Lontis Eugen R, Yoshida Ken, Jensen Winnie
Annu Int Conf IEEE Eng Med Biol Soc. 2019 Jul;2019:6458-6461. doi: 10.1109/EMBC.2019.8856724.
Electrical stimulation (ES) of referred sensation areas (RSAs) may provide sensory input attempting to alleviate phantom limb pain (PLP). Characterization of referred sensation areas (RSAs) in a 34 year-old male with transpelvic amputation is presented in this paper. PLP was experienced as cramps of muscles of phantom leg and as piercing sensation of the phantom ankle alternating with unpleasant sensation as that given by crawling spiders in an atypical pattern lasting for e.g. 36 hours, with short episodes experienced approximately every 15 seconds on a 7-10 level on VAS scale. RSAs were determined by light brushing of a 350 x 250 mm area around the scar on the amputation site. Combinations of pulse widths of 200 to 600 μs and frequencies from 20 to 120 Hz were used for test of ES of RSAs. Pleasant massaging effect of muscles of phantom leg and of phantom toes, with lasting effect of minutes, was evoked by ES. However, increase of pain level was reported for stimuli of certain parameters and location of electrodes. Sensation evoked by tactile stimulation of given RSA differed of that evoked by ES of the corresponding RSA and neighbour areas. Following ES, increase in non-painful sensations from extended areas of phantom leg was reported as phantom leg coming to life. Furthermore, the phantom leg was perceived lighter and easier to move imaginary. RSAs may qualify for generating sensory input attempting to alleviate PLP, however, thorough analysis of sensation evoked by ES and of pain profile must be performed.
对牵涉感觉区（RSA）进行电刺激（ES）可能会提供感觉输入，试图缓解幻肢痛（PLP）。本文介绍了一名34岁经盆腔截肢男性的牵涉感觉区（RSA）特征。幻肢痛表现为幻腿肌肉痉挛以及幻踝关节的刺痛感，与爬行蜘蛛产生的不适感交替出现，呈非典型模式，持续约36小时，在视觉模拟评分量表（VAS）上，每隔约15秒会出现一次短时间发作，疼痛程度为7 - 10级。通过轻刷截肢部位瘢痕周围350×250毫米的区域来确定牵涉感觉区（RSA）。使用脉宽为200至600微秒、频率为20至120赫兹的组合来测试牵涉感觉区（RSA）的电刺激。电刺激可诱发幻腿和幻趾肌肉产生愉悦的按摩效果，持续数分钟。然而，某些参数的刺激和电极位置会导致疼痛程度增加。对给定牵涉感觉区（RSA）进行触觉刺激所诱发的感觉与对相应牵涉感觉区（RSA）及其相邻区域进行电刺激所诱发的感觉不同。电刺激后，幻腿扩展区域的非疼痛感觉增加，幻腿仿佛恢复了生机。此外，感觉幻腿变轻，更容易进行想象中的移动。牵涉感觉区（RSA）可能适合产生感觉输入以试图缓解幻肢痛，然而，必须对电刺激诱发的感觉和疼痛特征进行全面分析。
