Changes in Functional and Structural Brain Connectivity Following Bilateral Hand Transplantation.

Area of Science:

• Neuroscience
• Reconstructive Surgery
• Medical Imaging

Background:

• Hand transplantation is a complex surgical procedure for limb loss.
• Understanding brain adaptation post-transplantation is crucial for recovery.
• Altered brain connectivity is observed following amputation.

Purpose of the Study:

• To investigate functional and structural brain connectivity changes in a bilateral hand transplant recipient.
• To compare brain connectivity in the patient to healthy controls.
• To track changes over 1.5 years post-transplantation.

Main Methods:

• Utilized resting-state functional MRI and diffusion-weighted imaging (DWI).
• Applied graph theoretical analyses to assess network connectivity.
• Compared a bilateral hand transplant patient (pre- and post-operative) to 10 age-matched controls.

Main Results:

• Preoperative functional and structural connectivity were elevated compared to controls, indicating amputation response.
• Postoperative functional connectivity decreased towards control levels over 1.5 years.
• Structural connectivity remained stable, potentially supporting functional reorganization.

Conclusions:

• Hand transplantation may facilitate a return to more typical brain organization.
• Brain functional connectivity adapts post-transplantation, normalizing over time.
• Structural connectivity may play a supportive role in functional recovery.