Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru.
Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA; Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Heverlee, Belgium.
Cortex. 2024 Dec;181:295-304. doi: 10.1016/j.cortex.2024.09.001. Epub 2024 Sep 11.
Phantom motor execution (PME) shows promise as a new treatment for phantom limb pain (PLP) by inducing motor-related analgesia and retraining the pain network activation. However, the current understanding of the neural correlates underlying PME is limited. Databases were systematically searched for multimodal neuroimaging studies to explore the neural correlates of PME. A narrative synthesis (17 studies, n = 328) and coordinate-based meta-analysis were performed to identify activation commonalities. Contrasting PME-vs-REST revealed differential activation of the supplementary motor area (SMA), post-central gyrus, and dorsolateral superior frontal gyrus; while PME-vs-ME revealed differential activation of the right anterior insula, anterior cingulate, left amygdala, and right striatum. Further narrative synthesis revealed a positive correlation between PME-induced brain activity and PLP intensity, and a specific connectivity pattern during PME on the SMA-M1 network compared to ME and motor imagery. Our results suggest that the PME represents a distinct type of motor network activation, partially overlapping with ME and motor imagery activations but with special activation of interoceptive regulation and mood-related regions. Thus, confirming its potential as a therapeutic approach for PLP.
幻肢运动执行（PME）有望成为治疗幻肢痛（PLP）的新方法，通过诱导与运动相关的镇痛和重新训练疼痛网络激活。然而，目前对 PME 潜在的神经相关性的理解是有限的。我们系统地搜索了多模态神经影像学研究数据库，以探索 PME 的神经相关性。进行了叙述性综合（17 项研究，n=328）和基于坐标的荟萃分析，以确定激活的共性。与 REST 相比，PME 激活了补充运动区（SMA）、后中央回和额上外侧回；而与运动想象相比，PME 激活了右侧前岛叶、前扣带、左侧杏仁核和右侧纹状体。进一步的叙述性综合表明，PME 诱导的大脑活动与 PLP 强度之间存在正相关，并且与 ME 和运动想象相比，在 SMA-M1 网络上的 PME 期间存在特定的连接模式。我们的研究结果表明，PME 代表了一种独特的运动网络激活类型，与 ME 和运动想象激活部分重叠，但与内脏调节和情绪相关区域的特殊激活有关。因此，证实了其作为 PLP 治疗方法的潜力。
