Neural modifications of transtibial prosthesis (TTP) users: an event-related potentials study

Individuals with lower-limb amputations are highly dependent upon prostheses to perform daily activities and adapt to environmental changes. Transtibial prosthesis (TTP) users in particular, experience greater challenges in motor control and demonstrate impaired cognitive functions, when compared to able-bodied persons. The identification of neural mechanisms underlying adaptation or compensation may contribute to the development and expansion of rehabilitation strategies.

To examine neuroplasticity changes in transtibial amputees by analyzing event-related potentials (ERPs) obtained from Electroencephalogram (EEG) during Go/No-Go tasks to assess cognitive control and neural adaptations.

Twenty-eight TTP users and twenty-eight able-bodied persons were recruited. EEG was recorded in eyes-open resting states, and ERPs during a Go/No-go task.

Our findings demonstrate that, during the resting-state, the TTP users group exhibited no significant differences in brain activity across regions. However, during Go/No-go task, an increase of N2 amplitude was observed, and significant reduction in the amplitude of P3 amplitude was noted when compared to able-bodied group.

These findings demonstrated neural modifications by individuals with transtibial amputation, particularly in relation to inhibitory control, which is essential for effective attentional control. Deficits in inhibitory control may interfere with decision-making processes, thereby impairing the execution of daily activities that require sustained attention and cognitive flexibility. Based on these findings of neural adaptions, it may be necessary to consider targeted interventions aimed at enhancing cognitive control and incorporating specific cortical training strategies for TTP users.