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A thesis submitted in partial fulfilment of - Queen Margaret University

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1998), t<strong>in</strong>gl<strong>in</strong>g, itch<strong>in</strong>g or pa<strong>in</strong>ful sensations (Hunter et al. 2003) even as long as<br />

25 years after the loss <strong>of</strong> the limb (Sherman, Sherman and Parker, 1984). This<br />

phenomenon <strong>in</strong>dicates that the bra<strong>in</strong> has not fully registered that the limb is no<br />

longer part <strong>of</strong> the body and cont<strong>in</strong>ues to feel sensations <strong>in</strong> that (nonexistent) arm<br />

or leg. Maladaptive cortical reorganisation has also been found to occur <strong>in</strong><br />

amputees where the sensory regions from their face and upper arm re-map to<br />

occupy the cortical territory previously held by the now amputated limb (Yang,<br />

Gallen, Ramachandran, Cobb, Schwartz and Bloom, 1994). Functional<br />

deviancies reported by amputees have supported these f<strong>in</strong>d<strong>in</strong>gs, for example<br />

when their faces were touched with vibration or various temperatures <strong>of</strong> water<br />

they felt the sensation as if it were on their phantom limb, further <strong>in</strong>dicat<strong>in</strong>g<br />

maladaptive connections made by unguided plasticity. Research has<br />

demonstrated that it is possible to reverse these maladaptive connections us<strong>in</strong>g<br />

experience-dependent rehabilitation (Ramachandran and Hirste<strong>in</strong>, 1998). This<br />

phantom limb phenomenon provides fundamental <strong>in</strong>sights <strong>in</strong>to the functional<br />

reorganisation <strong>of</strong> the human bra<strong>in</strong> (Ramachandran and Hirste<strong>in</strong>, 1998). That is,<br />

these studies demonstrate that the neuronal connections <strong>in</strong> the bra<strong>in</strong> can be rerouted<br />

or re-mapped through experience-dependent learn<strong>in</strong>g as neural circuits<br />

are tra<strong>in</strong>ed or even tricked <strong>in</strong>to chang<strong>in</strong>g their connection patterns (Robertson,<br />

1999). Additionally, these studies also demonstrate that without such guided<br />

plasticity maladaptive connections may be made reduc<strong>in</strong>g the functional ability<br />

<strong>of</strong> the <strong>in</strong>dividual.<br />

In summary, the evidence presented above has demonstrated the ability <strong>of</strong> the<br />

adult bra<strong>in</strong> to recover function follow<strong>in</strong>g a stroke and bra<strong>in</strong>-imag<strong>in</strong>g techniques<br />

have identified cortical plasticity <strong>in</strong> the motor and sensory cortex as a result <strong>of</strong><br />

experience-dependent rehabilitation. The importance <strong>of</strong> rehabilitation has also<br />

been demonstrated <strong>in</strong> guid<strong>in</strong>g this cortical reorganisation with evidence<br />

<strong>in</strong>dicat<strong>in</strong>g that maladaptive neural connections can be made if the bra<strong>in</strong> is left to<br />

recover <strong>in</strong>dependent <strong>of</strong> any structured guidance. This <strong>in</strong>vestigation aims to<br />

28

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