Factors of Cortical Plasticity in Brachial Plexus Injury

Cortical plasticity is the brain’s capability of decoding new information through growth and reorganization over our whole life spam. It is the basis for good outcomes after reinnervation and for rehabilitation of adult and obstetric brachial plexus injury. Knowledge about cortical reorganization is crucial to reconstructive surgeons and physiotherapists that aim to give their patients a reasonable prognosis. This chapter intends to present and summarize the current literature on how to detect and quantify cortical plasticity and how research on factors that influence cortical plasticity, mainly in relation to peripheral nerve and more precise brachial plexus injury progresses. Peculiarities of adult and obstetric brachial plexus injuries and their treatment are given. We present techniques that visualize and quantify cortical plasticity with focus on functional imaging like fMRI and nTMS as well as molecular aspects. Future research is needed to understand mechanisms of how molecular changes on a synaptic level of a neuron influence the macroscopic plasticity, to improve rehabilitative resources, to understand the exact prognostic value of nTMS in brachial plexus injury and to investigate the therapeutic capability of rTMS.

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Role of MRI in the diagnosis of adult traumatic and obstetric brachial plexus injury compared to intraoperative findings

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00310-2 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Doria Mohammed Gad ◽

Mostafa Thabet Hussein ◽

Nagham Nabil Mahmoud Omar ◽

Mohamed Mostafa Kotb ◽

Mohamed Abdel-Tawab ◽

...

Keyword(s):

Brachial Plexus ◽

Tissue Characterization ◽

Brachial Plexus Injury ◽

Imaging Modality ◽

Preoperative Evaluation ◽

Diagnostic Modality ◽

Non Invasive ◽

Upper Limb Function ◽

Obstetric Brachial Plexus ◽

Sensitivity Specificity

Abstract Background Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality. Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences. Results In obstetric cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 63%, 89%, and 82%, respectively, while for postganglionic lesions, MRI sensitivity, specificity, and accuracy were 60%, 99%, and 95%, respectively. In adult cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 96%, 95%, and 95% respectively, while for postganglionic injury, MRI sensitivity, specificity, and accuracy were 60%, 100%, and 99%, respectively. Conclusion MRI represents a safe, non-invasive, diagnostic modality having the multiplanar capability and better soft tissue characterization.

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51. Early electrophysiologic findings in neonatal obstetric brachial plexus injury

Clinical Neurophysiology ◽

10.1016/j.clinph.2008.10.069 ◽

2009 ◽

Vol 120 (2) ◽

pp. e103

Author(s):

D. Chkhartishvili ◽

G. Natriashvili

Keyword(s):

Brachial Plexus ◽

Brachial Plexus Injury ◽

Obstetric Brachial Plexus ◽

Obstetric Brachial Plexus Injury

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Comparing the Efficacy of Triple Nerve Transfers with Nerve Graft Reconstruction in Upper Trunk Obstetric Brachial Plexus Injury

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000003668 ◽

2017 ◽

Vol 140 (4) ◽

pp. 747-756 ◽

Cited By ~ 10

Author(s):

Kathleen M. O’Grady ◽

Hollie A. Power ◽

Jaret L. Olson ◽

Michael J. Morhart ◽

A. Robertson Harrop ◽

...

Keyword(s):

Brachial Plexus ◽

Brachial Plexus Injury ◽

Nerve Graft ◽

Nerve Transfers ◽

Obstetric Brachial Plexus ◽

Graft Reconstruction ◽

Obstetric Brachial Plexus Injury

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The Effects of Virtual Reality on Upper Extremity in Patients with Obstetric Brachial Plexus Injury

Journal of Pediatric Neurology ◽

10.1055/s-0041-1724100 ◽

2021 ◽

Author(s):

Havva Ezgi Karas ◽

Emine Atıcı ◽

Gamze Aydın ◽

Mert Demirsöz

Keyword(s):

Virtual Reality ◽

Brachial Plexus ◽

Upper Extremity ◽

Brachial Plexus Injury ◽

Control Group ◽

Nintendo Wii ◽

Significant Difference ◽

Obstetric Brachial Plexus ◽

Conventional Physiotherapy ◽

Obstetric Brachial Plexus Injury

AbstractThe present study aimed to examine the effects of playing Nintendo Wii games on upper extremity functions compared with conventional physiotherapy, in children with obstetric brachial plexus injury (OBPI). Twenty-two patients with brachial plexus injuries were enrolled. The patients were divided into two groups by simple randomization. The control group (conventional physiotherapy group [CTG]: n = 11) received conventional physiotherapy for 6 weeks (40 minutes per day, for 4 days per week). The study group, called Nintendo Wii group (NWG; n = 11), received conventional physiotherapy as well as tennis, baseball, and boxing games with Nintendo Wii on days when there was no physical therapy. The upper extremity range of motion (ROM) was evaluated using a digital goniometer, motor function was assessed using the Active Movement Scale (AMS), and shoulder functions were assessed with the Mallet Scoring System (MSS). Virtual reality treatment had a positive effect on shoulder flexion, forearm pronation, wrist flexion, ROM, and functionality (p < 0.05). There was a significant improvement in shoulder abduction and shoulder external rotation in the CTG (p < 0.05). There was no significant difference in the MSS values of either groups (p > 0.05). As per the AMS, in the NWG, the shoulder internal rotation increased significantly (p < 0.05). Nintendo Wii treatment used in addition to conventional physiotherapy may be effective in increasing upper extremity functions in children with OBPI. Clinical Trials Number NCT04605601.

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