Reorganization of cortical representations of the hand following alterations of skin inputs induced by nerve injury, skin island transfers, and experience

J Hand Ther. Apr-Jun 1993;6(2):89-104. doi: 10.1016/s0894-1130(12)80290-0.


Tactile experiences remodel the central nervous system representations of the body surface. The results of assessments of ten peripheral manipulations that reveal different aspects of representational plasticity are reviewed: (1) chronic peripheral denervation; (2) surgical amputation; (3) digital syndactyly and its natural behavioral equivalents; (4) peripheral nerve crush with reinnervation; (5) peripheral nerve transection and repair, with reinnervation; (6) denervation of very large skin surfaces, for very long times; (7) electrical stimulation of large-fiber afferents in the median nerve, simulating electroacupuncture; (8) implantation of always-innervated island pedicle flaps; (9) behavioral training with locationally invariant stimuli; and (10) behavioral training with moving stimuli. Focus is on the changes recorded in a primary somatosensory cortical field, area 3b, following these ten manipulations, in adult monkeys. On the basis of these findings, the following are discussed: (1) how altered schedules of activity from the skin contribute to cortical representational remodeling; (2) other factors that influence the representational remodeling; (3) where the remodeling actually occurs; and (4) some implications of these findings for sensory rehabilitation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Amputation
  • Animals
  • Aotidae
  • Cerebral Cortex / physiology
  • Conditioning, Classical
  • Denervation
  • Electroacupuncture
  • Fingers / surgery
  • Form Perception*
  • Hand / innervation*
  • Humans
  • Median Nerve / physiology
  • Peripheral Nerve Injuries
  • Saimiri
  • Skin Transplantation
  • Syndactyly / physiopathology
  • Touch / physiology*