Cortical Plasticity

Despite an almost electromyographically silent thigh, the brain was activated during the command for movements. This assured that the signals surged by the amputee demonstrated the substantial efforts resulting the alteration of oxygenated hemoglobin. Brodmann's areas 4 and 6 send orders to the limb that is nonexistent. Phantom limb pain is not just a phenomenon associated with a stump. The brain has not been damaged, and its areas of command and perception are still intact and in use. Also, fitting prosthesis immediately after amputation while the patient is still under anesthesia and then continuously beginning vibratory stimulus training may permit the preservation of perception in the sensory cortex and become an important factor in avoiding pain. The lower limb, although artificial is still sensed as "being

in the face of damage to specific regions. Recent studies of the abilities of persons with left and

Phantom limb syndrome occurs when a patient feels the sensations of an amputated limb. Derek Steen experienced

PA is considered to be a restitutional treatment approach as it facilitates the mechanisms of recovery. In theory its main aim is to attempt to alter the damaged function within the brain, that allow for visual attention.

In America, Cocaine dependence is an issue which involves nearly every one in three drug related emergency hospital visits, having various personal and social economic impacts (Martell, Orson et al. 2009). Many individuals who suffer have been found to have impaired cognitive functions and manifest a myriad of biological and neurological dysfunctions. The relationship between cocaine and cocaine dependence on brain physiology is its effects on particular brain regions and receptors leading to synaptic plasticity mediating altered ability of learning and consolidation [pic](Martinez, Narendran et al. 2007; Thomas, Kalivas et al. 2008; Mameli, Halbout et al.

For some amputees, there may be a physical and emotional pain with the lost of a limb. Bionics may not look and feel like a biological limb, but it comes close in providing the functions and fills the blank space of a missing limb. Providing individuals with bionic prosthetic technology assists in the reduction of health care cost by enabling an individual to maintain an appropriate activity level. Bionic limbs “enables people to return to work and other important daily activities faster and easier than before” ( Hixenbaugh, 2010, p. 721). With the use of bionics an amputee can walk with a natural gait and reduce the occurrence of stress on other joints ( Hixenbaugh, 2010, p. 725). This alleviates the chance of chronic or acute pain. An amputee can achieve a close to normal or normal metabolic energy exertion and reduced the amount of energy exerted from the amputee ( Hixenbaugh, 2010, p. 725). This may give the wearer the ability to withstand longer minor physical activities, such as walking for longer periods of time. Individals that wear BioM walk at 23% faster than the speed of wearing a traditional prosthetic ( Hixenbaugh, 2010, p. 725). This gives an amputee to walk at a natural speed. Through the use of external input bionics use, amputees gain the ability to safely walk on different terrains and stairs. Overall bionic prosthetics improve quality of life for amputee veterans as well as other individuals with

Dr. Ramachandran has devised an experiment that he says has to be tested on many more patients with phantom limb syndrome before he can be certain that it will help amputees with phantom limb pain. He uses what he calls a “mirror-box”, testing this with another patient named James Peacock who lost his right hand and has severe pain in his missing hand and as though the missing hand is constantly clenching. Dr. Ramachandran explains that this patients brain is sending signals to his missing limb trying to clench it, but because the limb isn’t there is unable to send messages back to the brain letting it know that it’s clenching too much or too fast. He theorized, “That maybe the brain can be fooled by visual feedback?” So, taking a wooden box dividing it with a mirror that is facing the limb

The somatosensory cortex is a segment of cerebrum that oversees real sensations, both proprioceptive sensations (vibes of development or the body's situation in space) and cutaneous sensations (those of weight, vibration, touch, and so forth). Past to the new work, neural inserts focusing on comparable mind regions dominatingly delivered sensations, for example, shivering or humming in the hand. The Andersen lab's embed can deliver significantly more common sensation by means of intracortical incitement, similar to sensations experienced by the patient preceding his damage.

The direct pathway model shows that pain is caused when the brain receives a signal from stimulation of the nociceptors in the skin (Goldstein, 2010). However, this is not the only way to experience pain. The phenomenon named the Phantom Limb gives an example of this. Phantom limb occurs in people that are missing one or more of their limbs; these amputees still experience the limb, even though it is not attached to the body. When people experience phantom limb, they often scratch at the missing limb or try walking on the limb that is not there. Amputees often swing the limb with their body movements even though the limb is not there. Amputees often experience pain, or a burning sensation or sharp stinging sensations. The phantom limb experience is in direct confrontation with the direct pathway model; however, the phantom can be better explained by another model; the gateway

Preoperative anesthesia, pharmacotherapy and mirror therapy have been the most popular and widely used treatment therapies for patients with PLP, but there are many more therapies emerging from studies have shown promising results. One such treatment therapy is eye movement desensitization and reprocessing (EMDR). In a clinical study done by de Roos et al. (2010), ten participants with leg amputations (one participant had both legs amputated) who experienced PLP which ranged from, “aching, squeezing, cramping, shooting, burning, stinging, and stabbing” pain, to be treated using EMDR (de Roos et al., 2010, p. 66). De Roos et al. theorized that:

Like any pain, PLP responds partially to pharmacological interventions (Flor et Al., 2002). If you treat the phantom pain with morphine, muscle relaxants, antidepressants, and even sodium channel blockers, some patients find relief of symptoms (Flor et Al., 2002). Additionally, in line with the homunculus theory, cortical reorganization prevention training shows promise (Flor et Al., 2006). A common way of achieving this is with a mirror (McCabe, Haig, Halligan & Blake, 2005). By placing a mirror next to a non-amputated arm so that the mirrored image appears to be the ‘missing’ arm, you can trick the brain into thinking it has control over the limb again (McCabe et Al., 2005). This method is largely based on neurologic principles, and is aimed to reduce the amount of noise experienced by the brain (McCabe et Al., 2005). A last resort method is surgical revision of the residual limb (Flor et Al., 2002). Removing neurons, sections of the spinal cord, or simply stump revision may improve pain symptoms (Flor et Al., 2002). Evidently, it can be difficult to determine a successful treatment for PLP, as the aetiological mechanisms are widely

Lofti, B. Merabet., & Alvaro,Pascual. Leone. (2009). Neural Reorganization Following Sensory Loss: The Opportunity of Change.Nature Reviews Neuroscience 11, no. 1 , 44.

Persistent with CRPS would have an adjusted impression of the influenced appendage. The patient may see the appendage to be longer or shorter and partner it with disfigurement. There are related engine cortex changes too, however it is hard to learn if these progressions are the reason for the condition or are an aftereffect of serious and unending afferent jolts fortifying the tangible and engine cortices.

Phantom limb is a condition that causes amputees to feel the presence of a missing limb. In addition to feeling pain, sensations of tingling and cramping can also be felt by individuals that have had a limb amputated. This condition develops due to the deprivation of sensory input corresponding to a certain region of the brain linked with the amputated limb, which causes the brain to misinterpret signals from other body parts. There is a map of the entire surface of the body along a vertical strip of cortex in the brain, therefore, every point of the body surface has a point on this body map. Once a limb is amputated, the part of the brain corresponding to the limb lacks sensory input. Sensory signals from other parts of the body

difficulty in fixating the eyes (oculomotor apraxia), and inability to move the hand to a