Induced sensorimotor brain plasticity controls pain in phantom limb patients.
The cause of pain in a phantom limb after partial or complete deafferentation is an important problem. A popular but increasingly controversial theory is that it results from maladaptive reorganization of the sensorimotor cortex, suggesting that experimental induction of further reorganization should affect the pain, especially if it results in functional restoration. Here we use a brain-machine interface (BMI) based on real-time magnetoencephalography signals to reconstruct affected hand movements with a robotic hand. BMI training induces significant plasticity in the sensorimotor cortex, manifested as improved discriminability of movement information and enhanced prosthetic control. Contrary to our expectation that functional restoration would reduce pain, the BMI training with the phantom hand intensifies the pain. In contrast, BMI training designed to dissociate the prosthetic and phantom hands actually reduces pain. These results reveal a functional relevance between sensorimotor cortical plasticity and pain, and may provide a novel treatment with BMI neurofeedback.
Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Division of Functional Diagnostic Science, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Department of Neuroinformatics, ATR Computational Neuroscience Laboratories, 2-2-2 Hikaridai, Seika-cho, Kyoto 619-0288, Japan.|Department of Neuroinformatics, CiNet Computational Neuroscience Laboratories, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|JST PRESTO, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Division of Clinical Neuroengineering, Osaka University, Global Center for Medical Engineering and Informactics, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Takufumi
T
Yanagisawa
Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Department of Neuroinformatics, ATR Computational Neuroscience Laboratories, 2-2-2 Hikaridai, Seika-cho, Kyoto 619-0288, Japan.|Department of Neuroinformatics, CiNet Computational Neuroscience Laboratories, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Graduate School of Information Science, Nara Institute of Science and Technology, 8916-5 Takayamacho, Ikoma, Nara 630-0192, Japan.
Ryohei
R
Fukuma
Department of Engineering, University of Cambridge, Computational and Biological Learning Laboratory, Trumpington Street, Cambridge CB2 1PZ, UK.|National Institute for Information and Communications Technology, Center for Information and Neural Networks, 1-3 Suita, Osaka 565-0871, Japan.
Ben
B
Seymour
Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Koichi
K
Hosomi
Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Haruhiko
H
Kishima
Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Takeshi
T
Shimizu
Department of Mechanical Engineering and Intelligent Systems, The University of Electro-Communications, 1-5-1 Chofugaoka, Chofu, Tokyo 182-8585, Japan.
Hiroshi
H
Yokoi
Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Department of Neuroinformatics, CiNet Computational Neuroscience Laboratories, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Division of Clinical Neuroengineering, Osaka University, Global Center for Medical Engineering and Informactics, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Masayuki
M
Hirata
Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Department of Neuroinformatics, CiNet Computational Neuroscience Laboratories, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Division of Clinical Neuroengineering, Osaka University, Global Center for Medical Engineering and Informactics, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Toshiki
T
Yoshimine
Department of Neuroinformatics, ATR Computational Neuroscience Laboratories, 2-2-2 Hikaridai, Seika-cho, Kyoto 619-0288, Japan.|Graduate School of Information Science, Nara Institute of Science and Technology, 8916-5 Takayamacho, Ikoma, Nara 630-0192, Japan.|Graduate School of Informatics, Kyoto University, Yoshidahonmachi, Sakyoku, Kyoto 606-8501, Japan.
Yukiyasu
Y
Kamitani
Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.|Department of Neuromodulation and Neurosurgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Youichi
Y
Saitoh
D000328:Adult; D020516:Brachial Plexus Neuropathies / Q000503:physiopathology; D062207:Brain-Computer Interfaces; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D008875:Middle Aged; D058765:Neurofeedback / Q000379:methods*; D009473:Neuronal Plasticity; D059408:Pain Management / Q000379:methods*; D010591:Phantom Limb / Q000503:physiopathology / Q000628:therapy*; D019736:Prostheses and Implants; D066191:Sensorimotor Cortex / Q000503:physiopathology