Research Article Assessment of Emotional Expressions after Full-Face Transplantation Çağdaş Topçu, 1 Hilmi Uysal, 2 Ömer Özkan, 3 Özlenen Özkan, 3 Övünç Polat, 1 Merve Bedeloğlu, 1 Arzu Akgül, 1 Ela Naz Döğer, 1 Refik Sever, 1 Nur Ebru Barçın, 2 Kadriye Tombak, 4 and Ömer Halil Çolak 1 1 Faculty of Engineering, Department of Electrical-Electronics Engineering, Akdeniz University, Antalya, Turkey 2 Faculty of Medicine, Department of Neurology, Akdeniz University, Antalya, Turkey 3 Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Akdeniz University, Antalya, Turkey 4 Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Akdeniz University, Antalya, Turkey Correspondence should be addressed to Hilmi Uysal; uysalh@akdeniz.edu.tr Received 21 September 2016; Accepted 7 May 2017; Published 21 June 2017 Academic Editor: Gionata Strigaro Copyright © 2017 Çağdaş Topçu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We assessed clinical features as well as sensory and motor recoveries in 3 full-face transplantation patients. A frequency analysis was performed on facial surface electromyography data collected during 6 basic emotional expressions and 4 primary facial movements. Motor progress was assessed using the wavelet packet method by comparison against the mean results obtained from 10 healthy subjects. Analyses were conducted on 1 patient at approximately 1 year after face transplantation and at 2 years after transplantation in the remaining 2 patients. Motor recovery was observed following sensory recovery in all 3 patients; however, the 3 cases had different backgrounds and exhibited different degrees and rates of sensory and motor improvements after transplant. Wavelet packet energy was detected in all patients during emotional expressions and primary movements; however, there were fewer active channels during expressions in transplant patients compared to healthy individuals, and patterns of wavelet packet energy were different for each patient. Finally, high-frequency components were typically detected in patients during emotional expressions, but fewer channels demonstrated these high-frequency components in patients compared to healthy individuals. Our data suggest that the posttransplantation recovery of emotional facial expression requires neural plasticity. 1. Introduction Facial anatomy not only affects functional aspects of daily life such as eating and speaking but also affects an individual’s psychology and social relationships. Unilateral and bilateral hand and arm transplantations have been performed safely and successfully around the world since 1998 [1]. More recently, surgeons have begun to optimize and implement partial- and complete-face transplantations, in part due to the failure of conventional approaches to facial reconstruction. In 2005, a partial-face transplantation was performed on a 38-year-old woman who had been bitten by a dog; this patient has since undergone additional surgical treatment [2]. Since 2005, a total of 28 partial- and full-face transplantations have been performed. Functional improvements (e.g., ability to eat, drink, speak, smell, and smile) after the operation were reported in all patients [3]. Over time, functional improvements in emotional expression were also reported in the first partial-face transplant case [4]. However, no study to date has comprehensively assessed the recovery of emotional expression after full-face transplant or evalu- ated modifications in the somatosensory cortex after face transplantation [5]. In this study, we assessed clinical features as well as motor and sensory improvements after full-face transplanta- tion in 3 patients. Semmes-Weinstein’s monofilament test (SWMT) was used to evaluate touch thresholds; a monofila- ment kit comprising 20 monofilaments with 4 different levels was employed to obtain normal values for various areas Hindawi Neural Plasticity Volume 2017, Article ID 8789724, 7 pages https://doi.org/10.1155/2017/8789724