The relationship of perceptual phenomena and cortical reorganization in upper extremity amputees
Section snippets
Participants
Sixteen unilateral upper extremity amputees, 14 male and two female, were studied. Their mean age was 57.5 years (S.D.=10.68, range 39–74). Thirteen participants were right-handed, three had no clear hand preference, and none was left-handed. Mean age at the time of the amputation was 21.83 years (S.D.=10.95, range 2–47). The average time since amputation was 50.33 years (S.D.=15.14, range 15–65). The mean stump length was 33.38 cm (S.D.=18.67, range 0–54). Forty-four per cent of the sample had
Painful and non-painful phantom phenomena and cortical reorganization
Eleven of the 16 amputees in the study suffered from phantom limb pain. They showed a significantly larger amount of reorganization of primary somatosensory cortex as assessed with the Euclidean distance measure (M=20.25 mm, S.D.=5.15) than the remaining five amputees without phantom limb pain [M=3.36 mm, S.D.=2.87; t(14)=6.79, P<0.001]. Phantom limb pain as assessed by the MPI Pain Intensity Scale was highly correlated with cortical reorganization (r16=0.91, P<0.001).
Non-painful phantom
Painful and non-painful phantom sensations
Cortical reorganization in primary somatosensory cortex was positively associated with phantom limb pain, and this phenomenon seems to be very stable.1., 5., 6., 22., 27. Non-painful phantom sensations were not consistently related to these plastic cortical changes. When a significant correlation was found, it was entirely mediated by phantom limb pain. We assume that other cortical areas, for example, the posterior parietal cortex and SII, may be involved in the subjective awareness of a still
Conclusions
The data of this study suggest that reorganizational changes in SI appear to be mainly related to spontaneously occurring or induced phantom limb pain, whereas no significant relationship was found with non-painful phantom phenomena and perception thresholds. The stable relationship between phantom limb pain and cortical reorganization1., 5., 6., 16., 22., 27. and our present findings suggest that plastic changes in the primary somatosensory cortex may be an important neural correlate of
Acknowledgements
This work was supported by the Deutsche Forschungsgemeinschaft (Fl 156/16).
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2020, Psychiatry Research - NeuroimagingStructural and functional motor cortex asymmetry in unilateral lower limb amputation with phantom limb pain
2020, Clinical NeurophysiologyCitation Excerpt :Cortical representation changes are frequently observed in PLP patient studies; however, mixed results are observed. The cortical remapping theory states that after limb amputation, the central control area of the amputated limb becomes deafferented, and the potential unmasking of previously silent connections leads to functional and cortical reorganization (Flor et al., 1995, Grüsser et al., 2001, Montoya et al., 1998, Ramachandran et al., 1992). In this regard, Flor et al. (1995) and Raffin et al. (2016) showed that cortical changes (maladaptive reorganization) were closely associated with PLP: they reported a shift of nearby lip representation area into the deafferented hand region in upper-limb amputees.
5.42 - Phantom Limb Pain
2020, The Senses: A Comprehensive Reference: Volume 1-7, Second Edition
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