Neuroelectric source imaging of steady-state movement-related cortical potentials in human upper extremity amputees with and without phantom limb pain.
Whereas several studies reported a close relationship between changes in the somatotopic organization of primary somatosensory cortex and phantom limb pain, the relationship between alterations in the motor cortex and amputation-related phenomena has not yet been explored in detail. This study used steady-state movement-related cortical potentials (MRCPs) combined with neuroelectric source imaging to assess the relationship of changes in motor cortex and amputation-related phenomena such as painful and non-painful phantom and residual limb sensations, telescoping, and prosthesis use. Eight upper limb amputees were investigated. A significant positive relationship between reorganization of the motor cortex (distance of the MRCP source location from the mirrored source for hand movement) and phantom limb pain was found. Non-painful phantom sensations as well as painful and non-painful residual limb sensations were unrelated to motor cortical reorganization. A higher amount of motor reorganization was associated with less daily prosthesis use, which also tended to be related to more severe phantom limb pain. These results extend previous findings of a positive relationship between somatosensory reorganization and phantom limb pain to the motor domain and suggest a potential positive effect of prosthesis use on phantom limb pain and cortical reorganization.
Biopsychology Unit, University of Technology Dresden, Zellescher Weg 17, 01062 Dresden, Germany.
Anke
A
Karl
Werner
W
Mühlnickel
Ralf
R
Kurth
Herta
H
Flor
D000328:Adult; D000368:Aged; D000672:Amputation Stumps / Q000294:innervation / Q000503:physiopathology; D000674:Amputees / Q000523:psychology*; D001931:Brain Mapping; D004576:Electromyography / Q000379:methods; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D005528:Foot / Q000294:innervation / Q000503:physiopathology; D007839:Functional Laterality / Q000502:physiology; D006225:Hand / Q000294:innervation / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009068:Movement / Q000502:physiology*; D010591:Phantom Limb / Q000503:physiopathology*; D014059:Tongue / Q000294:innervation / Q000503:physiopathology; D034941:Upper Extremity / Q000294:innervation / Q000503:physiopathology*