Review Article
Plasticity of the Central Nervous System Involving Peripheral Nerve Transfer
Figure 2
Neuroplasticity after an intercostal-to-musculocutaneous nerve transfer with moderate clinical outcomes. In the early phase of morphological reinnervation (left), biceps contraction is mediated by the original intercostal nerve’s primary motor cortex located in the midline. The descending pathway for elbow flexion from the motor cortex to the motor neuron pool of the intercostal nerve T3 is shown in red. Several years later (right), patients begin to contract their biceps independently of respiration. The cortical region representing musculocutaneous nerve delivers the motor control command to biceps brachii via the new relay diaphragm area. The new connection between the 2 cortexes (curved arrow) is reactivated.