Ortega-Márquez Jorge, Garnier Justyna, Mena Lucas, Palagi Vigano Ana Victoria, Grützmacher Eleonora Boschetti, Vallejos-Penaloza Gabriel, Costa Valton, Martinez-Magallanes Daniela, Vaz de Macedo Antonio, de Paula-Garcia Waynice Neiva, Schwartz Denise Saretta, Fregni Felipe, Pacheco-Barrios Kevin
Master of Medical Sciences in Clinical Investigation, Harvard Medical School, Boston, MA 02115, USA.
Department of Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland.
Biomedicines. 2024 Sep 6;12(9):2035. doi: 10.3390/biomedicines12092035.
Phantom limb pain (PLP) is highly prevalent after amputation. However, the influence of non-painful sensations (PLS) remains unclear. This study examines the PLP-PLS index as a novel tool to differentiate PLP from PLS and explores the association of clinical factors with the index.
We conducted a cross-sectional analysis of baseline data from 112 participants in a previous factorial trial in patients with unilateral traumatic lower limb amputation. Linear regression models were used to examine the associations between the index and various demographic, psychological and clinical factors. Logistic and Poisson regression, and e-value calculation were utilized for sensitivity analyses.
Adjusted multivariable linear regression models demonstrated significant associations of phantom movement sensation (β: -1.532; 95% CI: -2.615 to -0.449; = 0.006) and time since amputation (β: 0.005; 95% CI: 0.0006 to 0.0101; = 0.026) with the PLP-PLS index. These findings were confirmed by multivariable logistic regression (phantom movement sensation OR: 0.469; 95% CI: 0.200 to 1.099, = 0.082; time since amputation OR: 1.003; 95% CI: 1.00003 to 1.007; = 0.048) and sensitivity analyses.
Time since amputation and phantom movement sensation likely reflect distinct phenotypes and potential mechanisms for PLP and PLS. The PLP-PLS index is a promising clinical tool for selecting therapies to prevent/treat PLP and for measuring treatment effects to modulate phantom pain. These findings emphasize the importance of understanding the mechanisms underlying PLP and PLS for improving clinical management and guiding future research.
截肢后幻肢痛（PLP）极为常见。然而，非疼痛性感觉（PLS）的影响仍不明确。本研究将PLP-PLS指数作为一种区分PLP与PLS的新工具进行检验，并探讨临床因素与该指数的关联。
我们对之前一项针对单侧创伤性下肢截肢患者的析因试验中112名参与者的基线数据进行了横断面分析。使用线性回归模型检验该指数与各种人口统计学、心理和临床因素之间的关联。采用逻辑回归、泊松回归和e值计算进行敏感性分析。
调整后的多变量线性回归模型显示，幻肢运动感觉（β：-1.532；95%置信区间：-2.615至-0.449；P = 0.006）和截肢后时间（β：0.005；95%置信区间：0.0006至0.0101；P = 0.026）与PLP-PLS指数存在显著关联。多变量逻辑回归（幻肢运动感觉比值比：0.469；95%置信区间：0.200至1.099，P = 0.082；截肢后时间比值比：1.003；95%置信区间：1.00003至1.007；P = 0.048）和敏感性分析证实了这些发现。
截肢后时间和幻肢运动感觉可能反映了PLP和PLS的不同表型及潜在机制。PLP-PLS指数是一种有前景的临床工具，可用于选择预防/治疗PLP的疗法以及衡量调节幻肢痛的治疗效果。这些发现强调了理解PLP和PLS潜在机制对于改善临床管理和指导未来研究的重要性。
