Review
Clinical Neurology
Jacob Boomgaardt, Kovosh Dastan, Tiffany Chan, Ashley Shilling, Alaa Abd-Elsayed, Lynn Kohan
Summary: Phantom limb pain is a common and challenging condition with no consensus on optimal management and varying clinical responses to available treatments.
JOURNAL OF PAIN RESEARCH
(2022)
Article
Clinical Neurology
Martin Diers, Bertram Krumm, Xaver Fuchs, Robin Bekrater-Bodmann, Christopher Milde, Joerg Trojan, Jens Foell, Susanne Becker, Gerhard Ruemenapf, Herta Flor
Summary: This study examined the prevalence of phantom limb pain in amputees and identified different factors associated with phantom limb pain and residual limb pain. Clinical/demographic variables and perceptual variables were found to be major contributors to phantom limb pain.
Article
Surgery
Brian L. Chang, Josh Mondshine, Christopher M. Fleury, Christopher E. Attinger, Grant M. Kleiber
Summary: The study found that symptomatic neuroma formation was most common in the superficial peroneal and saphenous nerves in patients undergoing below-knee amputation. Diabetes and obesity were protective factors against symptomatic neuroma formation, and nerve-specific phantom limb pain was highly correlated with the presence of symptomatic neuromas.
PLASTIC AND RECONSTRUCTIVE SURGERY
(2022)
Review
Clinical Neurology
Hunter R. Schone, Chris Baker, Joel Katz, Lone Nikolajsen, Katleho Limakatso, Herta Flor, Tamar R. Makin
Summary: Phantom limb pain (PLP) is a common experience for individuals who have undergone limb amputation, but its characteristics vary greatly. The lack of reliable data has made it challenging to understand the mechanisms of PLP and find effective treatments. However, recent research provides an opportunity to re-examine our assumptions about PLP and its treatments. This review aims to generate consensus on the best ways to study and treat PLP, addressing conceptual and methodological challenges and offering potential solutions. The hope is that a critical evaluation of foundational knowledge will lead to more informed decisions in testing interventions and guide the development of new PLP treatments.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2022)
Article
Multidisciplinary Sciences
Gaia Risso, Greta Preatoni, Giacomo Valle, Michele Marazzi, Noelle Moana Bracher, Stanisa Raspopovic
Summary: The multisensory integration of signals plays a crucial role in developing a clear percept of the environment and body. Lower-limb amputees often face challenges in integrating multisensory signals, leading to pain and distorted phantom limb perception. However, a multisensory framework combining virtual reality and electro-cutaneous stimulation can effectively improve sensory perception and reduce phantom limb distortions.
Article
Neurosciences
Qin Guo, Zhong Di, Hong-Fang Tian, Quan-Ai Zhang
Summary: In this case study, contralateral acupuncture showed positive effect in reducing phantom limb pain and sensation, with complete relief after the third session and no side effects or relapse during the next 9 months. However, more robust evidence is needed to support the efficacy of this treatment technique for such indication.
FRONTIERS IN NEUROSCIENCE
(2021)
Review
Medicine, Research & Experimental
Damien P. Kuffler
Summary: At least two million people in the United States of America live with lost limbs, and the number is expected to double by 2050. Within days to weeks of the amputation, up to 90% of these individuals develop neuropathic pain, presenting as phantom limb pain (PLP). The primary treatment for PLP is the administration of pharmacological agents, although alternative techniques are also discussed.
EXPERIMENTAL BIOLOGY AND MEDICINE
(2023)
Review
Behavioral Sciences
Jonathan D. Browne, Ryan Fraiser, Yi Cai, Dillon Leung, Albert Leung, Michael Vaninetti
Summary: This article introduces the application of neuroimaging techniques in the study of Phantom Limb Pain (PLP). Diffusion tensor imaging, functional magnetic resonance imaging, electroencephalography, and magnetoencephalography are all key tools for PLP research, each with its own unique mechanisms and applications. Their combined use can reveal the true nature of PLP and help develop innovative treatment methods.
BRAIN AND BEHAVIOR
(2022)
Review
Clinical Neurology
Hongfang Tian, Hantong Hu, Xingling Li, Jing Liu, Qin Guo, Yang Li, Dexiong Han
Summary: Phantom limb pain (PLP) and jumping residual limb are common issues among amputees and pose challenges for management. There is limited literature on effective treatments for both complications, but auricular therapy (AT) shows promising results in this case.
Review
Clinical Neurology
Johannes Neumueller, Kordula Lang-Illievich, Connor T. A. Brenna, Christoph Klivinyi, Helmar Bornemann-Cimenti
Summary: calcitonin has emerged as a novel analgesic for phantom limb pain (PLP) with documented benefits. There is limited evidence on its use in chronic PLP, but further research is warranted.
Article
Rehabilitation
Cody L. McDonald, Alison Kahn, Brian J. Hafner, Sara J. Morgan
Summary: This study estimated the prevalence of secondary prosthesis use among lower limb prosthesis users and found that most users did not use secondary prostheses. The most common types of secondary prostheses were back-up and activity-specific prostheses. Additionally, secondary prosthesis users differed from non-users in terms of gender, race, and other characteristics.
DISABILITY AND REHABILITATION
(2023)
Review
Anesthesiology
Anna Stankevicius, Sarah B. Wallwork, Simon J. Summers, Brenton Hordacre, Tasha R. Stanton
Summary: This systematic rapid review found that the majority of individuals will experience some form of phantom phenomena at some point post-amputation, with the highest lifetime prevalence. Consideration of individual patient characteristics is crucial for understanding the incidence and prevalence of phantom phenomena.
EUROPEAN JOURNAL OF PAIN
(2021)
Article
Rehabilitation
Ellie Balakhanlou, Joseph Webster, Matthew Borgia, Linda Resnik
Summary: The study highlights that PLP is prevalent and persistent in veterans with major upper limb amputation, with factors such as amputation level, etiology, and residual limb pain intensity contributing to the severity of PLP.
Review
Rehabilitation
Kalter Hali, Marc A. Manzo, Robert Koucheki, Jay S. Wunder, Richard J. Jenkinson, Amanda L. Mayo, Peter C. Ferguson, Johnathan R. Lex
Summary: The research summarizes the effectiveness of virtual reality (VR) therapy for the management of phantom limb pain (PLP). The findings suggest that VR therapy can significantly reduce PLP, and combining it with tactile stimulation leads to better outcomes. However, the low quality of studies, heterogeneity in subject population and intervention type, and lack of long-term relief data make it difficult to draw definitive conclusions.
DISABILITY AND REHABILITATION
(2023)
Article
Neurosciences
Lingyan Wang, Steffie N. Tomson, Grace Lu, Jeffrey M. Yau
Summary: This study found that cortical activity in individuals with lower limb loss changes during movements of their sound and phantom limbs. Unlike upper limb amputees, less is known about SMC activity in lower limb amputees. The brain responses during phantom ankle movements did not correlate with self-report assessments of pain experiences, nonpainful sensations, and phantom movement capabilities.
EUROPEAN JOURNAL OF NEUROSCIENCE
(2021)
Review
Clinical Neurology
Hunter R. Schone, Chris Baker, Joel Katz, Lone Nikolajsen, Katleho Limakatso, Herta Flor, Tamar R. Makin
Summary: Phantom limb pain (PLP) is a common experience for individuals who have undergone limb amputation, but its characteristics vary greatly. The lack of reliable data has made it challenging to understand the mechanisms of PLP and find effective treatments. However, recent research provides an opportunity to re-examine our assumptions about PLP and its treatments. This review aims to generate consensus on the best ways to study and treat PLP, addressing conceptual and methodological challenges and offering potential solutions. The hope is that a critical evaluation of foundational knowledge will lead to more informed decisions in testing interventions and guide the development of new PLP treatments.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2022)
Article
Clinical Neurology
Martin Diers, Bertram Krumm, Xaver Fuchs, Robin Bekrater-Bodmann, Christopher Milde, Joerg Trojan, Jens Foell, Susanne Becker, Gerhard Ruemenapf, Herta Flor
Summary: This study examined the prevalence of phantom limb pain in amputees and identified different factors associated with phantom limb pain and residual limb pain. Clinical/demographic variables and perceptual variables were found to be major contributors to phantom limb pain.
Article
Anesthesiology
Laila K. Franke, Stephan F. Miedl, Sarah K. Danboeck, Markus Grill, Michael Liedlgruber, Martin Kronbichler, Herta Flor, Frank H. Wilhelm
Summary: Psychological trauma is often accompanied by physical pain, with PTSD frequently co-occurring with chronic pain. Classical conditioning may explain the mechanism behind pain intrusions, where pain experiences can occur even without nociceptive input.
Article
Anesthesiology
Joachim Erlenwein, Martin Diers, Jennifer Ernst, Friederike Schulz, Frank Petzke
Summary: Phantom limb pain is common in amputees and is caused by the lack of sensory feedback and neuroplastic changes in the brain. Factors such as severe pain experience, sensitization mechanisms, and changes in body perception contribute to the development of chronic phantom limb pain. Psychosocial factors also play a role. Modern amputation medicine requires interdisciplinary collaboration.
Article
Clinical Neurology
Martin Diers, Xaver Fuchs, Robin Bekrater-Bodmann, Herta Flor
Summary: Phantom limb pain is rare in congenital amputees and those who had an early limb amputation, possibly due to reduced nociceptive input and adaptability of the somatosensory system.
Article
Clinical Neurology
Anna M. Zamorano, Boris Kleber, Federico Arguissain, Shellie Boudreau, Peter Vuust, Herta Flor, Thomas Graven -Nielsen
Summary: Repetitive movements are a major risk factor for musculoskeletal pain and can lead to brain plasticity changes. This study aimed to investigate the brain processing of prolonged muscle pain in musicians. The results showed that musicians had lower pain intensity compared to non-musicians, and higher training volume was associated with lower pain scores.
Article
Anesthesiology
Ana Maria Gonzalez-Roldan, Smadar Bustan, Sandra Kamping, Herta Flor, Fernand Anton
Summary: This study investigated whether experimentally induced pain-related suffering leads individuals to focus more on themselves and less on the external world. The results showed that experiencing prolonged and intense painful stimuli leads to attentional shifts towards oneself and reduced focus on others. These findings contribute to a better understanding of the social dynamics of pain and suffering.
Article
Neurosciences
Nathalie E. Holz, Mariam Zabihi, Seyed Mostafa Kia, Maximillian Monninger, Pascal-M. Aggensteiner, Sebastian Siehl, Dorothea L. Floris, Arun L. W. Bokde, Sylvane Desrivieres, Herta Flor, Antoine Grigis, Hugh H. Garavan, Penny N. Gowland, Andreas Heinz, Ruediger Bruehl, Jean-Luc Martinot, Marie-Laure Paillere Martinot, Dimitri Papadopoulos Orfanos, Tomas Paus, Luise K. Poustka, Juliane H. Froehner, Michael N. Smolka, Nilakshi Vaidya, Henrik Walter, Robert Whelan, Gunter H. Schumann, Andreas N. Meyer-Lindenberg, Daniel Brandeis, Jan K. Buitelaar, Frauke F. Nees, Christian Beckmann, IMAGEN Consortium, Tobias Banaschewski, Andre F. Marquand
Summary: In a longitudinal study, Holz et al. found that adversity leads to widespread structural brain changes. These changes were replicated in different cohorts and predicted anxiety in individuals. The study highlights the importance of considering individual-level factors in understanding the impact of adversity on brain structure and mental health.
NATURE NEUROSCIENCE
(2023)
Article
Anesthesiology
Herta Flor, Koichi Noguchi, Rolf-Detlef Treede, Dennis C. Turk
Summary: The decades since the inauguration of the International Association for the Study of Pain have witnessed significant progress in pain research, including advancements in scientific concepts, new technologies, and approaches, which have positively influenced pain management and education.
Article
Psychiatry
Livia Cosentino, Stephanie H. Witt, Helene Dukal, Francesca Zidda, Sebastian Siehl, Herta Flor, Bianca De Filippis
Summary: Traumatic events can lead to post-traumatic stress disorder (PTSD), which is more prevalent in women. Adverse childhood experiences (ACE) increase the risk of PTSD in adulthood. Epigenetic mechanisms, specifically a mutation in the methyl-CpG binding protein 2 (MECP2) in mice, contribute to susceptibility to PTSD-like alterations, with sex-dependent biological signatures. This study investigated whether the elevated risk of PTSD associated with ACE exposure is accompanied by decreased levels of MECP2 in the blood of humans, and if sex plays a role. Results revealed that among trauma-exposed women, downregulation of MECP2 was associated with increased PTSD symptoms linked to ACE exposure. The findings suggest that MECP2 expression may play a role in the pathophysiology of post-traumatic stress, warranting further research on its potential sex-dependent role in the onset and progression of PTSD.
TRANSLATIONAL PSYCHIATRY
(2023)
Article
Psychology, Mathematical
Stella Guldner, Nadine Lavan, Clare Lally, Lisa Wittmann, Frauke Nees, Herta Flor, Carolyn McGettigan
Summary: The voice is a variable and dynamic social tool with functional relevance for self-presentation. Intentional voice modulations can effectively evoke trait impressions in listeners, which can be recognized and influence social interactions.
PSYCHONOMIC BULLETIN & REVIEW
(2023)
Review
Biology
Deepti Mittal, Rebecca Mease, Thomas Kuner, Herta Flor, Rohini Kuner, Jamila Andoh
Summary: The importance of effective research data management (RDM) strategies grows with advancements in data acquisition techniques and research methods, especially in neuroscience. However, large-scale neuroscience research consortia face challenges in implementing a coherent RDM plan due to the diverse research strategies and requirements they encompass. This article presents a concrete RDM strategy implemented for the Heidelberg Collaborative Research Consortium, focusing on sustainable solutions that incentivize incremental RDM while respecting research-specific requirements.
Article
Rheumatology
Benjamin Mosch, Verena Hagena, Stephan Herpertz, Martin Diers
Summary: This study identified different types of brain morphometric changes in patients with fibromyalgia, including abnormalities in gray and white matter. These changes may affect areas related to sensory and affective pain processing. The study also found the influence of behavioral and clinical factors on structural changes.
ARTHRITIS RESEARCH & THERAPY
(2023)
Article
Neuroimaging
Benjamin Mosch, Verena Hagena, Stephan Herpertz, Michaela Ruttorf, Martin Diers
Summary: The perceived lack of control over pain experience is a major contributor to agony and impaired quality of life in chronic pain patients, such as fibromyalgia (FM). This study used functional magnetic resonance imaging (fMRI) to investigate how perceived control affects pain perception and the underlying neural mechanisms. The results showed that FM patients failed to activate brain areas involved in pain modulation and reappraisal processes, and exhibited disrupted functional connectivity and decreased gray matter volumes compared to healthy controls. These findings provide evidence for extensive impairments in pain modulation in FM.
NEUROIMAGE-CLINICAL
(2023)