Decrease in phantom limb pain associated with prosthesis-induced increased use of an amputation stump in humans

Weiß, Thomas; Miltner, Wolfgang H. R.; Adler, T.; Brückner, Lutz; Taub, Edward

doi:10.1016/s0304-3940(99)00595-9

Cited by 142 publications

(73 citation statements)

References 15 publications

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“…58,77 However, not all studies have found an association between prosthesis use and decreased pain and/or cortical reorganization. 78,79 Moreover, the two studies that did find an association used transversal or retrospective designs, which makes it difficult to ascertain whether this association indeed reflects a causal relationship.…”

Section: Can Motor Training Results In Both Motor-cortex Reorganizatiomentioning

confidence: 99%

Interactions between Pain and the Motor Cortex: Insights from Research on Phantom Limb Pain and Complex Regional Pain Syndrome

Mercier

Léonard²

2011

Physiotherapy Canada

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Purpose: Pain is a significantly disabling problem that often interacts with other deficits during the rehabilitation process. The aim of this paper is to review evidence of interactions between pain and the motor cortex in order to attempt to answer the following questions: (1) Does acute pain interfere with motorcortex activity? (2) Does chronic pain interfere with motor-cortex activity, and, conversely, does motor-cortex plasticity contribute to chronic pain? (3) Can the induction of motor plasticity by means of motor-cortex stimulation decrease pain? (4) Can motor training result in both motor-cortex reorganization and pain relief? Summary of Key Points: Acute experimental pain has been clearly shown to exert an inhibitory influence over the motor cortex, which can interfere with motor learning capacities. Current evidence also suggests a relationship between chronic pain and motor-cortex reorganization, but it is still unclear whether one causes the other. However, there is growing evidence that interventions aimed at normalizing motor-cortex organization can lead to pain relief. Conclusions: Interactions between pain and the motor cortex are complex, and more studies are needed to understand these interactions in our patients, as well as to develop optimal rehabilitative strategies.Key Words: motor control, motor cortex, pain, plasticity, rehabilitation RÉ SUMÉObjectif : La douleur est considé rablement invalidante et pré sente souvent des interactions avec d'autres dé ficits au cours du processus de ré adaptation. L'objectif de cet article est d'analyser donné e supportant la pré sence d'interactions entre la douleur et le cortex moteur afin de tenter de ré pondre aux questions suivantes : (1) La douleur aiguë nuit-elle à l'activité du cortex moteur? (2) La douleur chronique altè re-t-elle l'activité du cortex moteur et, ré ciproquement, la ré organisation du cortex moteur contribue-t-elle à la douleur chronique? (3) L'induction de la plasticité motrice par stimulation du cortex moteur peut-elle ré duire la douleur? (4) L'entraînement moteur peut-il amener à la fois une ré organisation du cortex moteur et un soulagement de la douleur? Ré sumé des principaux points : Il a é té clairement dé montré que la douleur aiguë expé rimentale exerce une influence inhibitoire sur le cortex moteur, qui peut entraver les capacité s d'apprentissage moteur. Les donné e actuelles suggè rent é galement qu'il existe une relation entre la douleur chronique et la ré organisation du cortex moteur, mais il n'est pas clair que l'un provoque l'autre. Il existe toutefois des preuves de plus en plus nombreuses que les interventions visant à normaliser l'organisation du cortex peuvent amener un soulagement de la douleur. Conclusions : Les interactions entre la douleur et le cortex moteur sont complexes et d'autres é tudes sont né cessaires pour comprendre ces interactions chez nos patients et pour concevoir des straté gies de ré adaptation optimales.

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Section: Can Motor Training Results In Both Motor-cortex Reorganizatiomentioning

confidence: 99%

Interactions between Pain and the Motor Cortex: Insights from Research on Phantom Limb Pain and Complex Regional Pain Syndrome

Mercier

Léonard²

2011

Physiotherapy Canada

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“…As discussed above, the signature CI therapy intervention is used for stroke patients with an upper extremity paresis. The original therapy has recently been extended in our laboratory to treat deficits in arm use in people with traumatic brain injury 52 , cerebral palsy (E.T., S. C. DeLuca, K. Echols and S. L. Ramey, unpublished observations), FOCAL HAND DYSTONIA 53,54 , phantom limb pain 55 and APHASIA 56 , and to treat lower limb impairments in people with chronic stroke, spinal cord injury and hip fractures 26 .…”

Section: Other Applications Of CI Therapymentioning

confidence: 99%

New treatments in neurorehabiliation founded on basic research

2002

Self Cite

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The relative dearth of effective interventions in neurorehabilitation could be partly attributable to the weak contribution that this field has received from basic sciences such as neuroscience and behavioural psychology. Neuroscience holds an important place in the curriculum of physical therapy schools, but its influence has been largely didactic and has had little bearing on clinical practice. Behavioural psychology has contributed much to the treatment of chronic pain 1 , but has little or no place in the curriculum of physical rehabilitation schools or in the development of treatments for movement disorders. In other health-related fields, basic research has, of course, been of inestimable value in enabling the development of new therapeutic interventions. In the neurosciences, the fruitfulness of this approach has been amply shown by the development of treatments for Parkinson's disease and other disorders on the basis of the pioneering work of Carlsson and others on chemical neurotransmission 2,3 . The paradigm shift that is mentioned in the preface refers to the fact that this process of translation of basic research into new treatments is beginning to take place in the field of neurorehabilitation and is proceeding at an accelerating pace.After injury to the central nervous system (CNS), the initial deficit in behaviour, perception and/or cognitive ability is frequently followed by a spontaneous recovery of function. This resiliency may be considered as one type of behavioural plasticity. By apparent contrast, the traditional view in neuroscience during the first threequarters of the last century was that the mature CNS has little capacity to reorganize and repair itself in response to injury. This view extends back into the nineteenth century, promoted initially by Broca's studies on the localization of function within the brain 4 , which emphasized the constancy of organization of the mature CNS even after substantial injury. Although contrary views were expressed 5,6 , the mature CNS was generally believed 7 to show little or no plasticity 8 . Hughlings Jackson's hierarchical view 9 that lower centres of the brain substituted in function for higher damaged centres after CNS insult, together with other related formulations, had an important influence for most of the twentieth century on our thinking about the recovery of function. However, the phenomenon of spontaneous recovery of function was never fully explained and received little experimental attention, largely because the techniques needed to explore this process had not yet been developed. Beginning in the 1970s, research from several laboratories, including those of Merzenich Recent discoveries about how the central nervous system responds to injury and how patients reacquire lost behaviours by training have yielded promising new therapies for neurorehabilitation. Until recently, this field had been largely static, but the current melding of basic behavioural science with neuroscience promises entirely new approaches to improving behavioural, ...

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“…post-stroke recovery), whereas other forms of plasticity can induce maladaptive neuroplastic changes and negatively affect disease pathogenesis [25,27,41,[55][56][57]. Notable examples of maladaptive cortical reorganization include focal hand dystonia [58], phantom limb pain [59], and tinnitus [60,61], which can have disastrous effects on one's quality of life [41]. Most strategies addressing the adverse consequences of plasticity involve prevention rather than promotion.…”

Section: Plasticity-preventing Interventionsmentioning

confidence: 99%

Neuroplasticity-targeted Intervention for Idiopathic Sudden Sensorineural Hearing Loss: A New Therapeutic Direction

2017

NNR

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Decrease in phantom limb pain associated with prosthesis-induced increased use of an amputation stump in humans

Cited by 142 publications

References 15 publications

Interactions between Pain and the Motor Cortex: Insights from Research on Phantom Limb Pain and Complex Regional Pain Syndrome

Interactions between Pain and the Motor Cortex: Insights from Research on Phantom Limb Pain and Complex Regional Pain Syndrome

New treatments in neurorehabiliation founded on basic research

Neuroplasticity-targeted Intervention for Idiopathic Sudden Sensorineural Hearing Loss: A New Therapeutic Direction

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