Reorganização cortical e subcortical após amputação de membro superior: uma revisão integrativa

Abstract

Upper limb amputation is a procedure that alters physical functionality and quality of life. In addition to compromising autonomy, the loss of a limb can lead to sensory disturbances, such as phantom limb pain, which are often associated with cortical and subcortical reorganization. This generates challenges related to physical, emotional, and neurophysiological adaptation. Faced with the absence of stimuli from the lost limb, the brain reconfigures neural representations in the primary somatosensory cortical areas (S1) and in adjacent regions, such as the ventral posterior (VP) nucleus of the thalamus, the parietal cortex, and the prefrontal cortex, to process information from other parts of the body. This study conducted a qualitative analysis of articles that examined upper limb amputation and its neurophysiological effects in non-human primates. The articles were retrieved from the PubMed and Connected Papers databases using specific descriptors in English, Portuguese, and Spanish. Inclusion and exclusion criteria were established to identify the most relevant studies, focusing on primates with upper limb amputation and on studies of areas 3a or 3b of the somatosensory cortex and the ventral posterolateral (VPL) nucleus of the thalamus. After the initial screening, seven articles met the selection criteria and were examined in detail to deepen the understanding of the neuroplasticity processes involved.