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CNS Changes Following Upper Limb Loss

Functional, Structural, and Metabolic Central Nervous System Changes Following Damage of the Central Nervous System

Status
Recruiting
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT06043518
Enrollment
70
Registered
2023-09-21
Start date
2023-07-05
Completion date
2027-06-30
Last updated
2025-11-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Amputation, Congenital, Upper Limb; Amelia

Keywords

Plasticity, Congenital amputee, Upper limb amelia, Somatotopy, Functional MRI, Hand, Reorganisation

Brief summary

The objective of this study is to better understand the structural and functional changes that the central nervous system (CNS) undergoes following congenital upper limb loss. The focus is on the brain's sensory processing and how neuronal changes may relate to clinical measures. By doing so, the hope is to gain insight into the contribution of critical periods to the plasticity of the sensorimotor processing stream. Both macroscopic and microscopic changes of the brain will be examined in individuals with upper limb amelia and compared to healthy controls. fMRI will be combined with behavioural testing to understand which clinical and behavioural determinants drive somatosensory representations along the entire somatosensory processing stream. Using advanced imaging techniques, the aim is to investigate the contribution of brainstem reorganisation to plasticity observed at the cortical level and, by doing so, gain a better understanding of the mechanistic underpinnings of functional reorganisation. Overall, the hope is to provide the first mechanistic insight into whether early life experiences are crucial for the development of the relay nuclei in the central nervous system and how these changes relate to clinical measures such as adaptive behaviours or pain.

Interventions

DIAGNOSTIC_TESTMRI

Use of functional and structural MRI in both the brain and the spinal cord as well as questionnaires and clinical measures of motor function

Sponsors

ETH Zurich
CollaboratorOTHER
University of Zurich
Lead SponsorOTHER

Study design

Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
Yes

Inclusion criteria

- Patients: * Age 18-75 * Upper-limb congenital amputees with complete absence of a hand * Signed informed consent

Exclusion criteria

- Patients: * Contraindications to magnetic resonance imaging * Neurological impairment of body function impairments not induced by spinal cord injury * BMI \> 40 * Pregnancy * Claustrophobia Inclusion Criteria - Healthy subjects: * Age 18-75 * Signed Informed consent

Design outcomes

Primary

MeasureTime frameDescription
Change of functional MRI (fMRI) parameter between 2 to 4 time pointsUp to 50 weeksChange of brain activities is assessed between 2 to 4 time points using fMRI during resting-state or a specific task in patients with congenital amputations and compared to healthy controls

Secondary

MeasureTime frameDescription
Conventional magnetic resonance imaging (MRI) parameterUp to 50 weeksStructural characteristics in the brain and cervical spinal cord are assessed in patients with congenital upper-limb amputations using conventional MRI and compared to healthy controls
Amputees: Motor Activity Log questionnaireUp to 50 weeksEvaluation of residual limb and/or prosthesis usage as compared to other body parts via a questionnaire and behavioural assessments.

Countries

Switzerland

Contacts

Primary ContactPaige Howell, PhD
paige.howell@hest.ethz.ch+41 44 632 32 94
Backup ContactSanne Kikkert
sanne.kikkert@balgrist.ch+41 44 632 32 94

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026