ICPLP2021 - Prof. Flor: Phantom limb pain: a dynamic network perspective скачать в хорошем качестве

ICPLP2021 - Prof. Flor: Phantom limb pain: a dynamic network perspective

Abstract: Functional and structural plasticity in neural circuits has been associated with phantom limb pain. Such plastic changes involve both injury- and use-related alterations including the acquisition of compensatory motor skills and coping with a chronic pain condition. We address how functional changes interrelate with pain symptoms, not only locally within the primary somatosensory and motor cortex but at a network-level. We show the differential contribution of perceptual factors such as embodiment or agency, behavioural factors such as use of a prosthesis or use of the intact limb, prior pain experiences, non-painful phantom sensations including telescoping and referred sensations as well as psychological factors such as anxiety and depression to sensorimotor changes and pain. Peripheral factors can also modulate these central changes. We suggest that both central and peripheral factors interact in a dynamic manner and modulate the phantom pain experience. Ongoing longitudinal studies as well as studies employing evoked phantom pain and virtual reality paradigms seek to differentiate antecedents and consequences of pain and the role of brain regions involved in sensory and affective mechanisms. Biography: Prof. Herta Flor is a neuroscientist and the scientific director of the Department of Neuropsychology at the University of Heidelberg, Central Institute for Mental Health, Mannheim, Germany. Prof. Flor is distinguished for seminal discoveries in the field of pain and phantom phenomena including the cortical processing of pain-related information in humans. Most of her work on the topic of pain focuses on the role of learning and memory processes and related plastic changes in the brain in the development and maintenance of chronic pain. 00:00:00 Introduction 00:00:42 Prof. Flor: Phantom limb pain (PLP): a dynamic network perspective 00:01:12 Cortical reorganization in phantom pain 00:02:08 Brain changes during phantom/imagery: is phantom limb pain related to preserved function 00:02:58 A study with different tasks 00:05:07 Somatosensory stimulation 00:08:52 Virtual mirror task 00:09:22 Telescoping 00:11:09 Relationship of PLP and residual limb pain and heat sensitivity 00:12:45 Relationship between reorganization in affected M1 and SI and prosthesis use 00:14:22 Relationship depends on location of activation 00:16:28 Role for structural changes 00:17:56 Mystery of PLP blocking DRG activity 00:20:10 Referred sensations in amputees 00:22:29 Analyses of neural circuits in phantom pain need to consider different factors 00:23:39 Dissecting phantom limb pain: causes versus consequences 00:25:12 Questions