Sensorimotor training and cortical reorganization.

Several disorders that involve motor and sensory disturbances such as chronic pain, tinnitus, stroke or dystonia are also characterized by changes in the sensory and motor maps in the sensorimotor cortices. This article reviews training procedures that target these maladaptive changes and the behavioral and cortical changes that accompany them. In addition, we will discuss factors that influence these training procedures and discuss new developments. These procedures include training of perceptual abilities, motor function, direct cortical stimulation as well as behavioral approaches and have been shown to reorganize the altered sensory and motor maps. Treatments that combine several modalities such as imagery or mirror treatment as well as use of prostheses also have beneficial effects. Further research must elucidate the mechanisms of these plastic changes and relate them to disorders and treatments.

[1]  E. Taub,et al.  Effects of constraint-induced movement therapy on patients with chronic motor deficits after stroke: a replication. , 1999, Stroke.

[2]  D. Price,et al.  Plasticity in brain processing and modulation of pain. , 2006, Progress in brain research.

[3]  Eugen Diesch,et al.  Enhancement of steady‐state auditory evoked magnetic fields in tinnitus , 2004, The European journal of neuroscience.

[4]  Thomas Weiss,et al.  Decrease in phantom limb pain associated with prosthesis-induced increased use of an amputation stump in humans , 1999, Neuroscience Letters.

[5]  J. Rothwell,et al.  Subthreshold low-frequency repetitive transcranial magnetic stimulation over the premotor cortex modulates writer's cramp. , 2004, Brain : a journal of neurology.

[6]  H. Flor,et al.  Phantom movements and pain. An fMRI study in upper limb amputees. , 2001, Brain : a journal of neurology.

[7]  I Berry,et al.  Virtual Movements Activate Primary Sensorimotor Areas in Amputees: Report of Three Cases , 2001, Neurosurgery.

[8]  O. L. Zangwill,et al.  Restoration of Function after Brain Injury , 1965 .

[9]  M. Hallett,et al.  Sensory training as treatment for focal hand dystonia: A 1‐year follow‐up , 2003, Movement disorders : official journal of the Movement Disorder Society.

[10]  H. Stam,et al.  Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. , 2008, Archives of physical medicine and rehabilitation.

[11]  J. Liepert,et al.  Treatment-induced cortical reorganization after stroke in humans. , 2000, Stroke.

[12]  Gitendra Uswatte,et al.  Constraint-induced movement therapy: bridging from the primate laboratory to the stroke rehabilitation laboratory. , 2003, Journal of rehabilitation medicine.

[13]  E. Taub Movement In Nonhuman Primates Deprived Of Somatosensory Feedback , 1976, Exercise and sport sciences reviews.

[14]  Felipe Fregni,et al.  New insights into neuromodulatory approaches for the treatment of pain. , 2008, The journal of pain : official journal of the American Pain Society.

[15]  V. Ramachandran,et al.  Touching the phantom limb , 1995, Nature.

[16]  A. Sirigu,et al.  Illusory movements of the paralyzed limb restore motor cortex activity , 2003, NeuroImage.

[17]  Berthold Langguth,et al.  Altered motor cortex excitability in tinnitus patients: a hint at crossmodal plasticity , 2005, Neuroscience Letters.

[18]  N. Miller,et al.  Technique to improve chronic motor deficit after stroke. , 1993, Archives of physical medicine and rehabilitation.

[19]  R. Hari,et al.  Altered central sensorimotor processing in patients with complex regional pain syndrome , 2002, Pain.

[20]  I ROCK,et al.  Vision and Touch: An Experimentally Created Conflict between the Two Senses , 1964, Science.

[21]  Frank Birklein,et al.  Functional imaging of allodynia in complex regional pain syndrome , 2006, Neurology.

[22]  I. Robertson,et al.  Rehabilitation of brain damage: brain plasticity and principles of guided recovery. , 1999, Psychological bulletin.

[23]  Sergio P. Rigonatti,et al.  Site‐specific Effects of Transcranial Direct Current Stimulation on Sleep and Pain in Fibromyalgia: A Randomized, Sham‐controlled Study , 2007, Pain practice : the official journal of World Institute of Pain.

[24]  C. Maihöfner,et al.  Decreased perceptual learning ability in complex regional pain syndrome , 2007, European journal of pain.

[25]  Lars Ersland,et al.  Phantom limb imaginary fingertapping causes primary motor cortex activation: an fMRI study , 1996, Neuroreport.

[26]  John D E Gabrieli,et al.  Control over brain activation and pain learned by using real-time functional MRI. , 2005, Proceedings of the National Academy of Sciences of the United States of America.

[27]  T. Nurmikko,et al.  Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery , 2008, Brain : a journal of neurology.

[28]  H. Flor,et al.  Extinction training for tinnitus. , 2007, Progress in brain research.

[29]  J. A. Stevens,et al.  Simulation of Bilateral Movement Training Through Mirror Reflection: A Case Report Demonstrating an Occupational Therapy Technique for Hemiparesis , 2004, Topics in stroke rehabilitation.

[30]  R. DeCharms Applications of real-time fMRI , 2008, Nature Reviews Neuroscience.

[31]  M. Merzenich,et al.  Plasticity in the frequency representation of primary auditory cortex following discrimination training in adult owl monkeys , 1993, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[32]  E. Taub,et al.  Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. , 1999, Journal of rehabilitation research and development.

[33]  C Xerri,et al.  Plasticity of primary somatosensory cortex paralleling sensorimotor skill recovery from stroke in adult monkeys. , 1998, Journal of neurophysiology.

[34]  B. Godde,et al.  Tactile Coactivation-Induced Changes in Spatial Discrimination Performance , 2000, The Journal of Neuroscience.

[35]  Mark Hallett,et al.  Abnormal somatosensory homunculus in dystonia of the hand , 1998, Annals of neurology.

[36]  Kenneth M Heilman,et al.  Mirror therapy for phantom limb pain. , 2007, The New England journal of medicine.

[37]  T. Elbert,et al.  Reorganization of auditory cortex in tinnitus. , 1998, Proceedings of the National Academy of Sciences of the United States of America.

[38]  Thomas Elbert,et al.  Longer versus shorter daily constraint-induced movement therapy of chronic hemiparesis: an exploratory study. , 2002, Archives of physical medicine and rehabilitation.

[39]  N. Birbaumer,et al.  Does use of a myoelectric prosthesis prevent cortical reorganization and phantom limb pain? , 1999, Nature Neuroscience.

[40]  Eugen Diesch,et al.  Auditory Discrimination Training for the Treatment of Tinnitus , 2004, Applied psychophysiology and biofeedback.

[41]  Christoph Braun,et al.  Behavioral significance of input-dependent plasticity of human somatosensory cortex , 2003, Neuroreport.

[42]  S. Bandinelli,et al.  Motor reorganization after upper limb amputation in man. A study with focal magnetic stimulation. , 1991, Brain : a journal of neurology.

[43]  B. Rosen,et al.  Motor Recovery and Cortical Reorganization after Constraint-Induced Movement Therapy in Stroke Patients: A Preliminary Study , 2002, Neurorehabilitation and neural repair.

[44]  M M Merzenich,et al.  Somatosensory Representation of the Digits and Clinical Performance in Patients with Focal Hand Dystonia , 2003, American journal of physical medicine & rehabilitation.

[45]  S. Page,et al.  A randomized efficacy and feasibility study of imagery in acute stroke , 2001, Clinical rehabilitation.

[46]  H. Dinse,et al.  Sensorimotor returning in complex regional pain syndrome parallels pain reduction , 2005, Annals of neurology.

[47]  Felipe Fregni,et al.  Updates on the use of non-invasive brain stimulation in physical and rehabilitation medicine. , 2009, Journal of rehabilitation medicine.

[48]  J. Hoogduin,et al.  Cerebral activation during motor imagery in complex regional pain syndrome type 1 with dystonia , 2008, PAIN.

[49]  Alvaro Pascual-Leone,et al.  Recent advances in the treatment of chronic pain with non-invasive brain stimulation techniques , 2007, The Lancet Neurology.

[50]  M. Könönen,et al.  Alterations in cortical excitability in chronic stroke after constraint-induced movement therapy , 2008, Neurological Research.

[51]  M. Erb,et al.  Activation of Cortical and Cerebellar Motor Areas during Executed and Imagined Hand Movements: An fMRI Study , 1999, Journal of Cognitive Neuroscience.

[52]  Karen D Davis,et al.  The effect of tactile and visual sensory inputs on phantom limb awareness. , 2003, Brain : a journal of neurology.

[53]  J. Summers,et al.  Mirror, mirror on the wall: viewing a mirror reflection of unilateral hand movements facilitates ipsilateral M1 excitability , 2005, Experimental Brain Research.

[54]  B. Langguth,et al.  Repetitive transcranial magnetic stimulation and chronic tinnitus , 2006, Acta oto-laryngologica. Supplementum.

[55]  T. Elbert,et al.  Neurofeedback for treating tinnitus. , 2007, Progress in brain research.

[56]  T. Elbert,et al.  Changing the Brain through Therapy for Musicians' Hand Dystonia , 2005, Annals of the New York Academy of Sciences.

[57]  B. Pleger,et al.  Repetitive transcranial magnetic stimulation of the motor cortex attenuates pain perception in complex regional pain syndrome type I , 2004, Neuroscience Letters.

[58]  Eckart Altenmüller,et al.  Constraint-induced movement therapy for focal hand dystonia in musicians , 1999, The Lancet.

[59]  S L Wolf,et al.  Doing It with Mirrors: A Case Study of a Novel Approach to Neurorehabilitation , 2000, Neurorehabilitation and neural repair.

[60]  Thomas Elbert,et al.  Tinnitus Perception and Distress Is Related to Abnormal Spontaneous Brain Activity as Measured by Magnetoencephalography , 2005, PLoS medicine.

[61]  T. Elbert,et al.  Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation , 1995, Nature.

[62]  Phantom limb pain , 2001, The Lancet.

[63]  Eckart Altenmüller,et al.  Sensory motor retuning: a behavioral treatment for focal hand dystonia of pianists and guitarists. , 2002, Archives of physical medicine and rehabilitation.

[64]  M. Hallett,et al.  Sensory training for patients with focal hand dystonia , 2002, Annals of neurology.

[65]  E. Brodie,et al.  Increased motor control of a phantom leg in humans results from the visual feedback of a virtual leg , 2003, Neuroscience Letters.

[66]  G. Moseley,et al.  Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial , 2004, Pain.

[67]  John C. Marshall,et al.  When seeing is feeling: Acquired synaesthesia or phantom touch? , 1996 .

[68]  G. Deuschl,et al.  The motor system shows adaptive changes in complex regional pain syndrome. , 2007, Brain : a journal of neurology.

[69]  A Villringer,et al.  Constraint-induced movement therapy for motor recovery in chronic stroke patients. , 1999, Archives of physical medicine and rehabilitation.

[70]  C Maier,et al.  Bilateral motor cortex disinhibition in complex regional pain , 2003 .

[71]  B. Neundörfer,et al.  Patterns of cortical reorganization in complex regional pain syndrome , 2003, Neurology.

[72]  W M Jenkins,et al.  A primate genesis model of focal dystonia and repetitive strain injury , 1996, Neurology.

[73]  K. Reilly,et al.  Mapping phantom movement representations in the motor cortex of amputees. , 2006, Brain : a journal of neurology.

[74]  G. Moseley,et al.  Graded motor imagery for pathologic pain , 2006, Neurology.

[75]  Chetwyn C. H. Chan,et al.  Mental imagery for promoting relearning for people after stroke: a randomized controlled trial. , 2004, Archives of physical medicine and rehabilitation.

[76]  Berthold Langguth,et al.  Combined temporal and prefrontal transcranial magnetic stimulation for tinnitus treatment: A pilot study , 2008, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[77]  J. Liepert,et al.  Motor cortex plasticity during constraint-induced movement therapy in stroke patients , 1998, Neuroscience Letters.

[78]  L. Stone,et al.  Rehabilitation of hemiparesis after stroke with a mirror , 1999, The Lancet.

[79]  B. Rockstroh,et al.  Effective behavioral treatment of focal hand dystonia in musicians alters somatosensory cortical organization , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[80]  B. Neundörfer,et al.  Cortical reorganization during recovery from complex regional pain syndrome , 2004, Neurology.

[81]  Sanjeev Arora,et al.  Lasting effects of repeated rTMS application in focal hand dystonia. , 2009, Restorative neurology and neuroscience.

[82]  J. Donoghue Plasticity of adult sensorimotor representations , 1995, Current Opinion in Neurobiology.

[83]  N Birbaumer,et al.  Reorganization of Motor and Somatosensory Cortex in Upper Extremity Amputees with Phantom Limb Pain , 2001, The Journal of Neuroscience.

[84]  H. Karbe,et al.  Mirror Therapy Promotes Recovery From Severe Hemiparesis: A Randomized Controlled Trial , 2009, Neurorehabilitation and neural repair.

[85]  Christian Gerloff,et al.  Dose‐dependent attenuation of auditory phantom perception (tinnitus) by PET‐guided repetitive transcranial magnetic stimulation , 2007, Human brain mapping.

[86]  S. Karamürsel,et al.  Neurofeedback in fibromyalgia syndrome. , 2007, Agri : Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology.

[87]  D. De Ridder,et al.  Auditory cortex stimulation for tinnitus. , 2007, Acta neurochirurgica. Supplement.

[88]  N Birbaumer,et al.  Extensive reorganization of the somatosensory cortex in adult humans after nervous system injury. , 1994, Neuroreport.

[89]  G. Yavuzer,et al.  Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. , 2007, Archives of physical medicine and rehabilitation.

[90]  H. Flor,et al.  Effect of sensory discrimination training on cortical reorganisation and phantom limb pain , 2001, The Lancet.

[91]  B. Rockstroh,et al.  Alteration of digital representations in somatosensory cortex in focal hand dystonia , 1998, Neuroreport.

[92]  B. Langguth,et al.  Transcranial magnetic stimulation (TMS) for treatment of chronic tinnitus: clinical effects. , 2007, Progress in brain research.

[93]  Isabelle Berry,et al.  Cortical Areas Involved in Virtual Movement of Phantom Limbs: Comparison with Normal Subjects , 2003, Neurosurgery.

[94]  Y. Kim,et al.  Plastic changes of motor network after constraint-induced movement therapy. , 2004, Yonsei medical journal.

[95]  S. Page,et al.  Effects of mental practice on affected limb use and function in chronic stroke. , 2005, Archives of physical medicine and rehabilitation.

[96]  Grant D Searchfield,et al.  Object identification and attention training for treating tinnitus. , 2007, Progress in brain research.

[97]  J C Rothwell,et al.  Reorganization of cortical blood flow and transcranial magnetic stimulation maps in human subjects after upper limb amputation. , 1994, Journal of neurophysiology.

[98]  Sergio P. Rigonatti,et al.  A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. , 2006, Arthritis and rheumatism.

[99]  H. Flor,et al.  Plasticity in the motor system related to therapy-induced improvement of movement after stroke. , 1999, Neuroreport.

[100]  Katja Wiech,et al.  Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain , 2008, PAIN®.

[101]  Hubert R. Dinse,et al.  Associative pairing of tactile stimulation induces somatosensory cortical reorganization in rats and humans , 1996, Neuroreport.

[102]  F. E. Bloom,et al.  Sensory maps in the human brain , 1994, Nature.

[103]  G. Moseley,et al.  Is successful rehabilitation of complex regional pain syndrome due to sustained attention to the affected limb? A randomised clinical trial , 2005, Pain.

[104]  M. Hallett,et al.  Motor training as treatment in focal hand dystonia , 2005, Movement disorders : official journal of the Movement Disorder Society.

[105]  E. Brodie,et al.  Analgesia through the looking‐glass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation and movement , 2007, European journal of pain.