Unveiling the phantom: What neuroimaging has taught us about phantom limb pain

Browne, Jonathan D.; Fraiser, Ryan; Cai, Yi; Leung, Dillon; Leung, Albert; Vaninetti, Michael

doi:10.1002/brb3.2509

Cited by 6 publications

(1 citation statement)

References 74 publications

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“…of therapy and response to stimulation. However, they had limitations such as accessibility, practicality, and reproducibility, which limited their clinical use [39].…”

Section: Open Access Journal Of Neurology and Neurosurgerymentioning

confidence: 99%

Phantom Limb Pain: Current Concepts and Treatment Strategies

Nieto‐Salazar

2023

OAJNN

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Phantom limb syndrome (PLS) is described as the perception of feelings originating from a limb that has been amputated or is otherwise absent [1]. Despite this physical absence, patients may experience various sensory and motor sensations as if the limb were still present. Phantom limb symptoms encompass a range of sensations, including the missing limb's presence, movements such as wiggling toes or opening and closing the hand, pressure, tingling, itching, temperature changes, and pain [1-3]. Phantom limb pain (PLP) is commonly encountered in these patients, and it can vary in intensity, duration, and quality, ranging from throbbing or stabbing sensations to burning or cramping feelings. There is a high statistical heterogeneity across prevalence studies due to the different time windows assessed [4-10]. However, it is estimated that approximately 60-80% of individuals who have undergone limb amputation may experience phantom limb sensations, and around 50-85% of those individuals may also experience phantom limb pain [11,12]. Several factors have been identified as potential risk factors for developing this type of pain, including the level of amputation, pre-existing pain, post-amputation pain, chronic pain history, and psychological factors (i.e., anxiety, depression, post-traumatic stress disorder) [12,13].

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“…of therapy and response to stimulation. However, they had limitations such as accessibility, practicality, and reproducibility, which limited their clinical use [39].…”

Section: Open Access Journal Of Neurology and Neurosurgerymentioning

confidence: 99%

Phantom Limb Pain: Current Concepts and Treatment Strategies

Nieto‐Salazar

2023

OAJNN

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Unveiling the phantom: What neuroimaging has taught us about phantom limb pain

Browne¹,

Fraiser

Cai

et al. 2022

Brain and Behavior

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It consists of pain perception of a previously amputated limb. The exact pain mechanism is disputed and includes mechanisms involving cerebral, peripheral, and spinal origins. Such controversy limits researchers' and clinicians' ability to develop consistent therapeutics or management. Neuroimaging is an essential tool that can address this problem. This review explores diffusion tensor imaging, functional magnetic resonance imaging, electroencephalography, and magnetoencephalography in the context of PLP. These imaging modalities have distinct mechanisms, implications, applications, and limitations. Diffusion tensor imaging can outline structural changes and has surgical applications. Functional magnetic resonance imaging captures functional changes with spatial resolution and has therapeutic applications. Electroencephalography and magnetoencephalography can identify functional changes with a strong temporal resolution. Each imaging technique provides a unique perspective and they can be used in concert to reveal the true nature of PLP. Furthermore, researchers can utilize the respective strengths of each neuroimaging technique to support the development of innovative therapies. PLP exemplifies how neuroimaging and clinical management are intricately connected. This review can assist clinicians and researchers seeking a foundation for applications and understanding the limitations of neuroimaging techniques in the context of PLP.

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