Graduate School of Health Science, Kio University, Nara, Japan.
Neurorehabilitation Research Center, Kio University, Nara, Japan.
Restor Neurol Neurosci. 2021;39(2):101-110. doi: 10.3233/RNN-201132.
Patients with brachial plexus avulsion (BPA) usually experience phantom sensations and phantom limb pain (PLP) in the deafferented limb. It has been suggested that evoking the sensation of touch in the deafferented limb by stimulating referred sensation areas (RSAs) on the cheek or shoulder might alleviate PLP. However, feasible rehabilitation techniques using this approach have not been reported.
The present study sought to examine the analgesic effects of simple electrical stimulation of RSAs in BPA patients with PLP.
Study 1: Electrical stimulation of RSAs for 60 minutes was conducted for six BPA patients suffering from PLP to examine short-term analgesic effects. Study 2: A single case design experiment was conducted with two BPA patients to investigate whether electrical stimulation of RSAs was more effective for alleviating PLP than control electrical stimulation (electrical stimulation of sites on side opposite to the RSAs), and to elucidate the long-term effects of electrical stimulation of RSAs.
Study 1: Electrical stimulation of RSAs evoked phantom touch sensations in the deafferented limb, and significantly alleviated PLP (p < 0.05). Study 2: PLP was alleviated more after electrical stimulation on RSAs compared with control electrical stimulation (p < 0.05). However, the analgesic effects of electrical stimulation on RSAs were observed only in the short term, not in the long term (p > 0.05).
Electrical stimulation of RSAs not only evoked phantom touch sensation but also alleviated PLP in the short term. The results indicate that electrical stimulation of RSAs may provide a useful practical rehabilitation technique for PLP. Future studies will be required to clarify the mechanisms underlying immediate PLP alleviation via electrical stimulation of RSAs.
臂丛神经撕脱伤（BPA）患者在去传入的肢体中通常会出现幻肢感觉和幻肢痛（PLP）。有人提出，通过刺激脸颊或肩部的牵涉感觉区（RSA）来诱发去传入肢体的触觉感觉可能会缓解 PLP。然而，尚未报道使用这种方法的可行康复技术。
本研究旨在检查刺激 RSA 对 BPA 伴 PLP 患者的镇痛效果。
研究 1：对 6 名患有 PLP 的 BPA 患者进行 60 分钟的 RSA 电刺激，以检查短期镇痛效果。研究 2：对 2 名 BPA 患者进行单病例设计实验，以研究刺激 RSA 是否比对照电刺激（对 RSA 相反侧的部位进行电刺激）更能缓解 PLP，并阐明 RSA 电刺激的长期效果。
研究 1：刺激 RSA 可诱发去传入肢体的幻触感觉，并显著缓解 PLP（p<0.05）。研究 2：与对照电刺激相比，刺激 RSA 后 PLP 缓解更明显（p<0.05）。然而，刺激 RSA 的镇痛效果仅在短期观察到，而不是长期（p>0.05）。
刺激 RSA 不仅可以诱发幻触感觉，而且可以在短期内缓解 PLP。结果表明，刺激 RSA 可能为 PLP 提供一种有用的实用康复技术。需要进一步的研究来阐明通过刺激 RSA 即刻缓解 PLP 的机制。
