Phantom limb pain: a case of maladaptive CNS plasticity?
Phantom pain refers to pain in a body part that has been amputated or deafferented. It has often been viewed as a type of mental disorder or has been assumed to stem from pathological alterations in the region of the amputation stump. In the past decade, evidence has accumulated that phantom pain might be a phenomenon of the CNS that is related to plastic changes at several levels of the neuraxis and especially the cortex. Here, we discuss the evidence for putative pathophysiological mechanisms with an emphasis on central, and in particular cortical, changes. We cite both animal and human studies and derive suggestions for innovative interventions aimed at alleviating phantom pain.
Flor
Herta
H
Department of Clinical and Cognitive Neuroscience, University of Heidelberg, Central Institute of Mental Health, D-68159 Mannheim, Germany. herta.flor@zi-mannheim.de
Nikolajsen
Lone
L
Staehelin Jensen
Troels
T
D000222:Adaptation, Physiological; D000818:Animals; D002490:Central Nervous System / Q000503:physiopathology*; D004599:Electric Stimulation Therapy / Q000379:methods / Q000639:trends; D006801:Humans; D009473:Neuronal Plasticity; D010148:Intractable Pain / Q000503:physiopathology* / Q000628:therapy; D010591:Phantom Limb / Q000503:physiopathology* / Q000628:therapy; D011984:Sensory Receptor Cells / Q000503:physiopathology; D013003:Somatosensory Cortex / Q000503:physiopathology; D013116:Spinal Cord / Q000503:physiopathology