter volume in prosthesis users.
• Decreased cortical thickness in premotor cortex, orbitofrontal cortex, and other brain regions.
• Reduced white matter integrity in corona radiata, fronto-occipital fasciculus, and corpus callosum.
• Decreased functional connectivity between cortical and subcortical areas.

Conclusions:

• Lower-limb amputation induces structural and functional brain changes.
• Modifications include gray matter volume reduction and white matter integrity decrease.
• Observed brain changes are independent of pain and prosthesis use.