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Real-time Video Projection in an MRI for Characterization of Neural Correlates Associated with Mirror Therapy for Phantom Limb Pain
Published on: April 20, 2019
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Noninvasive Brain Stimulation, Maladaptive Plasticity, and Bayesian Analysis in Phantom Limb Pain
1Neuromodulation Laboratory, Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA.
Medical Acupuncture
|September 7, 2017
Summary
Phantom limb pain (PLP) involves stump-level changes and central nervous system alterations. Noninvasive brain stimulation techniques like transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) show promise for managing PLP.
Area of Science:
- Neuroscience
- Pain Management
- Rehabilitation Medicine
Background:
- Phantom limb pain (PLP) is a prevalent, poorly understood condition following amputation.
- PLP involves complex multifactorial bases including local stump changes, spinal modifications, deafferentation, and central sensitization.
- These neurophysiological changes lead to maladaptive plasticity and defective sensory information processing.
Purpose of the Study:
- To discuss the multifactorial bases of phantom limb pain.
- To explore noninvasive brain stimulation techniques as potential interventions for PLP.
- To highlight the role of neurocomputational understanding and Bayesian analysis in PLP treatment.
Main Methods:
- Review of neurophysiology and imaging studies identifying cortical reorganization in PLP.
- Discussion of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) mechanisms.
- Integration of brain stimulation with cognitive behavioral techniques for comprehensive rehabilitation.
Main Results:
- Noninvasive brain stimulation (tDCS, rTMS) modulates synaptic plasticity (LTP/LTD) to target central sensitization and maladaptive plasticity.
- These techniques offer a promising alternative for managing PLP.
- Cortical reorganization contributes to the perpetuation of PLP.
Conclusions:
- A dynamic neurocomputational perspective is crucial for developing improved PLP treatments.
- Bayesian analysis of sensory information can guide and monitor therapeutic interventions for PLP resolution.
- Comprehensive rehabilitation programs incorporating noninvasive brain stimulation are beneficial.
