Grasping objects by former amputees: The visuo-motor control of allografted hands

Article type: Research Article

Authors: Huchon, Laure^{a; b; c; *} | Badet, Lionel^{c; d} | Roy, Alice Catherine^e | Finos, Livio^f | Gazarian, Aram^g | Revol, Patrice^{a; b; c} | Bernardon, Laurence^h | Rossetti, Yves^{a; b; c} | Morelon, Emmanuel^{c; i} | Rode, Gilles^{a; b; c; 1} | Farnè, Alessandro^{a; c; 1}

Affiliations: [a] ImpAct Team, INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Lyon, France | [b] Physical and Rehabilitation Medicine Department, Mouvement Handicap, Henry Gabrielle Hospital, Hospices Civils de Lyon, Lyon, France | [c] Claude Bernard Lyon 1 University, Lyon, France | [d] Transplantation Surgery Department, Edouart Herriot Hospital, Hospices Civils de Lyon, Lyon, France | [e] Dynamique du Langage, CNRS and Lyon 2 University, UMR5596, Lyon, France | [f] Department of Statistical Sciences, University of Padova, Padova, Italy | [g] Orthopaedic Surgery Department, Clinique du Parc Lyon, Lyon, France | [h] Romans Ferrari Pediatric Rehabilitation Medical Center, Miribel, France | [i] Nephrology and Immunology Department, Edouart Herriot Hospital, Hospices Civils de Lyon, Lyon, France

Correspondence: [*] Correspondence to: Laure Huchon, Hôpital Henry Gabrielle, 20 route de Vourles 69230 Saint Genis Laval, France. Tel.: +33 4 78 86 52 68; Fax: +33 4 78 86 50 81; E-mail: laure.huchon@chu-lyon.fr.

Note: [1] These authors contributed equally to the work.

Abstract: Purpose: Hand allograft has recently emerged as a therapeutic option for upper limb amputees. Functional neuroimaging studies have progressively revealed sensorimotor cortices plasticity following both amputation and transplantation. The purpose of our study was to assess and characterize the functional recovery of the visuo-motor control of prehension in bilateral hand transplanted patients. Methods: Using kinematics recordings, we characterized the performance of prehension with or without visual feed-back for object of different position and size, in five bilateral hand allograft recipients and age-matched control subjects. Both hands were assessed, separately. Results: Despite an overall slower execution, allografted patients succeeded in grasping for more than 90% of the trials. They exhibited a preserved hand grip scaling according to object size, and preserved prehension performances when tested without visual feedback. These findings highlight the allograft recipients’ abilities to produce an effective motor program, and a good proprioceptive-dependent online control. Nevertheless, the maximum grip aperture was reduced and delayed, the coupling between Transport and Grasp components was altered, and the final phase of the movement was lengthened. Conclusion: Hand allotransplantation can offer recipients a good recovery of the visuo-motor control of prehension, with slight impairments likely attributable to peripheral neuro-orthopedic limitations.

Keywords: Hand transplantation, kinematics, prehension, visuo-motor control, neural plasticity

DOI: 10.3233/RNN-150502

Journal: Restorative Neurology and Neuroscience, vol. 34, no. 4, pp. 615-633, 2016