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NMDA‐mediated mechanisms in cortical excitability changes after limb amputation
Author(s) -
Schwenkreis P.,
Maier C.,
Pleger B.,
Mansourian N.,
Dertwinkel R.,
Malin JP.,
Tegenthoff M.,
Zenz M.
Publication year - 2003
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1034/j.1600-0404.2003.00114.x
Subject(s) - memantine , transcranial magnetic stimulation , phantom limb , nmda receptor , amputation , phantom pain , medicine , facilitation , placebo , chronic pain , anesthesia , physical medicine and rehabilitation , psychology , neuroscience , stimulation , physical therapy , surgery , receptor , alternative medicine , pathology
Objectives –The aim of our study was to determine the role of N ‐methyl‐ d ‐aspartate (NMDA)‐mediated mechanisms in cortical excitability changes after limb amputation, and their possible relationship to phantom pain. Materials and methods – Sixteen upper limb amputees who were suffering from chronic phantom pain received the NMDA‐antagonist memantine or placebo for 3 weeks. Intracortical inhibition (ICI) and intracortical facilitation (ICF) were determined at baseline and on day 21 using transcranial magnetic stimulation. Simultaneously, phantom pain intensity was assessed. Results – Memantine reduced ICF and enhanced ICI to roughly the same extent as seen in healthy subjects in a previous study. These changes were not correlated to the reduction of phantom pain. Conclusion – We therefore conclude that NMDA‐mediated mechanisms influence changes of ICI and ICF occurring after limb amputation. However, our results suggest that these cortical excitability changes and phantom pain are independent of each other.