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, CortexMakin 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.