Willoch F, Rosen G, Tölle T R, Oye I, Wester H J, Berner N, Schwaiger M, Bartenstein P
Department of Nuclear Medicine, Technische Universität München, Munich, Germany.
Ann Neurol. 2000 Dec;48(6):842-9.
Pain and other phantom limb (PL) sensations have been proposed to be generated in the brain and to be reflected in activation of specific neural circuits. To test this hypothesis, hypnosis was used as a cognitive tool to alternate between the sensation of PL movement and pain in 8 amputees. Brain activity was measured using positron emission tomography. PL movement and pain were represented by a propagation of neuronal activity within the corresponding sensorimotor and pain-processing networks. The sensation of movement was significantly (corrected for multiple comparisons) related to activity in the supplementary motor area and the primary sensorimotor cortex. The sensation of a painful PL posture activated the same brain areas but was weaker and less extended in the supplementary motor area. In contrast to the sensation of movement, pain was significantly related to activity in the thalamus, anterior cingulate, and lateral prefrontal cortex. Subjectively rated PL pain sensation correlated positively to activations in the anterior and posterior cingulate. These findings provide evidence that PL sensations are produced by the same central nervous processes that underlie the experience of the body when it is intact and that the corporeal awareness of PL pain is encoded in a thalamocortical network.
疼痛和其他幻肢（PL）感觉被认为是在大脑中产生的，并反映在特定神经回路的激活上。为了验证这一假设，催眠被用作一种认知工具，让8名截肢者在幻肢运动和疼痛的感觉之间交替。使用正电子发射断层扫描测量大脑活动。幻肢运动和疼痛通过相应感觉运动和疼痛处理网络内神经元活动的传播来表示。运动感觉与辅助运动区和初级感觉运动皮层的活动显著相关（经多重比较校正）。疼痛性幻肢姿势的感觉激活了相同的脑区，但在辅助运动区较弱且范围较小。与运动感觉相反，疼痛与丘脑、前扣带回和外侧前额叶皮层的活动显著相关。主观评定的幻肢疼痛感觉与前扣带回和后扣带回的激活呈正相关。这些发现提供了证据，表明幻肢感觉是由身体完整时体验所基于的相同中枢神经过程产生的，并且幻肢疼痛的身体意识是在丘脑皮质网络中编码的。
