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Related Experiment Videos

Phantoms in rheumatology.

C S McCabe1, R C Haigh, N G Shenker

  • 1The Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, UK.

Novartis Foundation Symposium
|July 31, 2004
PubMed
Summary

Rheumatology pain, like phantom limb pain (PLP) in amputees, may stem from a motor/sensory conflict. This study introduces

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Area of Science:

  • Neuroscience
  • Rheumatology
  • Pain Management

Background:

  • Rheumatology pain conditions like rheumatoid arthritis, fibromyalgia, and complex regional pain syndrome (CRPS) share similarities with amputee phantom limb pain (PLP).
  • Clinical observations suggest cortical sensory reorganization may underlie these pain experiences.

Purpose of the Study:

  • To investigate the hypothesis that a motor/sensory conflict causes pain and altered body image in rheumatology patients, similar to PLP.
  • To test the efficacy of mirror therapy in correcting this conflict and alleviating pain in CRPS patients.
  • To explore the generation and exacerbation of sensory disturbances by artificially inducing motor/sensory conflict in healthy and chronic pain populations.

Main Methods:

  • Clinical case illustrations of cortical sensory reorganization in rheumatology pain conditions.
  • Mirror therapy intervention for patients with acute, intermediate, and chronic CRPS.
  • Experimental induction of motor/sensory conflict in healthy volunteers and chronic pain patients.

Main Results:

  • Mirror therapy demonstrated analgesic efficacy in CRPS patients across disease stages.
  • Artificial induction of motor/sensory conflict successfully created sensory disturbances in healthy individuals.
  • Motor/sensory conflict exacerbated existing pain in chronic pain patients.

Conclusions:

  • A mismatch between motor output and sensory input is a key mechanism generating pain and sensory disturbances in rheumatology patients and healthy individuals.
  • The central monitoring mechanism for this process is termed 'ominory,' and the resulting disturbances are described as a 'dissensory state'.

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