19 GENERAL INTRODUCTION, AIMS & OUTLINE 1 A Part 1 of this thesis centres around the question of How the brain adapts to peripheral nerve damage in NA, corresponding with the first aim of this thesis: to determine whether cerebral alterations are involved in NA patients with residual complaints after peripheral nerve injury. Chapter 3 describes a preparatory cross-sectional behavioural study comparing NA patients to healthy volunteers. We investigated whether a hand laterality judgment task, which involves motor imagery, can provide behavioural evidence confirming the clinical suspicion that cerebral sensorimotor representations of the affected upper extremity are altered in NA. At the same time, this study identifies the hand laterality judgment task as a motor imagery tool sensitive to cerebral adaptations in NA. Chapter 4 describes a cross-sectional neuroimaging study, in which we use functional MRI and the motor imagery paradigm identified in chapter 3, to assess and localize cerebral adaptations related to the affected upper extremity in NA patients with persistent motor dysfunction as compared to healthy volunteers. We additionally relate cerebral adaptations to residual complaints. Part 2 centres around the question of How rehabilitation can aid recovery in NA, corresponding with the second aim of this thesis: to determine the effect of specialized multidisciplinary rehabilitation on clinical outcome and cerebral mechanisms. Chapter 5 describes a randomized controlled trial on the clinical effects of specialized, multidisciplinary out-patient rehabilitation. We compare our specialized rehabilitation program to usual care on a range of clinical domains, with functional capability of the upper extremity as the primary outcome measure. We additionally assess retention effects at 4 months follow-up. Chapter 6 describes the neuroimaging part of the randomized controlled trial described in chapter 5. We use the same motor imagery paradigm as in chapters 3 and 4, combined with functional MRI before and after treatment to investigate cerebral adaptations in NA patients in response to treatment and recovery. We compare the effect of our specialized rehabilitation program, which is focused on relearning motor control, to usual care on behavioural and cerebral responses. Chapter 7 summarizes and discusses the main findings of this thesis, and addresses the clinical implications for neuralgic amyotrophy and future directions. Chapter 8 provides a Dutch summary of the work described in this thesis.