Simulating sensory-motor incongruence in healthy volunteers: implications for a cortical model of pain

McCabe, Candy; Haigh, Richard; Halligan, Peter W.; Blake, David R.

doi:10.1093/rheumatology/keh529

Cited by 212 publications

(203 citation statements)

References 31 publications

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“…Our group and others have quantified that effect (1,2), but further interrogation led us to conclude that pain probably does not cause the delay, because experimentally induced hand pain, and the expectation of hand pain, has the opposite effect (3,4). A delay similar to that observed in CRPS patients can be induced in healthy controls by experimentally disrupting proprioceptive input (5), which seems consistent with the idea reported by McCabe et al (6) that disruption of cortical representation of the affected area might underpin the pain. Clearly, more studies are needed.…”

Section: To the Editorssupporting

confidence: 88%

“…For example, the Combinatietherapie Bij Reumatoïde Artritis (COBRA) trial and the BeSt study showed that a high oral pulse of prednisolone in combination with methotrexate and sulfasalazine is very effective and fast in lowering disease activity and delay of radiographic progression (2,3). Likewise, the effectiveness of low-dose glucocorticoid treatment has been demonstrated, among others, by Kirwan et al (4), van Everdingen et al (5), in the BARFOT trial (6), and has been documented in 2 meta-analyses, one with Dr. Saag as the first author (7,8). Additionally, a recent systematic review documented that glucocorticoids delay progression of joint damage on radiographs (9), and therefore should be regarded as disease-modifying therapy in RA.…”

Section: To the Editorsmentioning

confidence: 91%

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Moseley¹,

Birklein²,

Hilten³

et al. 2008

Arthritis & Rheumatism

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Section: To the Editorssupporting

confidence: 88%

Section: To the Editorsmentioning

confidence: 91%

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Moseley¹,

Birklein²,

Hilten³

et al. 2008

Arthritis & Rheumatism

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“…The mirror image of the normal body part reorganizes and integrate the mismatch between proprioception and visual feedback of the removed body. This reorganization decreases the sense or emotion of phantom limb pain in the amputated part (6). In the present study itself a significant improvement of 4 or more degrees of VAS score after six months of therapy proves that mirror image therapy is an effective treatment to reduce phantom limb pain in below knee amputees.…”

Section: Discussionsupporting

confidence: 68%

Role of Mirror Therapy for Phantom Limb Pain in Below Knee Amputees

Gupta¹,

Saraf²

2016

IOSR

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Material and methods: 96 patients who had phantom limb pain after below knee amputation were included in this study. They had to visit the hospital four times a week for a 15-minute treatment period. They performed movement of unaffected limb while watching its mirror reflection and thus creating a visual illusion of movement of affected limb. The degree of pain relief was measured on visual analog scale (VAS). Results: 70 patients out of 96 reported an improvement of 4 or more degrees of VAS score after 6 months of the treatment. The result was statistically significant. Conclusions: Mirror therapy improves pain sensation of the amputated part when other treatment modalities fail. This therapy works on the principle of mirror neuron system. A mirror neuron fires either when a person acts or when a person observes same action performed by another. The mirror image of the normal body part helps reorganize and integrate the mismatch between proprioception and visual feedback of the removed body.This reorganization decreases the sense or emotion of phantom limb pain in the amputated part.

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“…Whereas synchronous stimulation of external objects, such as a rubber hand, can lead to the illusion of body ownership (70), asynchronous stimulation in one sensory modality or between the senses can lead to abnormal sensory perception (71,72). On the basis of this concept it has been proposed that inappropriate cortical representation of proprioception may falsely signal incongruence between motor intention and movement, resulting in pathological pain in the same way that incongruence between vestibular and visual sensation results in motion sickness (73).…”

mentioning

confidence: 99%

“…On the basis of this concept it has been proposed that inappropriate cortical representation of proprioception may falsely signal incongruence between motor intention and movement, resulting in pathological pain in the same way that incongruence between vestibular and visual sensation results in motion sickness (73). This sensorimotor conflict can also induce pain in healthy volunteers (72). In this sense, phantom limb pain could hypothetically be related to a temporal incongruence between what is stored in memory (the presence of the limb) and deprivation of sensory input (the absence of the limb).…”

mentioning

confidence: 99%

Phantom percepts: Tinnitus and pain as persisting aversive memory networks

Ridder¹,

Elgoyhen

Romo

et al. 2011

Proc. Natl. Acad. Sci. U.S.A.

526

477

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Phantom perception refers to the conscious awareness of a percept in the absence of an external stimulus. On the basis of basic neuroscience on perception and clinical research in phantom pain and phantom sound, we propose a working model for their origin. Sensory deafferentation results in high-frequency, gamma band, synchronized neuronal activity in the sensory cortex. This activity becomes a conscious percept only if it is connected to larger coactivated "(self-)awareness" and "salience" brain networks. Through the involvement of learning mechanisms, the phantom percept becomes associated to distress, which in turn is reflected by a simultaneously coactivated nonspecific distress network consisting of the anterior cingulate cortex, anterior insula, and amygdala. Memory mechanisms play a role in the persistence of the awareness of the phantom percept, as well as in the reinforcement of the associated distress. Thus, different dynamic overlapping brain networks should be considered as targets for the treatment of this disorder.A fundamental concept in psychology and philosophy of the mind is the notion of perception: The act of interpreting and organizing a sensory stimulus to produce a meaningful experience of the world and of oneself. A stimulus produces an effect on the different sensory receptors, inducing sensation. Further processing of this sensory stimulation generates an internal representation of the outer and inner world called a percept. Since the first days of psychology, two challenging questions have existed: How is sensory information encoded and, in particular, how is this represented information transformed into the individual awareness of a conscious percept (1)? Our understanding of sensory encoding, perception, and consciousness is challenged with a further degree of complexity in the case of phantom perception, the conscious awareness of a percept in the absence of an external stimulus. Deciphering the underlying neural correlates of phantom perception is a scientific endeavor that will aid in understanding the active processes of selecting, organizing, and interpreting information, which ultimately lead to the formation of a conscious percept within the brain.Although some cases of phantom percepts have been described for the visual, olfactory, and gustatory systems, the vast majority of sensory phantoms are those present in the somatosensory (phantom limb perception/phantom limb pain and neuropathic pain) (2) and auditory (tinnitus) (3) modalities. Upfront we are challenged with the following questions: In the absence of an external sensory stimulus, where and how in the brain is the conscious percept generated? In addition, are the neural substrates underlying the generation of a conscious phantom percept similar for the auditory and somatosensory modalities? If so, can we advance in our understanding and treatment of tinnitus on the basis of what is known for phantom limb and phantom pain perception and vice versa? Here, we address these questions and propose a working model of how pha...

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Simulating sensory-motor incongruence in healthy volunteers: implications for a cortical model of pain

Abstract: Our findings support the hypothesis that motor-sensory conflict can induce pain and sensory disturbances in some normal individuals. We propose that prolonged sensory-motor conflict may induce long-term symptoms in some vulnerable subjects.

Cited by 212 publications

References 31 publications

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Role of Mirror Therapy for Phantom Limb Pain in Below Knee Amputees

Phantom percepts: Tinnitus and pain as persisting aversive memory networks

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