NEUROPLASTICITY AND REHABILITATION FOR PHANTOM PAIN AFTER AMPUTATION
DOI:
https://doi.org/10.32782/2221-1217-2025-2-02Keywords:
neuroplasticity, phantom pain, rehabilitation methodsAbstract
The article describes modern views on the essence, types, values and mechanisms of neuroplasticity, as well as the factors that affect it. Neuroplasticity plays a key role in the emergence and treatment of phantom pain. At present, scientists say that phantom pain is the result of adaptive cortical plasticity, which is caused by long sensory experience and changes in the brain organization, and not just the consequences of non-adaptive changes or neural degradation, as it was thought before. This forces one to rethink how the brain organizes its functions after amputation, and opens up new opportunities for the treatment of phantom pain. Changes after the loss of the limb in important areas of the cerebral hemisphere – motor and somatosensory – are described. After amputation, the patient may feel that he may move a lost limb. In this case, the corresponding bark zone in the precentral gyrus is activated. It is suggested that phantom pain can be the result of an imbalance between such motor commands and the absence of sensory feedback and may contribute to the occurrence of phantom pain. After amputation, the nervous system can misinterpret the signals coming from the remains of the limb. It can also cause a feeling of phantom pain. After amputation, sensitive impulses from the lost limb disappear, as a result, the reorganization of cortical maps occurs, the phenomenon of “mirror pain” and “telescoping” is manifested. High-field neuroimaging and multidimensional methods provide new opportunities for the study of somatosensory representations in the bark of the absent limb. Cortical mapping can be used as a potential landmark for rehabilitation monitoring after peripheral injuries. The main approaches that use neuroplasticity to relieve phantom pain include: proprioceptive training, mirror therapy, virtual reality, sensory and motor stimulation, cognitive-behavioral therapy, etc. A deep understanding of the motor and sensory restructuring of the peripheral and central nervous system, which occurs after amputation, can help to improve clinical interventions to improve the quality of life of people with the acquired loss of limbs.
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