Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
MacIver, K; Lloyd, DM; Kelly, S; Roberts, N; Nurmikko, T (2008)
Publisher: Oxford University Press
Languages: English
Types: Article
Using functional MRI (fMRI) we investigated 13 upper limb amputees with phantom limb pain (PLP) during hand and lip movement, before and after intensive 6-week training in mental imagery. Prior to training, activation elicited during lip purse showed evidence of cortical reorganization of motor (M1) and somatosensory (S1) cortices, expanding from lip area to hand area, which correlated with pain scores. In addition, during imagined movement of the phantom hand, and executed movement of the intact hand, group maps demonstrated activation not only in bilateral M1 and S1 hand area, but also lip area, showing a two-way process of reorganization. In healthy participants, activation during lip purse and imagined and executed movement of the non-dominant hand was confined to the respective cortical representation areas only. Following training, patients reported a significant reduction in intensity and unpleasantness of constant pain and exacerbations, with a corresponding elimination of cortical reorganization. Post hoc analyses showed that intensity of constant pain, but not exacerbations, correlated with reduction in cortical reorganization. The results of this study add to our current understanding of the pathophysiology of PLP, underlining the reversibility of neuroplastic changes in this patient population while offering a novel, simple method of pain relief.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56: 892-7.
    • Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-71.
    • Beckmann CF, Jenkinson M, Smith SM. General multi-level linear modelling for group analysis in FMRI. NeuroImage 2003; 20: 1052-63.
    • Chan BL, Witt R, Charrow AP, Magee A, Howard R, Pasquina F, et al. Mirror therapy for phantom limb pain. N Engl J Med 2007; 357: 2206-7.
    • Chen R, Cohen LG, Hallett M. Nervous system reorganisation following injury. Neuroscience 2002; 111: 761-73.
    • Cohen LG, Bandinelli S, Findley TW, Hallett M. Motor reorganisation after upper limb amputation in man. A study with focal magnetic stimulation. Brain 1991; 114: 615-27.
    • Dettmers C, Adler T, Rzanny R, van Schayck R, Gaser C, Weiss T, et al. Increased excitability in the primary motor cortex and supplementary motor area in patients with phantom limb pain after upper limb amputation. Neurosci Lett 2001; 307: 109-12.
    • Duvernoy HM. The human brain: surface, blood supply and threedimensional sectional anatomy. 2nd edn. New York: Springer Wien; 1999.
    • Ehrsson HH, Geyer S, Naito E. Imagery of voluntary movement of fingers, toes and tongue activates corresponding body-part-specific motor representations. J Neurophysiol 2003; 90: 3304-16.
    • Flor H, Nikolajsen L, Jensen TS. Phantom limb pain: a case of maladaptive CNS plasticity? Nat Rev Neurosci 2006; 7: 873-81.
    • Hamzei F, Liepert J, Dettmers C, Adler T, Kiebel S, Rijntjes M, et al. Structural and functional cortical abnormalities after upper limb amputation in childhood. NeuroReport 2001; 12: 957-62.
    • Harris JA. Cortical origin of pathological pain. Lancet 1999; 354: 1464-6.
    • Hesslow G. Conscious thought as simulation of behaviour. Trends Cogn Sci 2002; 6: 242-7.
    • Huse E, Larbig W, Flor H, Birbaumer N. The effect of opioids on phantom limb pain and cortical reorganisation. Pain 2001; 90: 47-55.
    • Jeannerod M. Mental imagery in the motor context. Neuropsychologia 1995; 33: 1419-32.
    • Jenkinson M, Smith SM. A global optimisation method for robust affine registration of brain images. Med Image Anal 2001; 5: 143-56.
    • Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med 1985; 8: 163-88.
    • Karl A, Birbaumer N, Lutzenberger W, Cohen LG, Flor H. Reorganisation of motor and somatosensory cortex in upper extremity amputees with phantom limb pain. J Neurosci 2001; 21: 3609-18.
    • Kelly C, Foxe JJ, Garavan H. Patterns of normal human brain plasticity after practice and their implications for neurorehabilitation. Arch Phys Med Rehab 2006; 87: S20-9.
    • Kelly C, Garavan H. Human functional neuroimaging of brain changes associated with practice. Cereb Cortex 2005; 15: 1089-102.
    • Kooijman CM, Dijkstra PU, Geertzen JHB, Elzinga A, van der Schans CP. Phantom pain and phantom sensations in upper limb amputees: an epidemiological study. Pain 2000; 87: 33-41.
    • Lotze M, Erb M, Flor H, Huelsmann E, Godde B, Grodd W. fMRI evaluation of somatotopic representation in human primary motor cortex. Neuroimage 2000; 11: 473-81.
    • Lotze M, Flor H, Grodd W, Larbig W, Birbaumer N. Phantom movements and pain: an fMRI study in upper limb amputees. Brain 2001; 124: 2268-77.
    • Lotze M, Grodd W, Birbaumer N, Erb M, Huse E, Flor H. Does use of a myoelectric prosthesis prevent cortical reorganisation and phantom limb pain? Nat Neurosci 1999; 2: 501-2.
    • Mackert B-M, Sappok T, Grusser S, Flor H, Curio G. The eloquence of silent cortex. NeuroReport 2003; 14: 409-12.
    • Maihofner C, Handwerker HO, Neundorfer B, Birklein F. Cortical reorganisation during recovery from complex regional pain syndrome. Neurology 2004; 63: 693-701.
    • Mercier C, Reilly KT, Vargas CD, Aballea A, Sirigu A. Mapping phantom movement representations in the motor cortex of amputees. Brain 2006; 129: 2202-10.
    • Moseley GL. Graded motor imagery for pathologic pain: a randomised controlled trial. Neurology 2006; 67: 2129-34.
    • Navarro X, Vivi M, Valero-Cabre A. Neural plasticity after peripheral nerve injury and regeneration. Prog Neurobiol 2007; 82: 163-201.
    • Pascual-Leone A, Amedi A, Fregni F, Merabet LB. The plastic human cortex. Annu Rev Neurosci 2005; 28: 377-401.
    • Pelled G, Chuang K-H, Dodd SJ, Koretsky AP. Functional MRI detection of bilateral cortical reorganisation in the rodent brain following peripheral nerve deafferentation. NeuroImage 2007; 37: 262-73.
    • Peyron R, Schneider F, Convers P, Barral F-G, Garcia-Larrea L, Laurent B. An fMRI study of cortical representation of mechanical allodynia in patients with neuropathic pain. Neurology 2004; 63: 1838-46.
    • Porro CA, Cettolo V, Francescato MP, Baraldi P. Ipsilateral involvement of primary motor cortex during motor imagery. Eur J Neurosci 2000; 12: 3059-63.
    • Ramachandran VS, Hirstein W. The perception of phantom limbs. The D. O. Hebb Lecture. Brain 1998; 121: 1603-30.
    • Reilly KT, Mercier C, Schieber MH, Sirigu A. Persistent commands in the amputee's brain. Brain 2006; 129: 2211-23.
    • Roricht S, Meyer B-U, Niehaus L, Brandt SA. Long-term reorganisation of motor cortex outputs after arm amputation. Neurology 1999; 53: 106-11.
    • Roux F-E, Ibarrola D, Lazorthes Y, Berry I. Chronic motor cortex stimulation for phantom limb pain: a functional magnetic resonance imaging study: technical case report. Neurosurgery 2001; 48: 681-8.
    • Schwenkreis P, Pleger B, Cornelius B, Weyen U, Dertwinkel R, Zenz M, et al. Reorganisation in the ipsilateral motor cortex of patients with lower limb amputation. Neurosci Lett 2003; 349: 187-90.
    • Sinis N, Birbaumer N, Gustin S, Schwarz A, Berdanger S, Becker ST, et al. Memantine treatment of complex regional pain syndrome. Clin J Pain 2007; 23: 237-43.
    • Smith SM, Brady JM. SUSAN - a new approach to low level image processing. Int J Comp Vis 1997; 23: 45-78.
    • Smith SM, Jenkinson M, Woolrich MW, Beckmann CF, Behrens TEJ, Johansen-Berg H, et al. Advances in functional and structural MR image analysis and implementation as FSL. NeuroImage 2004; 23: 208-19.
    • Stippich C, Ochmann H, Sartor K. Somatotopic mapping of the human primary sensorimotor cortex during motor imagery and execution by functional magnetic resonance imaging. Neurosci Lett 2002; 331: 50-4.
    • Weiss T, Miltner WHR, Adler T, Bruckner L, Taub E. Decrease in phantom limb pain associated with prosthesis-induced increased use of an amputation stump in humans. Neurosci Lett 1999; 272: 131-4.
    • Woolrich MW, Behrens TE, Beckman CF, Jenkinson M, Smith SM. Multilevel linear modelling for FMRI group analysis using Bayesian inference. Neuroimage 2004; 21: 1732-47.
    • Woolrich M, Brady M, Smith SM. Hierarchical fully Bayesian spatiotemporal analysis of FMRI data. In Seventh International Conference on Functional Mapping of the Human Brain; 2001.
    • Wu CW-H, Kaas JH. Reorganisation in primary motor cortex of primates with long-standing therapeutic amputations. J Neurosci 1999; 19: 7679-97.
    • Yousry TA, Schmid H, Alkhadi H, Schmidt D, Peraud A, Buettner A, et al. Localisation of the motor hand area to a knob on the precentral gyrus. A new landmark. Brain 1997; 120: 141-57.
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article