Subedi Bishnu, Grossberg George T
Department of Neurology & Psychiatry, Saint Louis University School of Medicine, St. Louis, MO 63104, USA.
Pain Res Treat. 2011;2011:864605. doi: 10.1155/2011/864605. Epub 2011 Aug 14.
The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain.
在过去几十年里，大量研究显著增进了我们对幻肢痛的了解。已发现包括截肢部位或截肢前疼痛的存在等多种因素与幻肢痛的发生呈正相关。过去几年里，提出的机制范式已从心理源性理论转向涉及皮质重组的外周和中枢神经变化。最近，大脑中镜像神经元在幻肢痛产生中的作用也被提了出来。人们采用了各种各样的治疗方法，但基于机制的具体治疗指南尚未形成。幻肢痛被认为是一种神经性疼痛，大多数治疗建议是基于对神经性疼痛综合征的建议。镜像疗法是一种相对较新提出的治疗幻肢痛的方法，在随机对照试验中的结果好坏参半。最成功的治疗结果包括多学科措施。本文试图回顾和总结与幻肢痛的提出机制和治疗相关的最新研究。
