The hand and the brain
Research on the relation between the central nervous system and hand disorders
Introduction
It is becoming increasingly clear that poor recovery in some patients with hand pathology is partly caused by a non-optimal reorganization of the brain.
For example, in patients with nerve injuries of the hand, the long period of de-afferentiation due to the nerve injury leads to a loss of the representation of the hand in the motor and sensory cortex. When the nerve regenerates, this representation is not easily regained in the adult brain.
In patients with chronic pain syndromes, such as complex regional pain syndrome or repetitive strain injury, changes in the reorganisation of the hand occur that may be related to a general sensitization of the central nervous system.
In a number of projects, we are investigating treatment protocols aimed at influencing the central nervous system components of hand disorders. These treatments include ‘mirror therapy’ and the use of selective cutaneous forearm anaesthesia to improve sensations. In addition, using fMRI, we are studying the underlying mechanisms of these central processes and how the new treatment regimens influence the central nervous system.
Specific projects:
Mirror therapy for improving hand functioning in chronic stroke