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Where is hidden the ghost in phantom sensations?

Michelangelo Buonocore1

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Summary

Phantom sensations (PS) are common in amputees and can arise from nerve damage or central nervous system changes. Understanding these diverse origins is key to interpreting phantom limb pain and other related phenomena.

Keywords:
Neuropathic painPain pathophysiologyPhantom painPhantom sensationsReferred pain

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Area of Science:

  • Neuroscience
  • Clinical Medicine
  • Physiology

Background:

  • Phantom sensations (PS) are frequently experienced by amputees, manifesting as sensations in a missing body part.
  • While commonly associated with limb amputation, PS can occur in various clinical contexts.
  • Existing theories often emphasize a central origin for these sensations.

Purpose of the Study:

  • To elucidate the diverse pathophysiological mechanisms underlying phantom sensations.
  • To differentiate between amputation-specific and more general neural processes contributing to PS.
  • To provide a framework for interpreting PS based on established pathophysiological principles.

Main Methods:

  • Review and synthesis of existing literature on phantom sensations.
  • Analysis of proposed pathophysiological mechanisms, including peripheral and central origins.
  • Categorization of PS generation based on neural activity and plasticity.

Main Results:

  • PS can originate from peripheral nerve activity, such as ectopic action potentials in interrupted nerve fibers.
  • Central mechanisms, including central sensitization and neuroplastic changes, can also generate PS.
  • Referred sensations, resulting from convergence of impulses from different body parts, contribute to PS.

Conclusions:

  • Phantom sensations result from a combination of neuropathic and non-neuropathic mechanisms.
  • These mechanisms can involve the amputated body part or other areas of the nervous system.
  • Interpreting PS requires adherence to pathophysiological principles rather than seeking unique amputation-specific causes.