Effects of regional anesthesia on phantom limb pain are mirrored in changes in cortical reorganization

Niels Birbaumer, Werner Lutzenberger, Pedro Montoya, Wolfgang Larbig, Klaus Unertl, Stephanie Töpfner, Wolfgang Grodd, Edward Taub, Herta Flor

Research output: Contribution to journalArticle

Abstract

The causes underlying phantom limb pain are still unknown. Recent studies on the consequences of nervous system damage in animals and humans reported substantial reorganization of primary somatosensory cortex subsequent to amputation, and one study showed that cortical reorganization is positively correlated with phantom limb pain. This paper examined the hypothesis of a functional relationship between cortical reorganization and phantom limb pain. Neuroelectric source imaging was used to determine changes in cortical reorganization in somatosensory cortex after anesthesia of an amputation stump produced by brachial plexus blockade in six phantom limb pain patients and four pain-free amputees. Three of six phantom limb subjects experienced a virtual elimination of current phantom pain attributable to anesthesia (mean change: 3.8 on an 11-point scale; Z = -1.83; p <0.05) that was mirrored by a very rapid elimination of cortical reorganization in somatosensory cortex (change = 19.8 mm; t((2)) = 5.60; p <0.05). Cortical reorganization remained unchanged (mean change = 1.6 mm) in three phantom limb pain amputees whose pain was not reduced by brachial plexus blockade and in the phantom pain-free amputation controls. These findings suggest that cortical reorganization and phantom limb pain might have a causal relationship. Methods designed to alter cortical reorganization should be examined for their efficacy in the treatment of phantom limb pain.

Original languageEnglish
Pages (from-to)5503-5508
Number of pages6
JournalJournal of Neuroscience
Volume17
Issue number14
Publication statusPublished - 1997

Keywords

  • Brachial plexus anesthesia
  • Cortical reorganization
  • EEG
  • Human
  • Neuroelectric source imaging
  • Pain treatment
  • Phantom limb pain
  • Plasticity

ASJC Scopus subject areas

  • Neuroscience(all)

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    Birbaumer, N., Lutzenberger, W., Montoya, P., Larbig, W., Unertl, K., Töpfner, S., Grodd, W., Taub, E., & Flor, H. (1997). Effects of regional anesthesia on phantom limb pain are mirrored in changes in cortical reorganization. Journal of Neuroscience, 17(14), 5503-5508.