About this trial
The objective of this study is to better understand the structural and functional changes that the central nervous system (CNS) undergoes following congenital upper limb loss. The focus is on the brain's sensory processing and how neuronal changes may relate to clinical measures. By doing so, the hope is to gain insight into the contribution of critical periods to the plasticity of the sensorimotor processing stream. Both macroscopic and microscopic changes of the brain will be examined in individuals with upper limb amelia and compared to healthy controls. fMRI will be combined with behavioural testing to understand which clinical and behavioural determinants drive somatosensory representations along the entire somatosensory processing stream. Using advanced imaging techniques, the aim is to investigate the contribution of brainstem reorganisation to plasticity observed at the cortical level and, by doing so, gain a better understanding of the mechanistic underpinnings of functional reorganisation. Overall, the hope is to provide the first mechanistic insight into whether early life experiences are crucial for the development of the relay nuclei in the central nervous system and how these changes relate to clinical measures such as adaptive behaviours or pain.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Age 18-75
Upper-limb congenital amputees with complete absence of a hand
Signed informed consent
Disqualifiers
Contraindications to magnetic resonance imaging
Neurological impairment of body function impairments not induced by spinal cord injury
BMI > 40
Pregnancy
Trial population
Patients with an upper-limb amputation and healthy subjects.
Trial design
Case-control
Prospective
Treatments tested in this trial
MRI
Diagnostic testUse of functional and structural MRI in both the brain and the spinal cord as well as questionnaires and clinical measures of motor function
MRI
Diagnostic testUse of functional and structural MRI in both the brain and the spinal cord and questionnaires.
Treatment groups
Trial outcomes
Primary outcomes
Change of functional MRI (fMRI) parameter between 2 to 4 time points
Change of brain activities is assessed between 2 to 4 time points using fMRI during resting-state or a specific task in patients with congenital amputations and compared to healthy controls
Secondary outcomes
Conventional magnetic resonance imaging (MRI) parameter
Structural characteristics in the brain and cervical spinal cord are assessed in patients with congenital upper-limb amputations using conventional MRI and compared to healthy controls
Amputees: Motor Activity Log questionnaire
Evaluation of residual limb and/or prosthesis usage as compared to other body parts via a questionnaire and behavioural assessments.
Sponsors and contacts
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University of Zurich
Lead sponsor
ETH Zurich
Collaborator