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Phantom limb pain in the human brain: Unraveling neural circuitries of phantom limb sensations using positron emission tomography
Author(s) -
Willoch Frode,
Rosen Gunnar,
Tölle Thomas Rudolf,
Øye Ivar,
Wester Hans Jürgen,
Berner Niels,
Schwaiger Markus,
Bartenstein Peter
Publication year - 2000
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/1531-8249(200012)48:6<842::aid-ana4>3.0.co;2-t
Subject(s) - sensation , phantom limb , positron emission tomography , psychology , thalamus , anterior cingulate cortex , neuroscience , cingulate cortex , phantom pain , physical medicine and rehabilitation , medicine , imaging phantom , central nervous system , cognition , nuclear medicine , amputation , psychiatry
Pain and other phantom limb (PL) sensations have been proposed to be generated in the brain and to be reflected in activation of specific neural circuits. To test this hypothesis, hypnosis was used as a cognitive tool to alternate between the sensation of PL movement and pain in 8 amputees. Brain activity was measured using positron emission tomography. PL movement and pain were represented by a propagation of neuronal activity within the corresponding sensorimotor and pain‐processing networks. The sensation of movement was significantly (corrected for multiple comparisons) related to activity in the supplementary motor area and the primary sensorimotor cortex. The sensation of a painful PL posture activated the same brain areas but was weaker and less extended in the supplementary motor area. In contrast to the sensation of movement, pain was significantly related to activity in the thalamus, anterior cingulate, and lateral prefrontal cortex. Subjectively rated PL pain sensation correlated positively to activations in the anterior and posterior cingulate. These findings provide evidence that PL sensations are produced by the same central nervous processes that underlie the experience of the body when it is intact and that the corporeal awareness of PL pain is encoded in a thalamocortical network. Ann Neurol 2000;48:842–849