MU researcher to improve current rehabilitation strategies for amputees

When a limb is lost or absent from birth, patients have different strategies that can be used for rehabilitation. However, this rehabilitation can be mentally exhausting and extremely painful in some cases, and scientists are looking for ways to improve the rehabilitation experience. Now, with the help of a $300,000 grant from the U.S. Department of Defense, one University of Missouri researcher will use the MU Brain Imaging Center to look for insights into the mental and physical discomfort that patients experience in an effort to improve current rehabilitation strategies. This is part of a collaboration with colleagues at the Christine M. Kleinert Institute in Louisville, Ky., which includes individuals who have undergone hand reattachments as well as recipients of hand transplants.

"Our goal is to learn about changes in brain organization and behavior that occur as the result of limb loss or congenital absence," said Scott Frey, professor of psychological sciences and director of the Brain Imaging Center. "These include changes associated with absence of a hand and with increased use of the remaining hand."

Currently, Frey is looking for volunteers, ages 18-70, who have lost, or been born without, an arm or hand, for the study designed to advance the understanding of brain reorganization. Participants, who are being sought regionally, will undergo functional and structural magnetic resonance imaging (MRI) while they perform movements and experience sensory stimuli. Unilateral amputees also will undergo testing of intact hand functions and will have an opportunity to participate in transcranial magnetic stimulation (TMS) to evaluate changes in connections between the brain and the hand. Volunteers will receive $30 per hour for their time. Travel expenses, meals and lodging also will be covered.

"The reorganizational changes that take place in the brain following the loss of a limb may play a variety of challenges faced by amputees, including pain," Frey said. "A better understanding of these changes may help in the development of more effective rehabilitation strategies for amputees and others who have experienced injuries to the body, brain or spinal cord."

This study would not be possible without MU's Brain Imaging Center. The MRI technology in the center allows researchers to collect behavioral data by producing pictures of the entire body, including the brain. The technology also captures certain functions, such as brain activity during a mental task and body metabolism.

"MU is one of the few academic institutions to have this technology available on campus and accessible to all departments and industries," Frey said. "We have conducted behavioral studies on diseases such as Parkinson's disease, autism and schizophrenia. The center allows us to have a space dedicated to these types of studies instead of sharing time with an MRI machine in a medical setting, which could delay studies and, as a result, inhibit researchers from obtaining information that could improve the lives of Missourians and citizens throughout the country."

Previously, Frey had studied how the brain reacts when a hand transplant is completed. In that study, he found that, following a hand transplant, normal activity does return to the region of the brain that controls hand function. In that study, the amputee Frey observed received a hand transplant 35 years after his accident.

While the current work is focused on hand loss, individuals with lower extremity amputation due to injury will be included in the near future. The new study will begin this spring.