The Problem of Central Nervous Reorganization After Nerve Regeneration and Muscle Transposition

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Abstract
The work on nervous sectioning with subsequent regeneration and reintegration of function is reviewed from the time of Flourens (1828) and critically examined in the light of present experimentation. In spite of extravagant claims by some of these workers that there is complete reorganization, reintegration, and coordination of movements, there is little evidence that supports even the most moderate assertions in this regard. Most of the more remarkable functional recoveries recorded appear to have been cases in which various types of compensatory adjustment on the part of the intact system, along with local mechanical and trophic changes in affected parts have together produced a serviceable effect which has been erroneously interpreted to be the product of extreme revision in the central synaptic association of the affected peripheral nerves. Failure to analyze the underlying factors contributing to readaptation, and failure to distinguish between indirect compensatory adjustment and adjustment in which the function of the affected nerves and end organs themselves is involved, has rendered invalid a large percentage of the conclusions regarding the reintegrative capacities of the nerve centers. Evidence definitely contradicts the supposition that any readaptation is achieved by spontaneous dynamic readjustment. There may be local morphologic and physiologic readaptive phenomena which are similar to improvement by learning.