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Mateo S, Guillot A, Henkous S, Gelis A, Daligault S, Rode G, Collet C, Di Rienzo F. Implicit and explicit motor imagery ability after SCI: Moving the elbow makes the difference. Brain Res 2024; 1836:148911. [PMID: 38604558 DOI: 10.1016/j.brainres.2024.148911] [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: 12/16/2023] [Revised: 03/23/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024]
Abstract
Cervical spinal cord injury (SCI) causes dramatic sensorimotor deficits that restrict both activity and participation. Restoring activity and participation requires extensive upper limb rehabilitation focusing elbow and wrist movements, which can include motor imagery. Yet, it remains unclear whether MI ability is impaired or spared after SCI. We investigated implicit and explicit MI ability in individuals with C6 or C7 SCI (SCIC6 and SCIC7 groups), as well as in age- and gender-matched controls without SCI. Inspired by previous studies, implicit MI evaluations involved hand laterality judgments, hand orientation judgments (HOJT) and hand-object interaction judgments. Explicit MI evaluations involved mental chronometry assessments of physically possible or impossible movements due to the paralysis of upper limb muscles in both groups of participants with SCI. HOJT was the paradigm in which implicit MI ability profiles differed the most between groups, particularly in the SCIC6 group who had impaired elbow movements in the horizontal plane. MI ability profiles were similar between groups for explicit MI evaluations, but reflected task familiarity with higher durations in the case of unfamiliar movements in controls or attempt to perform movements which were no longer possible in persons with SCI. Present results, obtained from a homogeneous population of individuals with SCI, suggest that people with long-term SCI rely on embodied cognitive motor strategies, similar to controls. Differences found in behavioral response pattern during implicit MI mirrored the actual motor deficit, particularly during tasks that involved internal representations of affected body parts.
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Affiliation(s)
- Sébastien Mateo
- Universite Lyon, UCBL-Lyon 1, INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Trajectoires Team, Centre Hospitalier Le Vinatier, Bâtiment 452, 95 Boulevard Pinel, F-69675 Bron, Auvergne-Rhône-Alpes, France; Lyon Neuroscience Research Center, Trajectoires Team, Centre Hospitalier Le Vinatier, Bâtiment 452, 95 Boulevard Pinel, F-69675 Bron, Auvergne-Rhône-Alpes, France
| | - Aymeric Guillot
- Universite Lyon, UCBL-Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, 27-29 Boulevard du 11 Novembre 1918, F-69622 Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Sonia Henkous
- Hospices Civils de Lyon, Hôpital Henry Gabrielle, Plate-forme Mouvement et Handicap, 20 route de Vourles, F-69230, Saint Genis Laval, Auvergne-Rhône-Alpes, France; Universite Lyon, UCBL-Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, 27-29 Boulevard du 11 Novembre 1918, F-69622 Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Anthony Gelis
- Centre Mutualiste Neurologique Propara, 263 rue du Caducée, F-34090, Montpellier, Occitanie, France
| | - Sébastien Daligault
- CERMEP, Imagerie du Vivant, 95 Boulevard Pinel, F-69677 Bron, Auvergne-Rhône-Alpes, France
| | - Gilles Rode
- Universite Lyon, UCBL-Lyon 1, INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Trajectoires Team, Centre Hospitalier Le Vinatier, Bâtiment 452, 95 Boulevard Pinel, F-69675 Bron, Auvergne-Rhône-Alpes, France; Lyon Neuroscience Research Center, Trajectoires Team, Centre Hospitalier Le Vinatier, Bâtiment 452, 95 Boulevard Pinel, F-69675 Bron, Auvergne-Rhône-Alpes, France
| | - Christian Collet
- Universite Lyon, UCBL-Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, 27-29 Boulevard du 11 Novembre 1918, F-69622 Villeurbanne, Auvergne-Rhône-Alpes, France
| | - Franck Di Rienzo
- Universite Lyon, UCBL-Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, UR 7424, 27-29 Boulevard du 11 Novembre 1918, F-69622 Villeurbanne, Auvergne-Rhône-Alpes, France.
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Wang D, Ding L, Wang X, Zhang K, Tong S, Jia J, Guo X. The Effect of Mirror Visual Feedback Therapy on the Hand Mental Rotation in Stroke Patients: An ERP study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083543 DOI: 10.1109/embc40787.2023.10340733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Mirror visual feedback (MVF) intervention is an adjunctive approach for motor recovery after stroke. It has been hypothesized that MVF can increase visual perception, motor imagery, and attention of/to the hands. However, neuroimaging evidence for this hypothesis is still lacking. In this study, we used a hand mental rotation task and event-related potential (ERP) analysis to explore the effect of MVF intervention on visual perception, motor preparation, and motor imagery of hands. We recruited 46 patients and randomly divided them into a mirror visual feedback group (MG) and a conventional intervention group (CG). By comparing ERP amplitude between the two groups and between before and after the intervention, we found that the N200 component, which was considered to be related to motor preparation, was significantly less negative in the affected hemisphere than that in the unaffected counterpart. After intervention, the N200 amplitude became more negative, reflecting a recovery of motor preparation. Specifically, MG showed a significant effect on the N200 for the hand pictures at large orientations, while the CG showed an effect mainly for the upright hand stimuli. The results suggested an improvement of preparation for motor imagery of complex and precise hand movements after MVF intervention.Clinical Relevance- This study might be helpful for understanding the neural mechanisms of MVF which can help stroke patients regain upper extremity function.
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Limakatso K. Managing acute phantom limb pain with transcutaneous electrical nerve stimulation: a case report. J Med Case Rep 2023; 17:209. [PMID: 37210525 DOI: 10.1186/s13256-023-03915-z] [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: 02/11/2021] [Accepted: 03/28/2023] [Indexed: 05/22/2023] Open
Abstract
INTRODUCTION Phantom limb pain is characterized by painful sensations in the amputated limb. The clinical presentation of acute phantom limb pain may differ from that of patients with chronic phantom limb pain. The variation observed implies that acute phantom limb pain may be driven by peripheral mechanisms, indicating that therapies focused on the peripheral nervous system might be successful in reducing pain. CASE PRESENTATION A 36-year-old African male with acute phantom limb pain in the left lower limb, was treated with transcutaneous electrical nerve stimulation. CONCLUSION The assessment results of the presented case and the evidence on acute phantom limb pain mechanisms contribute to the current body of literature, indicating that acute phantom limb pain presents differently to chronic phantom limb pain. These findings emphasize the importance of testing treatments that target the peripheral mechanisms responsible for phantom limb pain in relevant individuals with acquired amputations.
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Affiliation(s)
- Katleho Limakatso
- Department of Anaesthesia and Perioperative Medicine, Pain Management Unit, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
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Beisheim E, Pohlig R, Medina J, Hicks G, Sions J. Body representation among adults with phantom limb pain: Results from a foot identification task. Eur J Pain 2022; 26:255-269. [PMID: 34490685 PMCID: PMC8671232 DOI: 10.1002/ejp.1860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Impaired body representation (i.e. disrupted body awareness or perception) may be a critical, but understudied, factor underlying phantom limb pain (PLP). This cross-sectional study investigated whether adults with lower-limb loss (LLL) and PLP demonstrate impaired body representation as compared to Pain-Free peers with and without LLL. METHODS Participants (n = 41 adults with PLP, n = 27 Pain-Free peers with LLL, n = 39 Controls with intact limbs) completed an online foot identification task. Participants judged whether randomized images depicted left or right feet (i.e. left-right discrimination) as quickly as possible without limb movement. Using two Generalized Estimating Equations, effects of group, image characteristics (i.e. side, foot type, view, angle) and trial block (i.e. 1-4) were evaluated, with task response time and accuracy as dependent variables (a ≤ 0.050). RESULTS Adults with PLP demonstrated slower and less accurate performance as compared to Controls with intact limbs (p = 0.018) but performed similarly to Pain-Free peers with LLL (p = 0.394). Significant three-way interactions of group, view and angle indicated between-group differences were greatest for dorsal-view images, but smaller and angle-dependent for plantar-view images. While all groups demonstrated significant response time improvements across blocks, improvements were greatest among adults with PLP, who also reported significant reductions in pain intensity. CONCLUSIONS Adults with PLP demonstrate body representation impairments as compared to Controls with intact limbs. Body representation impairments, however, may not be unique to PLP, given similar performance between adults with and without PLP following LLL. SIGNIFICANCE Following lower-limb loss, adults with phantom limb pain (PLP) demonstrate impaired body representation as compared to Controls with intact limbs, evidenced by slower response times and reduced accuracy when completing a task requiring mental rotation. Importantly, 80% of participants with pre-task PLP reported reduced pain intensity during the task, providing compelling evidence for future investigations into whether imagery-based, mind-body interventions have positive effects on PLP.
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Affiliation(s)
- E.H. Beisheim
- University of Delaware Department of Physical Therapy, 540 South College Avenue, Newark, DE, 19713, USA
| | - R.T. Pohlig
- University of Delaware Biostatistics Core, 102B STAR Tower, Newark, DE, 19713, USA
| | - J. Medina
- University of Delaware Department of Psychological and Brain Sciences, 105 The Green, Room 108, Newark, DE, 19716, USA
| | - G.E. Hicks
- University of Delaware Department of Physical Therapy, 540 South College Avenue, Newark, DE, 19713, USA
| | - J.M. Sions
- University of Delaware Department of Physical Therapy, 540 South College Avenue, Newark, DE, 19713, USA
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McClanahan A, Moench M, Fu Q. Dimensionality analysis of forearm muscle activation for myoelectric control in transradial amputees. PLoS One 2020; 15:e0242921. [PMID: 33270686 PMCID: PMC7714228 DOI: 10.1371/journal.pone.0242921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/11/2020] [Indexed: 11/18/2022] Open
Abstract
Establishing a natural communication interface between the user and the terminal device is one of the central challenges of hand neuroprosthetics research. Surface electromyography (EMG) is the most common source of neural signals for interpreting a user’s intent in these interfaces. However, how the capacity of EMG generation is affected by various clinical parameters remains largely unknown. In this study, we examined the EMG activity of forearm muscles recorded from 11 transradially amputated subjects who performed a wide range of movements. EMG recordings from 40 able-bodied subjects were also analyzed to provide comparative benchmarks. By using non-negative matrix factorization, we extracted the synergistic EMG patterns for each subject to estimate the dimensionality of muscle control, under the framework of motor synergies. We found that amputees exhibited less than four synergies (with substantial variability related to the length of remaining limb and age), whereas able-bodied subjects commonly demonstrate five or more synergies. The results of this study provide novel insight into the muscle synergy framework and the design of natural myoelectric control interfaces.
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Affiliation(s)
- Alexander McClanahan
- College of Medicine, University of Central Florida, Orlando, Florida, United States of America
| | - Matthew Moench
- College of Medicine, University of Central Florida, Orlando, Florida, United States of America
| | - Qiushi Fu
- NeuroMechanical Systems Laboratory, Mechanical and Aerospace Engineering, University of Central Florida, Orlando, Florida, United States of America
- Biionix (Bionic Materials, Implants & Interfaces) Cluster, University of Central Florida, Orlando, Florida, United States of America
- * E-mail:
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Maimon-Mor RO, Schone HR, Moran R, Brugger P, Makin TR. Motor control drives visual bodily judgements. Cognition 2020; 196:104120. [PMID: 31945591 PMCID: PMC7033558 DOI: 10.1016/j.cognition.2019.104120] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 11/17/2022]
Abstract
The 'embodied cognition' framework proposes that our motor repertoire shapes visual perception and cognition. But recent studies showing normal visual body representation in individuals born without hands challenges the contribution of motor control on visual body representation. Here, we studied hand laterality judgements in three groups with fundamentally different visual and motor hand experiences: two-handed controls, one-handers born without a hand (congenital one-handers) and one-handers with an acquired amputation (amputees). Congenital one-handers, lacking both motor and first-person visual information of their missing hand, diverged in their performance from the other groups, exhibiting more errors for their intact hand and slower reaction-times for challenging hand postures. Amputees, who have lingering non-visual motor control of their missing (phantom) hand, performed the task similarly to controls. Amputees' reaction-times for visual laterality judgements correlated positively with their phantom hand's motor control, such that deteriorated motor control associated with slower visual laterality judgements. Finally, we have implemented a computational simulation to describe how a mechanism that utilises a single hand representation in congenital one-handers as opposed to two in controls, could replicate our empirical results. Together, our findings demonstrate that motor control is a driver in making visual bodily judgments.
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Affiliation(s)
- Roni O Maimon-Mor
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK; WIN Centre, Nuffield Department of Clinical Neuroscience, University of Oxford, Headington, Oxford OX3 9DU, UK.
| | - Hunter R Schone
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK
| | - Rani Moran
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, London WC1B 5EH, UK
| | - Peter Brugger
- Department of Neurology, Neuropsychology Unit, University Hospital Zurich, Switzerland
| | - Tamar R Makin
- Institute of Cognitive Neuroscience, University College London, London WC1N 3AZ, UK; WIN Centre, Nuffield Department of Clinical Neuroscience, University of Oxford, Headington, Oxford OX3 9DU, UK
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Guo X, Liu R, Lu J, Wu C, Lyu Y, Wang Z, Xiang J, Pan C, Tong S. Alterations in Brain Structural Connectivity After Unilateral Upper-Limb Amputation. IEEE Trans Neural Syst Rehabil Eng 2019; 27:2196-2204. [PMID: 31443033 DOI: 10.1109/tnsre.2019.2936615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Previous studies have indicated that amputation induces reorganization of functional brain network. However, the influence of amputation on structural brain network remains unclear. In this study, using diffusion tensor imaging (DTI), we aimed to investigate the alterations in fractional anisotropy (FA) network after unilateral upper-limb amputation. We acquired DTI from twenty-two upper-limb amputees (15 dominant-side and 7 nondominant-side amputees) as well as fifteen healthy controls. Using DTI tractography and graph theoretical approaches, we examined the topological changes in FA network of amputees. Compared with healthy controls, dominant-side amputees showed reduced global mean strength, increased characteristic path length, and decreased nodal strength in the contralateral sensorimotor system and visual areas. In particular, the nodal strength of the contralateral postcentral gyrus was negatively correlated with residual limb usage, representing a use-dependent reorganization. In addition, the nodal strength of the contralateral middle temporal gyrus was positively correlated with the magnitude of phantom limb sensation. Our results suggested a degeneration of FA network after dominant-side upper-limb amputation.
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Stone KD, Dijkerman HC, Bekrater-Bodmann R, Keizer A. Mental rotation of feet in individuals with Body Integrity Identity Disorder, lower-limb amputees, and normally-limbed controls. PLoS One 2019; 14:e0221105. [PMID: 31419248 PMCID: PMC6697338 DOI: 10.1371/journal.pone.0221105] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 07/30/2019] [Indexed: 01/28/2023] Open
Abstract
Body Integrity Identity Disorder (BIID) is a non-psychotic condition wherein individuals desire amputation or paralysis of one or more healthy, fully-functioning limbs (predominantly the legs). Individuals with BIID have been suggested to have a mismatch between the perceived mental representation of the body and its actual physical structure, such that their desired identity matches that of a lower-limb amputee. Accordingly, studies have reported an altered central network involving body representation of the legs in BIID, but its relationship to behavior remains unclear. In the present study, we investigated the integrity of body representation in individuals with BIID, acquired lower-limb amputees, and normally-limbed controls using an online mental rotation task. Participants judged the laterality of left and right foot images presented from different views, orientations, and of different types. We expected BIID participants to be slower for mentally rotating images that corresponded to their affected legs than lower-limb amputees and normally-limbed participants. We found that the groups did not significantly differ in their performance. All participants were slower at judging feet presented in awkward postures than natural postures, replicating previous studies and validating our online paradigm. The results are discussed in terms of the robust nature of visual and sensorimotor lower-limb representations, whether related to the self or as prototype, in the context of disturbed lower-limb integrity.
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Affiliation(s)
- Kayla D. Stone
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - H. Chris Dijkerman
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Robin Bekrater-Bodmann
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anouk Keizer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
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Ding L, Wang X, Guo X, Chen S, Wang H, Cui X, Rong J, Jia J. Effects of camera-based mirror visual feedback therapy for patients who had a stroke and the neural mechanisms involved: protocol of a multicentre randomised control study. BMJ Open 2019; 9:e022828. [PMID: 30833310 PMCID: PMC6443084 DOI: 10.1136/bmjopen-2018-022828] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION As a combination of visual stimulation and motor imagery, mirror visual feedback (MVF) is an effective treatment for motor impairment after stroke; however, few studies have investigated its effects on relevant cognitive processes such as visual perception and motor imagery. Camera-based MVF (camMVF) overcomes the intrinsic limitations of real mirrors and is recognised as an optimal setup. This study aims to investigate the effects of camMVF as an adjunct treatment for stroke patients, compare camMVF outcomes with those of conventional therapy and elucidate neural mechanisms through which MVF influences cognition and brain networks. METHODS AND ANALYSIS This will be a multicentre, single-blinded, randomised controlled trial including 90 patients randomised into three groups: camera-based mirror visual feedback intervention group (30), shielded mirror visual feedback intervention group (30) and conventional group (30). Patients in each group will receive a 60 min intervention 5 days per week over 4 weeks. The primary outcome will be the Fugl-Meyer Assessment Upper Limb subscale measurement. Secondary outcomes include the modified Ashworth Scale, Grip Strength test, Modified Barthel Index, Functional Independence Measure, Berg Balance Scale, 10-metre walking test, hand-laterality task and electroencephalography . ETHICS AND DISSEMINATION Ethics approval was granted by the Huashan Hospital Institutional Review Board on 15 March (KY2017-230). We plan to submit the results to a peer-reviewed journal and present them at conferences, rehabilitation forums and to the general public. TRIAL REGISTRATION NUMBER ChiCTR-INR-17013644; Pre-results.
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Affiliation(s)
- Li Ding
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xu Wang
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, China
| | - Xiaoli Guo
- School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, China
| | - Shugeng Chen
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hewei Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiao Cui
- Department of Rehabilitation Medicine, Shanghai Changning Tianshan Traditional Medicine Hospital, Shanghai, China
| | - Jifeng Rong
- Department of Rehabilitation Medicine, The first Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Guo X, Lyu Y, Wang Z, Li Y, Xiang J, Pan C, Flor H, Tong S. Correlates of Residual Limb Pain: From Residual Limb Length and Usage to Metabolites and Activity in Secondary Somatosensory Cortex. IEEE Trans Neural Syst Rehabil Eng 2018; 27:96-104. [PMID: 30530331 DOI: 10.1109/tnsre.2018.2885146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Most recent studies attribute residual limb pain to peripheral pathological changes of the stump. However, in this paper, we focus on its associations with the residual limb length, usage, as well as the metabolic and functional alterations of the brain. The secondary somatosensory cortex (S2), one important area involved in pain intensity discrimination, was selected as the region of interest. Twenty-two upper-limb amputees were recruited and divided into two groups, i.e., amputees with residual limb pain (9/22) and without residual limb pain (13/22). The residual limb length, usage, as well as the metabolite concentration, resting-state activity and BOLD responses to the tactile stimulation in the contralateral S2, were compared between the two groups and correlated with the pain intensity. The amputees with residual limb pain showed significantly shorter length and less usage of the residual limb than the amputees without residual limb pain, and the pain intensity was significantly negatively correlated with the residual limb length and usage. In addition, the pain intensity was significantly correlated with the tNAA/tCr ratio, resting-state fALFF in the slow-4 band, and BOLD response to the tactile stimulation in the contralateral S2, although there were no significant group differences. Regression analysis suggested that residual limb pain is associated with shorter residual limb length and less residual limb usage.
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