{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:09:11Z","timestamp":1790762951113,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T00:00:00Z","timestamp":1560816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although there are studies that have examined brain functional reorganization following upper\u2010limb amputation, understanding of the brain changes that occur in people with lower\u2010limb amputation is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate modifications in the brain following lower\u2010limb amputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included case\u2010control studies that evaluate neuroplasticity in the central nervous system using neuroimaging techniques. A literature search was conducted using MEDLINE, CINAHL, Web of Science, Scopus, and Cochrane.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven articles were included (total n\u2009=\u2009204 people with unilateral lower\u2010limb amputation). These studies showed an increase in cerebellar gray matter volume in prosthesis users, as well as a decrease in thickness of the premotor cortex, orbitofrontal cortex, temporo\u2010occipital junction, precentral gyrus, visual areas, and somatosensory cortex. Regarding white matter, the trials observed a decrease in the integrity at the corona radiata, the connections between the premotor areas, the fronto\u2010occipital fasciculus and the corpus callosum. In addition, a decreased functional connectivity between cortical and subcortical areas has been described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lower\u2010limb amputation causes changes in several brain structures that may occur in the absence of pain and regardless of prosthesis use. The modifications observed include thinning or loss of gray matter volume, decrease in the integrity of the white matter connections between brain structures and changes in the functional connectivity between cortical and subcortical areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>I.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12167","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T03:01:29Z","timestamp":1555383689000},"page":"1326-1334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Neuroplasticity Modifications Following a Lower\u2010Limb Amputation: A Systematic Review"],"prefix":"10.1002","volume":"11","author":[{"given":"Francisco","family":"Molina\u2010Rueda","sequence":"first","affiliation":[{"name":"Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitaci\u00f3n y Medicina F\u00edsica, Facultad de Ciencias de la Salud Universidad Rey Juan Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Navarro\u2010Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitaci\u00f3n y Medicina F\u00edsica, Facultad de Ciencias de la Salud Universidad Rey Juan Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9507-2717","authenticated-orcid":false,"given":"Alicia","family":"Cuesta\u2010G\u00f3mez","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitaci\u00f3n y Medicina F\u00edsica, Facultad de Ciencias de la Salud Universidad Rey Juan Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel M","family":"Alguacil\u2010Diego","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitaci\u00f3n y Medicina F\u00edsica, Facultad de Ciencias de la Salud Universidad Rey Juan Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Molero\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitaci\u00f3n y Medicina F\u00edsica, Facultad de Ciencias de la Salud Universidad Rey Juan Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Carratal\u00e1\u2010Tejada","sequence":"additional","affiliation":[{"name":"Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitaci\u00f3n y Medicina F\u00edsica, Facultad de Ciencias de la Salud Universidad Rey Juan Carlos  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,18]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"15","volume-title":"Pr\u00f3tesis, ortesis y ayudas t\u00e9cnicas. 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