Experimental Neuropsychology Research Unit, School of Psychology and Psychiatry, Monash University, Clayton, Australia.
Clin J Pain. 2011 Oct;27(8):691-8. doi: 10.1097/AJP.0b013e318216906f.
Phantom limb perception is common following amputation, and is sometimes characterised by pain that resembles the characteristics, intensity or location of past pain. We tested Flor's model that phantom pain results from memory for long-lasting znoxious input.
We report a questionnaire study of 283 amputees, that explored the experience of painful, non-painful and postural somatosensory memories in the phantom. We explore the impact of pre-amputation pain and impairment duration, and complications in the limb (eg, infection, gangrene, surgery, and vascular disease). Differences in mood, coping and adjustment to amputation are also explored in those with somatosensory pain memories.
Our findings support Flor's model, as amputation-related and non-amputation-related pain memories, and non-painful memories comprised pains or sensations that were either enduring/recurring pains or sensations (eg, ingrown toenail, corns, chilblains, arthritis-type pain in winter, night-cramps, or holding a tennis racquet), or resulted from a painful event with a "core-trauma" element (eg, fracture, crushing/penetration injury). Pain memories related to amputation were more common following functional impairment before amputation; infection or surgery prior to amputation; or having diabetic or vascular amputations-which are associated with multiple complications, including neuropathic changes, infection and prior surgery. Furthermore, participants with amputation-related pain memories exhibited higher sensory pain ratings, as well as poorer mood and adjustment to the limitations of amputation.
We propose that somatosensory pain memories likely relate to the generation and maintenance of limb representations upon which intense or emotionally powerful past experiences have been imprinted.
幻肢感在截肢后很常见，有时其特征是疼痛类似于过去疼痛的特征、强度或位置。我们测试了 Flor 的模型，即幻肢痛是由于对持久有害输入的记忆而产生的。
我们报告了一项对 283 名截肢者的问卷调查研究，该研究探讨了幻肢中疼痛、非疼痛和姿势体感记忆的体验。我们探讨了截肢前疼痛和损伤持续时间以及肢体并发症（例如感染、坏疽、手术和血管疾病）的影响。还探讨了那些有体感疼痛记忆的人在情绪、应对和适应截肢方面的差异。
我们的发现支持了 Flor 的模型，因为与截肢相关和与非截肢相关的疼痛记忆以及非疼痛记忆包括持续/反复出现的疼痛或感觉（例如，嵌甲、鸡眼、冻疮、冬季关节炎样疼痛、夜间抽筋或握持网球拍），或者是由具有“核心创伤”元素的疼痛事件引起的（例如，骨折、压碎/穿透伤）。在截肢前有功能障碍、截肢前有感染或手术、或患有糖尿病或血管性截肢的患者中，与截肢相关的疼痛记忆更为常见-这些截肢与多种并发症相关，包括神经病变变化、感染和先前的手术。此外，有截肢相关疼痛记忆的参与者表现出更高的体感疼痛评分，以及更差的情绪和对截肢限制的适应。
我们提出体感疼痛记忆可能与肢体代表的产生和维持有关，这些代表上铭刻了强烈或情绪强烈的过去经历。
