The neural correlates of phantom limb pain?
What is the neural basis of phantom limb pain?
Up to 80% of amputees report they suffer from phantom limb pain – pain perceived to arise from the ‘missing hand’. The neural underpinning of this fascinating phenomenon is still debated. We use neuroimaging to characterise the physiological basis of phantom pain. In particular, we are interested in how persistent activity in the missing hand area can contribute to the experience of phantom sensations and pain.
Example papers: Kikkert et al., 2018, Cortex; Makin et al., 2013, Nat. Comm.; Makin et al., 2015, Brain.
Can motor control impact phantom pain?
Many behavioural therapies aim to relieve phantom limb pain through movement of the phantom hand, under the assumption that better control (or imagery) of the phantom can cause pain relief (e.g., see mirror therapy, graded motor imagery). Despite this, there is little research providing a strong link between phantom limb pain and motor control. Recent work has demonstrated that an individual’s expectations to pain can modulate their subjective pain experience (predictive coding). We use a predictive coding framework to investigate whether phantom limb pain relates to sensorimotor prediction error. Throughout our work, we aim to provide a better understanding of the role of phantom hand motor control in predicting and modulating phantom limb pain.
Example papers: Kikkert et al., 2017, Cortex.
How can we relieve phantom limb pain?
Phantom limb pain poses a significant medical problem to many amputees. It also poses an unusual challenge to medical staff – how do you treat pain in a part of the body that no longer exists? We are applying discoveries made in our lab about the behavioural and brain correlates of phantom pain to investigate potential treatments for this condition. In particular, we apply non-invasive brain stimulation coupled with behavioural therapy, to help characterise the neural process enabling pain relief.
Example paper: Kikkert et al., 2018, Annals of Neurology.