{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:42:38Z","timestamp":1785901358486,"version":"3.56.0"},"reference-count":48,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The authors conducted a study to determine age- and time-dependent effects on the functional outcome after median nerve injury and repair and how such effects are related to changes in the pattern of cortical activation in response to tactile stimulation of the injured hand.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors studied 11 patients with complete unilateral median nerve injury at the wrist repaired with epineural suture. In addition, 8 patients who were reported on in a previous study were included in the statistical analysis. In the entire study cohort, the mean age at injury was 23.3 \u00b1 13.4 years (range 7\u201357 years) and the time after injury ranged from 1 to 11 years. Sensory perception was measured with the static 2-point discrimination test and monofilaments. Functional MR imaging was conducted during tactile stimulation (brush strokes) of Digits II\u2013III and IV\u2013V of both hands, respectively.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Tactile sensation was diminished in the median territory in all patients. The strongest predictor of 2-point discrimination was age at injury (p &lt; 0.0048), and when this was accounted for in the regression analysis, the other age- and time-dependent predictors had no effect. The activation ratios (injured\/healthy hand) for Digit II\u2013III and Digit IV\u2013V stimulation were positively correlated (rho 0.59, p &lt; 0.011). The activation ratio for Digit II\u2013III stimulation correlated weakly with time after injury (p &lt; 0.041). The activation ratio of Digits IV\u2013V correlated weakly with both age at injury (p &lt; 0.048) and time after injury (p &lt; 0.033), but no predictor reached significance in the regression model. The mean ratio of ipsi- and contralateral hemisphere activation after stimulation of the injured hand was 0.55, which was not significantly different from the corresponding ratio of the healthy hand (0.66).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Following a median nerve injury (1\u201311 years after injury) there may be an initial increase in the volume of the cortical representation, which subsequently declines during the restoration phase. These dynamic changes may involve both median and ulnar nerve cortical representation, because both showed negative correlation with time after injury. These findings are in agreement with animal studies showing that cortical plasticity is an important mechanism for functional recovery after peripheral nerve injury and repair.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.10.jns09698","type":"journal-article","created":{"date-parts":[[2009,11,13]],"date-time":"2009-11-13T15:03:44Z","timestamp":1258124624000},"page":"122-128","source":"Crossref","is-referenced-by-count":24,"title":["Age- and time-dependent effects on functional outcome and cortical activation pattern in patients with median nerve injury: a functional magnetic resonance imaging study"],"prefix":"10.3171","volume":"113","author":[{"given":"Lotta","family":"Fornander","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm;"},{"name":"Department of Orthopaedics, Vrinnevi Hospital, Norrk\u00f6ping;"},{"name":"Departments of Plastic Surgery, Hand Surgery and Burns, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbj\u00f6rn","family":"Nyman","sequence":"additional","affiliation":[{"name":"Anaesthesiology, University Hospital, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hansson","sequence":"additional","affiliation":[{"name":"Departments of Plastic Surgery, Hand Surgery and Burns, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Ragnehed","sequence":"additional","affiliation":[{"name":"Division of Radiological Sciences, IMH, Link\u00f6ping University; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Brismar","sequence":"additional","affiliation":[{"name":"Department of Clinical Neuroscience, Karolinska Institutet, Stockholm;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns09698","series-title":"Hand Clin","first-page":"67","article-title":"Functional results of primary nerve repair","volume":"16","author":"Allan","year":"2000"},{"key":"b2-jns09698","series-title":"The Hand: Examination and Diagnosis","author":"American Society for Surgery of the Hand","year":"1978"},{"key":"b3-jns09698","series-title":"Hand Clin","first-page":"527","article-title":"Advances in sensibility evaluation","volume":"7","author":"Bell-Krotoski","year":"1991"},{"key":"b4-jns09698","series-title":"Neuroimage","first-page":"927","article-title":"fMRI reflects functional connectivity of human somatosensory cortex","volume":"37","author":"Blatow","year":"2007"},{"key":"b5-jns09698","series-title":"Brain","first-page":"684","article-title":"Neural correlates of motor dysfunction in children with traumatic brain injury: exploration of compensatory recruitment patterns","volume":"132","author":"Caeyenberghs","year":"2009"},{"key":"b6-jns09698","series-title":"Science","first-page":"805","article-title":"Interhemispheric transfer of plasticity in the cerebral cortex","volume":"249","author":"Calford","year":"1990"},{"key":"b7-jns09698","series-title":"Rehabilitation of the Hand and Upper Extremity","first-page":"214","article-title":"Sensibility assessment for nerve lesions-in-continuity and nerve lacerations","author":"Callahan","year":"2002"},{"key":"b8-jns09698","series-title":"J Hand Surg Br","first-page":"58","article-title":"A comparative clinical and electromyographic study of median and ulnar nerve injuries at the wrist in children and adults","volume":"26","author":"Duteille","year":"2001"},{"key":"b9-jns09698","series-title":"Nature","first-page":"69","article-title":"Central reorganization of sensory pathways following peripheral nerve regeneration in fetal monkeys","volume":"381","author":"Florence","year":"1996"},{"key":"b10-jns09698","series-title":"Magn Reson Med","first-page":"139","article-title":"Functional MRI of human brain activation at high spatial resolution","volume":"29","author":"Frahm","year":"1993"},{"key":"b11-jns09698","series-title":"J Bone Joint Surg Am","first-page":"632","article-title":"Sensibility testing in peripheral-nerve compression syndromes. 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