Movement related cortical source for elbow flexion in patients with brachial plexus injury after intercostal-musculocutaneous nerve crossing

Nine patients with brachial plexus injury whose transected musculo-cutaneou s nerves had been sutured with intercostal nerves were examined and the rel ationship between flexion of the operated elbow and the respiratory movemen t were shown. Three out of nine patients showed independent control of move ment from respiration after regeneration. The primary motor cortex for eith er flexion of the elbow to the operated side or brisk voluntary inspiration was estimated in the medial vertex region of the frontal cortex by the dip ole-tracing method in these three patients. The present results suggest tha t patients contract the biceps muscle reinnervated by the intercostal nerve independently from respiratory movements using the same primary motor cort ex with trunk movements. Functional plasticity may occur in the patients us ing the primary trunk motor cortex for elbow flexion. (C) 1999 Elsevier Sci ence Ireland Ltd. All rights reserved.