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Reorganization of motor and somatosensory cortex in upper extremity amputees with phantom limb pain

Reorganization of motor and somatosensory cortex in upper extremity amputees with phantom limb pain
Reorganization of motor and somatosensory cortex in upper extremity amputees with phantom limb pain
Phantom limb pain (PLP) in amputees is associated with reorganizational changes in the somatosensory system. To investigate the relationship between somatosensory and motor reorganization and phantom limb pain, we used focal transcranial magnetic stimulation (TMS) of the motor cortex and neuroelectric source imaging of the somatosensory cortex (SI) in patients with and without phantom limb pain. For transcranial magnetic stimulation, recordings were made bilaterally from the biceps brachii, zygomaticus, and depressor labii inferioris muscles. Neuroelectric source imaging of the EEG was obtained after somatosensory stimulation of the skin overlying face and hand. Patients with phantom limb pain had larger motor-evoked potentials from the biceps brachii, and the map of outputs was larger for muscles on the amputated side compared with the intact side. The optimal scalp positions for stimulation of the zygomaticus and depressor labii inferioris muscles were displaced significantly more medially (toward the missing hand representation) in patients with phantom limb pain only. Neuroelectric source imaging revealed a similar medial displacement of the dipole center for face stimulation in patients with phantom limb pain. There was a high correlation between the magnitude of the shift of the cortical representation of the mouth into the hand area in motor and somatosensory cortex and phantom limb pain. These results show enhanced plasticity in both the motor and somatosensory domains in amputees with phantom limb pain.
cortical plasticity, sensorimotor reorganization, phantom limb pain, amputation, transcranial magnetic stimulation, neuroelectric source imaging
0270-6474
3609-3618
Karl, Anke
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Birbaumer, Niels
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Lutzenberger, Werner
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Cohen, Leonardo G.
40cec7dc-95ec-426c-b8b8-d6d72f1a09b6
Flor, Herta
4bd4c786-cfc6-4639-8dab-893f73dc4c88
Karl, Anke
7f091050-641c-4658-a247-785cfd194c3d
Birbaumer, Niels
ba8e0ee6-6b43-418d-a894-661f033912c9
Lutzenberger, Werner
5e2d7c69-de6b-4d79-9312-9fd6056c6101
Cohen, Leonardo G.
40cec7dc-95ec-426c-b8b8-d6d72f1a09b6
Flor, Herta
4bd4c786-cfc6-4639-8dab-893f73dc4c88

Karl, Anke, Birbaumer, Niels, Lutzenberger, Werner, Cohen, Leonardo G. and Flor, Herta (2001) Reorganization of motor and somatosensory cortex in upper extremity amputees with phantom limb pain. Journal of Neuroscience, 21 (10), 3609-3618.

Record type: Article

Abstract

Phantom limb pain (PLP) in amputees is associated with reorganizational changes in the somatosensory system. To investigate the relationship between somatosensory and motor reorganization and phantom limb pain, we used focal transcranial magnetic stimulation (TMS) of the motor cortex and neuroelectric source imaging of the somatosensory cortex (SI) in patients with and without phantom limb pain. For transcranial magnetic stimulation, recordings were made bilaterally from the biceps brachii, zygomaticus, and depressor labii inferioris muscles. Neuroelectric source imaging of the EEG was obtained after somatosensory stimulation of the skin overlying face and hand. Patients with phantom limb pain had larger motor-evoked potentials from the biceps brachii, and the map of outputs was larger for muscles on the amputated side compared with the intact side. The optimal scalp positions for stimulation of the zygomaticus and depressor labii inferioris muscles were displaced significantly more medially (toward the missing hand representation) in patients with phantom limb pain only. Neuroelectric source imaging revealed a similar medial displacement of the dipole center for face stimulation in patients with phantom limb pain. There was a high correlation between the magnitude of the shift of the cortical representation of the mouth into the hand area in motor and somatosensory cortex and phantom limb pain. These results show enhanced plasticity in both the motor and somatosensory domains in amputees with phantom limb pain.

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More information

Published date: 2001
Keywords: cortical plasticity, sensorimotor reorganization, phantom limb pain, amputation, transcranial magnetic stimulation, neuroelectric source imaging

Identifiers

Local EPrints ID: 40403
URI: http://eprints.soton.ac.uk/id/eprint/40403
ISSN: 0270-6474
PURE UUID: 795fbaa8-d42d-4a8b-8105-299a5bed0003

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Date deposited: 05 Jul 2006
Last modified: 15 Mar 2024 08:19

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Contributors

Author: Anke Karl
Author: Niels Birbaumer
Author: Werner Lutzenberger
Author: Leonardo G. Cohen
Author: Herta Flor

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