Schone Hunter R, Baker Chris I, Katz Joel, Nikolajsen Lone, Limakatso Katleho, Flor Herta, Makin Tamar R
NIMH, National Institutes of Health, Bethesda, Maryland, USA
Institute of Cognitive Neuroscience, University College London, London, UK.
J Neurol Neurosurg Psychiatry. 2022 May 24;93(8):833-43. doi: 10.1136/jnnp-2021-328428.
Phantom limb pain (PLP) impacts the majority of individuals who undergo limb amputation. The PLP experience is highly heterogenous in its quality, intensity, frequency and severity. This heterogeneity, combined with the low prevalence of amputation in the general population, has made it difficult to accumulate reliable data on PLP. Consequently, we lack consensus on PLP mechanisms, as well as effective treatment options. However, the wealth of new PLP research, over the past decade, provides a unique opportunity to re-evaluate some of the core assumptions underlying what we know about PLP and the rationale behind PLP treatments. The goal of this review is to help generate consensus in the field on how best to research PLP, from phenomenology to treatment. We highlight conceptual and methodological challenges in studying PLP, which have hindered progress on the topic and spawned disagreement in the field, and offer potential solutions to overcome these challenges. Our hope is that a constructive evaluation of the foundational knowledge underlying PLP research practices will enable more informed decisions when testing the efficacy of existing interventions and will guide the development of the next generation of PLP treatments.
幻肢痛（PLP）影响着大多数接受肢体截肢的人。幻肢痛的体验在性质、强度、频率和严重程度上具有高度异质性。这种异质性，再加上一般人群中截肢的低患病率，使得积累关于幻肢痛的可靠数据变得困难。因此，我们在幻肢痛机制以及有效的治疗选择方面缺乏共识。然而，在过去十年中，大量新的幻肢痛研究提供了一个独特的机会，来重新评估一些关于幻肢痛我们已知内容背后的核心假设以及幻肢痛治疗背后的基本原理。本综述的目的是帮助该领域就如何最好地研究幻肢痛（从现象学到治疗）达成共识。我们强调了研究幻肢痛时的概念和方法挑战，这些挑战阻碍了该主题的进展并在该领域引发了分歧，并提供了克服这些挑战的潜在解决方案。我们希望对幻肢痛研究实践背后的基础知识进行建设性评估，将使在测试现有干预措施的疗效时能够做出更明智的决策，并指导下一代幻肢痛治疗方法的开发。
