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Salgues S, Plancher G, Michael GA. Is it really on your hand? Spontaneous sensations are not peripheral sensations - Evidence from able-bodied individuals and a phantom limb syndrome patient. Brain Cogn 2024; 175:106138. [PMID: 38335922 DOI: 10.1016/j.bandc.2024.106138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 01/26/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
Among other bodily signals, the perception of sensations arising spontaneously on the skin with no external triggers contributes to body awareness. The topic of spontaneous sensations (SPS) being quite recent in the literature, there is still a debate whether this phenomenon is elicited by peripheral cutaneous units' activity underlying tactile perception or originates directly from central mechanisms. In a first experiment, we figured that, if SPS depended on peripheral afferents, their perception on the glabrous hand should relate to the hand tactile sensitivity. On the contrary, we found no relationship at all, which led us to envisage the scenario of SPS in the absence of cutaneous units. In a second experiment, we present the case of Julie, a right-hand amputee that could perceive and report SPS arising on her phantom limb syndrome. We found that SPS distribution on the phantom limb followed the same gradient as that observed in control participants, unlike SPS perceived on the intact left hand. Those findings are crucial to the understanding of neural factors determining body awareness through SPS perception and provide insights into the existence of a precise neural gradient underlying somesthesis.
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Affiliation(s)
- Sara Salgues
- Département de Sciences Cognitives, Psychologie Cognitive & Neuropsychologie, Institut de Psychologie, Unité de Recherche Étude des Mécanismes Cognitifs (EA 3082), Université Lumière Lyon 2, Lyon, France; Laboratoire Mémoire Cerveau et Cognition, Université Paris Cité, Paris, France.
| | - Gaën Plancher
- Département de Sciences Cognitives, Psychologie Cognitive & Neuropsychologie, Institut de Psychologie, Unité de Recherche Étude des Mécanismes Cognitifs (EA 3082), Université Lumière Lyon 2, Lyon, France; Institut Universitaire de France (IUF), France
| | - George A Michael
- Département de Sciences Cognitives, Psychologie Cognitive & Neuropsychologie, Institut de Psychologie, Unité de Recherche Étude des Mécanismes Cognitifs (EA 3082), Université Lumière Lyon 2, Lyon, France
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2
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Bao B, Sun Y, Lin J, Gao T, Shen J, Hu W, Zhu H, Zhu T, Li J, Wang Z, Wei H, Zheng X. Altered cortical thickness and structural covariance networks in upper limb amputees: A graph theoretical analysis. CNS Neurosci Ther 2023; 29:2901-2911. [PMID: 37122148 PMCID: PMC10493660 DOI: 10.1111/cns.14226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND The extensive functional and structural remodeling that occurs in the brain after amputation often results in phantom limb pain (PLP). These closely related phenomena are still not fully understood. METHODS Using magnetic resonance imaging (MRI) and graph theoretical analysis (GTA), we explored how alterations in brain cortical thickness (CTh) and structural covariance networks (SCNs) in upper limb amputees (ULAs) relate to PLP. In all, 45 ULAs and 45 healthy controls (HCs) underwent structural MRI. Regional network properties, including nodal degree, betweenness centrality (BC), and node efficiency, were analyzed with GTA. Similarly, global network properties, including global efficiency (Eglob), local efficiency (Eloc), clustering coefficient (Cp), characteristic path length (Lp), and the small-worldness index, were evaluated. RESULTS Compared with HCs, ULAs had reduced CThs in the postcentral and precentral gyri contralateral to the amputated limb; this decrease in CTh was negatively correlated with PLP intensity in ULAs. ULAs showed varying degrees of change in node efficiency in regional network properties compared to HCs (p < 0.005). There were no group differences in Eglob, Eloc, Cp, and Lp properties (all p > 0.05). The real-worldness SCN of ULAs showed a small-world topology ranging from 2% to 34%, and the area under the curve of the small-worldness index in ULAs was significantly different compared to HCs (p < 0.001). CONCLUSION These results suggest that the topological organization of human CNS functional networks is altered after amputation of the upper limb, providing further support for the cortical remapping theory of PLP.
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Affiliation(s)
- Bingbo Bao
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Yi Sun
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Junqing Lin
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Tao Gao
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Junjie Shen
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Wencheng Hu
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Hongyi Zhu
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Tianhao Zhu
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Jing Li
- Institute of Diagnostic and Interventional RadiologyShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Zhibin Wang
- Institute of Diagnostic and Interventional RadiologyShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Haifeng Wei
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
| | - Xianyou Zheng
- Department of Orthopedic SurgeryShanghai Jiao Tong University Affiliated Sixth People's HospitalShanghaiChina
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Risso G, Bassolino M. Assess and rehabilitate body representations via (neuro)robotics: An emergent perspective. Front Neurorobot 2022; 16:964720. [PMID: 36160286 PMCID: PMC9498221 DOI: 10.3389/fnbot.2022.964720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
The perceptions of our own body (e.g., size and shape) do not always coincide with its real characteristics (e.g., dimension). To track the complexity of our perception, the concept of mental representations (model) of the body has been conceived. Body representations (BRs) are stored in the brain and are maintained and updated through multiple sensory information. Despite being altered in different clinical conditions and being tightly linked with self-consciousness, which is one of the most astonishing features of the human mind, the BRs and, especially, the underlying mechanisms and functions are still unclear. In this vein, here we suggest that (neuro)robotics can make an important contribution to the study of BRs. The first section of the study highlights the potential impact of robotics devices in investigating BRs. Far to be exhaustive, we illustrate major examples of its possible exploitation to further improve the assessment of motor, haptic, and multisensory information building up the BRs. In the second section, we review the main evidence showing the contribution of neurorobotics-based (multi)sensory stimulation in reducing BRs distortions in various clinical conditions (e.g., stroke, amputees). The present study illustrates an emergent multidisciplinary perspective combining the neuroscience of BRs and (neuro)robotics to understand and modulate the perception and experience of one's own body. We suggest that (neuro)robotics can enhance the study of BRs by improving experimental rigor and introducing new experimental conditions. Furthermore, it might pave the way for the rehabilitation of altered body perceptions.
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Affiliation(s)
- Gaia Risso
- School of Health Sciences, Haute École spécialisée de Suisse occidentale (HES-SO) Valais-Wallis, Sion, Switzerland
- The Sense Innovation and Research Center, Sion, Switzerland
- Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia, Genoa, Italy
| | - Michela Bassolino
- School of Health Sciences, Haute École spécialisée de Suisse occidentale (HES-SO) Valais-Wallis, Sion, Switzerland
- The Sense Innovation and Research Center, Sion, Switzerland
- Laboratoire MySpace, Université de Lausanne, Lausanne, Switzerland
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4
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Bressler M, Merk J, Heinzel J, Butz MV, Daigeler A, Kolbenschlag J, Prahm C. Visualizing the Unseen: Illustrating and Documenting Phantom Limb Sensations and Phantom Limb Pain With C.A.L.A. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:806114. [PMID: 36189032 PMCID: PMC9397903 DOI: 10.3389/fresc.2022.806114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022]
Abstract
Currently, there is neither a standardized mode for the documentation of phantom sensations and phantom limb pain, nor for their visualization as perceived by patients. We have therefore created a tool that allows for both, as well as for the quantification of the patient's visible and invisible body image. A first version provides the principal functions: (1) Adapting a 3D avatar for self-identification of the patient; (2) modeling the shape of the phantom limb; (3) adjusting the position of the phantom limb; (4) drawing pain and cramps directly onto the avatar; and (5) quantifying their respective intensities. Our tool (C.A.L.A.) was evaluated with 33 occupational therapists, physiotherapists, and other medical staff. Participants were presented with two cases in which the appearance and the position of the phantom had to be modeled and pain and cramps had to be drawn. The usability of the software was evaluated using the System Usability Scale and its functional range was evaluated using a self-developed questionnaire and semi-structured interview. In addition, our tool was evaluated on 22 patients with limb amputations. For each patient, body image as well as phantom sensation and pain were modeled to evaluate the software's functional scope. The accuracy of the created body image was evaluated using a self-developed questionnaire and semi-structured interview. Additionally, pain sensation was assessed using the SF-McGill Pain Questionnaire. The System Usability Scale reached a level of 81%, indicating high usability. Observing the participants, though, identified several operational difficulties. While the provided functions were considered useful by most participants, the semi-structured interviews revealed the need for an improved pain documentation component. In conclusion, our tool allows for an accurate visualization of phantom limbs and phantom limb sensations. It can be used as both a descriptive and quantitative documentation tool for analyzing and monitoring phantom limbs. Thus, it can help to bridge the gap between the therapist's conception and the patient's perception. Based on the collected requirements, an improved version with extended functionality will be developed.
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Affiliation(s)
- Michael Bressler
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Clinic, University of Tuebingen, Tuebingen, Germany
| | - Joachim Merk
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Clinic, University of Tuebingen, Tuebingen, Germany
| | - Johannes Heinzel
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Clinic, University of Tuebingen, Tuebingen, Germany
| | - Martin V. Butz
- Neuro-Cognitive Modeling Group, Department of Computer Science and Department of Psychology, Faculty of Science, Eberhard Karls University, Tuebingen, Germany
| | - Adrien Daigeler
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Clinic, University of Tuebingen, Tuebingen, Germany
| | - Jonas Kolbenschlag
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Clinic, University of Tuebingen, Tuebingen, Germany
| | - Cosima Prahm
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Clinic, University of Tuebingen, Tuebingen, Germany
- *Correspondence: Cosima Prahm
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5
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Bekrater-Bodmann R. Mind over matter: Perceived phantom/prosthesis co-location contributes to prosthesis embodiment in lower limb amputees. Conscious Cogn 2022; 98:103268. [PMID: 34999318 DOI: 10.1016/j.concog.2021.103268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/13/2021] [Accepted: 12/29/2021] [Indexed: 11/27/2022]
Abstract
Prosthesis embodiment - the cognitive integration of a prosthesis into an amputees' body representation - has been identified as important for prosthetic rehabilitation. However, the underlying cognitive mechanisms remain unclear. There is reason to assume that phantom limbs that are experienced as part of the bodily self (phantom self-consciousness) can affect prosthesis embodiment, but only if the phantom and the prosthesis can be brought into perceived co-location (phantom prosthesis tolerance, PPT). In the present study, phantom-prosthesis interactions were examined in lower limb amputees, and a PPT component was psychometrically extracted. Mediation analysis revealed an indirect-only effect, where the relationship between phantom self-consciousness and prosthesis embodiment was mediated by PPT, indicating that phantom limbs can transfer their immanent vividness to the prosthesis. Subsequent analyses suggested that this effect can compensate for negative consequences on prosthesis embodiment that arise from phantom limb awareness. These results shape theoretical considerations about the cognitive processes contributing to the bodily self.
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Affiliation(s)
- Robin Bekrater-Bodmann
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
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6
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Schott GD. Drawing and Ignoring: The Perception of the Pictorial Line. Perception 2020; 49:893-896. [PMID: 32791941 DOI: 10.1177/0301006620944121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
For over 2000 years, the pictorial line has been recognized as being fundamental to drawing and several other art forms. Yet pictorial lines present intriguing issues, three of which are considered here: lines very rarely exist in the natural world; there is no known part of the brain which "processes" lines; and, paradoxically, we often pay very little attention to the lines themselves, and they have even been viewed as "an imaginary idea".
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Affiliation(s)
- G D Schott
- The National Hospital for Neurology and Neurosurgery, UK
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7
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Thøgersen M, Andoh J, Milde C, Graven-Nielsen T, Flor H, Petrini L. Individualized Augmented Reality Training Reduces Phantom Pain and Cortical Reorganization in Amputees: A Proof of Concept Study. THE JOURNAL OF PAIN 2020; 21:1257-1269. [PMID: 32574786 DOI: 10.1016/j.jpain.2020.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/30/2020] [Accepted: 06/13/2020] [Indexed: 02/08/2023]
Abstract
Phantom limb pain (PLP) may be relieved using a visual representation of an intact limb. However, patients with distorted (telescoped) phantoms seem unable to associate with visualizations of intact limbs. A virtual arm visualization was matched to the individual's phantom perception and controlled in an augmented reality (AR) intervention. Seven PLP participants with telescoped phantoms performed 8 supervised home-based AR-training sessions (45 minutes each) within 2 weeks. The virtual arm was superimposed in AR onto their residual limb and controlled using electromyography from the residual limb. AR-training sessions included 3 AR tasks aimed at reengaging the neural circuits related to the lost limb. Agency (Rubber hand illusion questionnaire) and telescoping (proprioceptive drift and felt telescoping) were monitored after individual training sessions. fMRI during lip pursing was assessed before and after intervention. Pain rating index scores were reduced by 52% (mean change = -1.884, P = .032, d = 1.135). Numerical rating scale scores of PLP severity (0-6) in patients benefitting from the intervention were reduced by 41% (mean change = .93 P = .022, d = 1.334). The lip pursing task illustrated decreased cortical activity in the primary somatosensory cortex, which correlated to the reduced numerical rating scale scores of PLP severity. PERSPECTIVE: Two weeks of novel AR interventions in patients with telescoped phantoms demonstrated reduced PLP and reversal of cortical reorganization. This research highlights the potential of individualized AR interventions for PLP and indicate the importance of agency in this type of treatments.
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Affiliation(s)
- Mikkel Thøgersen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jamila Andoh
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christopher Milde
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Herta Flor
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark; Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Laura Petrini
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
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8
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The Homuncular Jigsaw: Investigations of Phantom Limb and Body Awareness Following Brachial Plexus Block or Avulsion. J Clin Med 2019; 8:jcm8020182. [PMID: 30717476 PMCID: PMC6406464 DOI: 10.3390/jcm8020182] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 01/29/2019] [Accepted: 02/01/2019] [Indexed: 02/07/2023] Open
Abstract
Many neuropsychological theories agree that the brain maintains a relatively persistent representation of one’s own body, as indicated by vivid “phantom” experiences. It remains unclear how the loss of sensory and motor information contributes to the presence of this representation. Here, we focus on new empirical and theoretical evidence of phantom sensations following damage to or an anesthetic block of the brachial plexus. We suggest a crucial role of this structure in understanding the interaction between peripheral and central mechanisms in health and in pathology. Studies of brachial plexus function have shed new light on how neuroplasticity enables “somatotopic interferences”, including pain and body awareness. Understanding the relations among clinical disorders, their neural substrate, and behavioral outcomes may enhance methods of sensory rehabilitation for phantom limbs.
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9
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Niedernhuber M, Barone DG, Lenggenhager B. Prostheses as extensions of the body: Progress and challenges. Neurosci Biobehav Rev 2018; 92:1-6. [PMID: 29772308 DOI: 10.1016/j.neubiorev.2018.04.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 04/19/2018] [Accepted: 04/27/2018] [Indexed: 10/16/2022]
Abstract
Recent years have seen a surge of interest in the incorporation of artificial limbs. This research promises to provide individuals with sensorimotor disorders such as amputations with prostheses which feel like their own body part. While neuroscience made a leap towards uncovering the basic neurocognitive mechanisms of bodily self-consciousness, the development of incorporated prosthetic limbs still faces substantial challenges in basic neuroscience and in clinical reality. Here we critically examine recent findings on prosthesis incorporation to aid patient rehabilitation in the context of advances in cognitive and applied neuroscience as well as technology. To this end, we integrate results from fundamental and clinical neuropsychological research to outline how several crucial milestones will have to be passed to achieve the self-attribution of prostheses to one's own body. We further discuss the implications of these results for clinical treatment and patients' quality of life.
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Affiliation(s)
- Maria Niedernhuber
- Department of Psychology, University of Cambridge, CB2 3EB, Cambridge, United Kingdom.
| | - Damiano G Barone
- John van Geest Centre for Brain Repair, University of Cambridge, CB2 0PY, Cambridge, United Kingdom
| | - Bigna Lenggenhager
- Department of Psychology, University of Zürich, 8050, Zürich, Switzerland
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10
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Adamczyk WM, Luedtke K, Saulicz O, Saulicz E. Sensory dissociation in chronic low back pain: Two case reports. Physiother Theory Pract 2018; 34:643-651. [DOI: 10.1080/09593985.2017.1423431] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Wacław M. Adamczyk
- The Jerzy Kukuczka Academy of Physical Education, Department of Kinesiotherapy and Special Methods in Physiotherapy, Katowice, Poland
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
| | - Kerstin Luedtke
- University Medical Centre Hamburg, Eppendorf, Department of Systems Neuroscience, Hamburg, Germany
| | | | - Edward Saulicz
- The Jerzy Kukuczka Academy of Physical Education, Department of Kinesiotherapy and Special Methods in Physiotherapy, Katowice, Poland
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11
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Phantom limb perception interferes with motor imagery after unilateral upper-limb amputation. Sci Rep 2016; 6:21100. [PMID: 26879749 PMCID: PMC4754632 DOI: 10.1038/srep21100] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 01/18/2016] [Indexed: 11/24/2022] Open
Abstract
A potential contributor to impaired motor imagery in amputees is an alteration of the body schema as a result of the presence of a phantom limb. However, the nature of the relationship between motor imagery and phantom experiences remains unknown. In this study, the influence of phantom limb perception on motor imagery was investigated using a hand mental rotation task by means of behavioral and electrophysiological measures. Compared with healthy controls, significantly prolonged response time for both the intact and missing hand were observed specifically in amputees who perceived a phantom limb during the task but not in amputees without phantom limb perception. Event-related desynchronization of EEG in the beta band (beta-ERD) in central and parietal areas showed an angular disparity specifically in amputees with phantom limb perception, with its source localized in the right inferior parietal lobule. The response time as well as the beta-ERD values were significantly positively correlated with phantom vividness. Our results suggest that phantom limb perception during the task is an important interferential factor for motor imagery after amputation and the interference might be related to a change of the body representation resulting from an unnatural posture of the phantom limb.
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12
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De Graaf JB, Jarrassé N, Nicol C, Touillet A, Coyle T, Maynard L, Martinet N, Paysant J. Phantom hand and wrist movements in upper limb amputees are slow but naturally controlled movements. Neuroscience 2015; 312:48-57. [PMID: 26556065 DOI: 10.1016/j.neuroscience.2015.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/02/2015] [Accepted: 11/03/2015] [Indexed: 10/22/2022]
Abstract
After limb amputation, patients often wake up with a vivid perception of the presence of the missing limb, called "phantom limb". Phantom limbs have mostly been studied with respect to pain sensation. But patients can experience many other phantom sensations, including voluntary movements. The goal of the present study was to quantify phantom movement kinematics and relate these to intact limb kinematics and to the time elapsed since amputation. Six upper arm and two forearm amputees with various delays since amputation (6months to 32years) performed phantom finger, hand and wrist movements at self-chosen comfortable velocities. The kinematics of the phantom movements was indirectly obtained via the intact limb that synchronously mimicked the phantom limb movements, using a Cyberglove® for measuring finger movements and an inertial measurement unit for wrist movements. Results show that the execution of phantom movements is perceived as "natural" but effortful. The types of phantom movements that can be performed are variable between the patients but they could all perform thumb flexion/extension and global hand opening/closure. Finger extension movements appeared to be 24% faster than finger flexion movements. Neither the number of types of phantom movements that can be executed nor the kinematic characteristics were related to the elapsed time since amputation, highlighting the persistence of post-amputation neural adaptation. We hypothesize that the perceived slowness of phantom movements is related to altered proprioceptive feedback that cannot be recalibrated by lack of visual feedback during phantom movement execution.
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Affiliation(s)
- J B De Graaf
- Institute of Movement Sciences (ISM), UMR 7287 - CNRS & Aix-Marseille University, Marseille, France.
| | - N Jarrassé
- Institute of Intelligent Systems and Robotics (ISIR), UMR 7222, CNRS/INSERM, U1150 Agathe-ISIR, Sorbonne University, UPMC Univ Paris 06, Paris, France
| | - C Nicol
- Institute of Movement Sciences (ISM), UMR 7287 - CNRS & Aix-Marseille University, Marseille, France
| | - A Touillet
- Louis Pierquin Centre of the Regional Institute of Rehabilitation, Nancy, France
| | - T Coyle
- Institute of Movement Sciences (ISM), UMR 7287 - CNRS & Aix-Marseille University, Marseille, France
| | - L Maynard
- Centre for Functional Readaptation of Valmante, Marseille, France
| | - N Martinet
- Louis Pierquin Centre of the Regional Institute of Rehabilitation, Nancy, France
| | - J Paysant
- Louis Pierquin Centre of the Regional Institute of Rehabilitation, Nancy, France
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13
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Rektor I, Schachter SC, Arya R, Arzy S, Braakman H, Brodie MJ, Brugger P, Chang BS, Guekht A, Hermann B, Hesdorffer DC, Jones-Gotman M, Kanner AM, Garcia-Larrea L, Mareš P, Mula M, Neufeld M, Risse GL, Ryvlin P, Seeck M, Tomson T, Korczyn AD. Third International Congress on Epilepsy, Brain, and Mind: Part 2. Epilepsy Behav 2015; 50:138-59. [PMID: 26264466 DOI: 10.1016/j.yebeh.2015.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/07/2015] [Indexed: 01/01/2023]
Abstract
Epilepsy is both a disease of the brain and the mind. Here, we present the second of two papers with extended summaries of selected presentations of the Third International Congress on Epilepsy, Brain and Mind (April 3-5, 2014; Brno, Czech Republic). Humanistic, biologic, and therapeutic aspects of epilepsy, particularly those related to the mind, were discussed. The extended summaries provide current overviews of epilepsy, cognitive impairment, and treatment, including brain functional connectivity and functional organization; juvenile myoclonic epilepsy; cognitive problems in newly diagnosed epilepsy; SUDEP including studies on prevention and involvement of the serotoninergic system; aggression and antiepileptic drugs; body, mind, and brain, including pain, orientation, the "self-location", Gourmand syndrome, and obesity; euphoria, obsessions, and compulsions; and circumstantiality and psychiatric comorbidities.
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Affiliation(s)
- Ivan Rektor
- Masaryk University, Brno Epilepsy Center, St. Anne's Hospital and School of Medicine and Central European Institute of Technology (CEITEC), Brno, Czech Republic
| | - Steven C Schachter
- Consortia for Improving Medicine with Innovation and Technology, Harvard Medical School, Boston, MA, USA.
| | - Ravindra Arya
- Comprehensive Epilepsy Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Shahar Arzy
- Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Hilde Braakman
- Academic Center for Epileptology, Kempenhaeghe & Maastricht UMC, Sterkselseweg 65, 5591 VE Heeze, The Netherlands
| | | | - Peter Brugger
- Neuropsychology Unit, Department of Neurology, University Hospital Zürich, Zurich, Switzerland
| | - Bernard S Chang
- Departments of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Alla Guekht
- Russian National Research Medical University, Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Bruce Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Dale C Hesdorffer
- Gertrude H. Sergievsky Center and Department of Epidemiology, Columbia University, NY, USA
| | - Marilyn Jones-Gotman
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Andres M Kanner
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Luis Garcia-Larrea
- NeuroPain Lab, Centre for Neuroscience of Lyon, Inserm U1028, Hôpital Neurologique, 59Bd Pinel 69003 Lyon, France
| | - Pavel Mareš
- Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Marco Mula
- Epilepsy Group, Atkinson Morley Regional Neuroscience Centre, St George's Hospital & Institute of Medical and Biomedical Sciences, St George's University of London, London, UK
| | - Miri Neufeld
- EEG and Epilepsy Unit, Department of Neurology, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Philippe Ryvlin
- Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland; TIGER, Lyon's Neuroscience Research Center, INSERM U1028, CNRS5292 Lyon, France
| | - Margitta Seeck
- Neurology Service, Hòpitaux Universitaires de Genève, Genève, Switzerland
| | - Torbjörn Tomson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Amos D Korczyn
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
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Osumi M, Sumitani M, Wake N, Sano Y, Ichinose A, Kumagaya SI, Kuniyoshi Y, Morioka S. Structured movement representations of a phantom limb associated with phantom limb pain. Neurosci Lett 2015; 605:7-11. [DOI: 10.1016/j.neulet.2015.08.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/25/2015] [Accepted: 08/05/2015] [Indexed: 02/06/2023]
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15
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Abstract
PURPOSE OF REVIEW The experience of ourselves as an embodied agent with a first-person perspective is referred to as 'bodily self'. We present a selective overview of relevant clinical and experimental studies. RECENT FINDINGS Sharing multisensory body space with others can be observed in patients with structurally altered bodies (amputations, congenital absence of limbs), with altered functionality after hemiplegia, such as denial of limb ownership (somatoparaphrenia) and with alterations in bodily self-consciousness on the level of the entire body (e.g. in autoscopic phenomena). In healthy participants, the mechanisms underpinning body ownership and observer perspective are empirically investigated by multisensory stimulation paradigms to alter the bodily self. The resulting illusions have promoted the understanding of complex disturbances of the bodily self, such as out-of-body experiences. We discuss the role of interoception in differentiating between self and others and review current advances in the study of body integrity identity disorder, a condition shaped as much by neurological as by social-psychological factors. SUMMARY We advocate a social neuroscience approach to the bodily self that takes into account the interactions between body, mind and society and might help close the divide between neurology and psychiatry.
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16
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Bova J, Sergent A. Chiropractic management of a 24-year-old woman with idiopathic, intermittent right-sided hemiparesthesia. J Chiropr Med 2014; 13:282-6. [PMID: 25435843 DOI: 10.1016/j.jcm.2014.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 07/01/2014] [Accepted: 07/03/2014] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE The purpose of this case report is to describe the chiropractic management of a patient with idiopathic, intermittent right-sided hemiparesthesia. CLINICAL FEATURES A 24-year-old woman presented with a 2-year history of intermittent idiopathic right arm paresthesia. She also had a 3-month history of intermittent idiopathic right leg/face paresthesia. These symptoms were strongest at night and caused insomnia and worsened over time. She rated her discomfort at 5/10 on a numeric scale. INTERVENTION AND OUTCOME Care included vibration stimulation therapy, spinal manipulation and cold laser therapy. She had a noticeable reduction in her paresthesia both subjectively and objectively. She showed improvement in paresthesia on the right side of her body after the first visit. The following week, after 2 visits she returned and stated that she was symptom free with 0/10 discomfort on a numeric scale. CONCLUSION This patient's symptoms of idiopathic, intermittent right-sided hemi-paresthesia seemed to improve with a short course of chiropractic care using manipulation, vibration therapy and cold laser therapy.
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Affiliation(s)
| | - Adam Sergent
- Assistant Professor, Clinic Services, Palmer Chiropractic College of Florida, Port Orange, FL
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