Effects of regional anesthesia on phantom limb pain are mirrored in changes in cortical reorganization
| Autor: | Werner Lutzenberger, Niels Birbaumer, Wolfgang Grodd, Klaus Unertl, Wolfgang Larbig, Pedro Montoya, Herta Flor, Edward Taub, Stephanie Töpfner |
|---|---|
| Předmět: |
Nervous system
Adult Male medicine.medical_treatment Phantom limb Pain Electroencephalography Somatosensory system Imaging phantom medicine Image Processing Computer-Assisted Humans Anesthetics Cerebral Cortex medicine.diagnostic_test General Neuroscience Anatomy Articles Middle Aged medicine.disease equipment and supplies body regions medicine.anatomical_structure Amputation Phantom Limb Anesthesia Female Psychology Brachial plexus Phantom pain |
| Zdroj: | Pedro Montoya Scopus-Elsevier Europe PubMed Central ResearcherID |
| Popis: | The causes underlying phantom limb pain are still unknown. Recent studies on the consequences of nervous system damage in animals and humans reported substantial reorganization of primary somatosensory cortex subsequent to amputation, and one study showed that cortical reorganization is positively correlated with phantom limb pain. This paper examined the hypothesis of a functional relationship between cortical reorganization and phantom limb pain. Neuroelectric source imaging was used to determine changes in cortical reorganization in somatosensory cortex after anesthesia of an amputation stump produced by brachial plexus blockade in six phantom limb pain patients and four pain-free amputees. Three of six phantom limb subjects experienced a virtual elimination of current phantom pain attributable to anesthesia (mean change: 3.8 on an 11-point scale;Z= −1.83;p< 0.05) that was mirrored by a very rapid elimination of cortical reorganization in somatosensory cortex (change = 19.8 mm;t(2)= 5.60;p< 0.05). Cortical reorganization remained unchanged (mean change = 1.6 mm) in three phantom limb pain amputees whose pain was not reduced by brachial plexus blockade and in the phantom pain-free amputation controls. These findings suggest that cortical reorganization and phantom limb pain might have a causal relationship. Methods designed to alter cortical reorganization should be examined for their efficacy in the treatment of phantom limb pain. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|