Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1978 May;41(5):425–432. doi: 10.1136/jnnp.41.5.425

Long-term effects of partial limb amputation in man.

A J McComas, R E Sica, S Banerjee
PMCID: PMC493049  PMID: 660205

Abstract

Ten patients with amputation of part of one arm have been studied electrophysiologically. In each patient the ulnar nerve was stimulated electrically in the amputation stump and at a corresponding level in the intact limb. Control observations were also made on 15 normal subject. In the partially-amputated (PA) limbs the amplitudes of the centripetal ulnar nerve compound action potentials, after maximal stimulation of fast-conducting fibres, were markedly reduced in comparison with the results in control limbs. A small decrease in the mean impulse conduction velocity was observed in the population of PA limbs. In comparison with control observations, stimulation of the ulnar nerve in a PA limb evoked responses in the contralateral somatosensory cortex which were significantly diminished. Simulation of PA limbs caused reflex excitation and inhibition of triceps motoneurones similar to that observed in control subjects. In the intact limbs of the amputees, however, inhibition was reduced, possibly as a consequence of overuse. It is concluded that the receipt of an input from the periphery is essential for the functional integrity of most motor and sensory nerve axons, and probably for fibres in the dorsal column-medial lemniscus pathway.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALLISON T. Recovery functions of somatosensory evoked responses in man. Electroencephalogr Clin Neurophysiol. 1962 Jun;14:331–343. doi: 10.1016/0013-4694(62)90110-4. [DOI] [PubMed] [Google Scholar]
  2. CRAGG B. G., THOMAS P. K. Changes in conduction velocity and fibre size proximal to peripheral nerve lesions. J Physiol. 1961 Jul;157:315–327. doi: 10.1113/jphysiol.1961.sp006724. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Caccia M. R., McComas A. J., Upton A. R., Blogg T. Cutaneous reflexes in small muscles of the hand. J Neurol Neurosurg Psychiatry. 1973 Dec;36(6):960–977. doi: 10.1136/jnnp.36.6.960. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Devor M., Wall P. D. Type of sensory nerve fibre sprouting to form a neuroma. Nature. 1976 Aug 19;262(5570):705–708. doi: 10.1038/262705a0. [DOI] [PubMed] [Google Scholar]
  5. Dostrovsky J. O., Millar J., Wall P. D. The immediate shift of afferent drive to dorsal column nucleus cells following deafferentation: a comparison of acute and chronic deafferentation in gracile nucleus and spinal cord. Exp Neurol. 1976 Sep;52(3):480–495. doi: 10.1016/0014-4886(76)90219-3. [DOI] [PubMed] [Google Scholar]
  6. ECCLES J. C., KRNJEVIC K., MILEDI R. Delayed effects of peripheral severance of afferent nerve fibres on the efficacy of their central synapses. J Physiol. 1959 Jan 28;145(1):204–220. doi: 10.1113/jphysiol.1959.sp006136. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. ECCLES J. C., McINTYRE A. K. The effects of disuse and of activity on mammalian spinal reflexes. J Physiol. 1953 Sep;121(3):492–516. doi: 10.1113/jphysiol.1953.sp004961. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. HALLIDAY A. M., WAKEFIELD G. S. Cerebral evoked potentials in patients with dissociated sensory loss. J Neurol Neurosurg Psychiatry. 1963 Jun;26:211–219. doi: 10.1136/jnnp.26.3.211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. KIRALY J. K., KRNJEVIC K. Some retrograde changes in function of nerves after peripheral section. Q J Exp Physiol Cogn Med Sci. 1959 Jul;44:244–257. doi: 10.1113/expphysiol.1959.sp001397. [DOI] [PubMed] [Google Scholar]
  10. McComas A., Sica R., Banerjee S. Central nervous system effects of limb amputation in man. Nature. 1978 Jan 5;271(5640):73–74. doi: 10.1038/271073a0. [DOI] [PubMed] [Google Scholar]
  11. Mendell L. M., Munson J. B., Scott J. G. Alterations of synapses on axotomized motoneurones. J Physiol. 1976 Feb;255(1):67–79. doi: 10.1113/jphysiol.1976.sp011270. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Millar J., Basbaum A. I., Wall P. D. Restructuring of the somatotopic map and appearance of abnormal neuronal activity in the gracile nucleus after partial deafferentation. Exp Neurol. 1976 Mar;50(3):658–672. doi: 10.1016/0014-4886(76)90035-2. [DOI] [PubMed] [Google Scholar]
  13. Wall P. D., Gutnick M. Ongoing activity in peripheral nerves: the physiology and pharmacology of impulses originating from a neuroma. Exp Neurol. 1974 Jun;43(3):580–593. doi: 10.1016/0014-4886(74)90197-6. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES