Flor H, Elbert T, Mühlnickel W, Pantev C, Wienbruch C, Taub E
Department of Psychology, Clinical Psychology and Behavioral Neuroscience, Humboldt-University, Berlin, Germany.
Exp Brain Res. 1998 Mar;119(2):205-12. doi: 10.1007/s002210050334.
The relationship between phantom limb phenomena and cortical reorganization was examined in five subjects with congenital absence of an upper limb and nine traumatic amputees. Neuromagnetic source imaging revealed minimal reorganization of primary somatosensory cortex in the congenital amputees (M=0.69 cm, SD 0.24) and the traumatic amputees without phantom limb pain (M=0.27 cm, SD 0.25); the amputees with phantom limb pain showed massive cortical reorganization (M=2.22 cm, SD 0.78). Phantom limb pain and nonpainful phantom limb phenomena were absent in the congenital amputees. Whereas phantom limb pain was positively related to cortical reorganization (r=0.87), nonpainful phantom phenomena were not significantly correlated with cortical reorganization (r=0.34). Sensory discrimination was normal and mislocalization (referral of stimulation-induced sensation to a phantom limb) was absent in the congenital amputees. The role of peripheral and central factors in the understanding of phantom limb pain and phantom limb phenomena is discussed in view of these findings.
对5名先天性上肢缺失患者和9名外伤性截肢者的幻肢现象与皮质重组之间的关系进行了研究。神经磁源成像显示，先天性截肢者（M = 0.69 cm，标准差0.24）和无幻肢痛的外伤性截肢者（M = 0.27 cm，标准差0.25）的初级体感皮层重组程度最小；有幻肢痛的截肢者表现出大量的皮质重组（M = 2.22 cm，标准差0.78）。先天性截肢者不存在幻肢痛和无痛性幻肢现象。虽然幻肢痛与皮质重组呈正相关（r = 0.87），但无痛性幻肢现象与皮质重组无显著相关性（r = 0.34）。先天性截肢者的感觉辨别正常，不存在错定（将刺激引起的感觉定位到幻肢）。鉴于这些发现，讨论了外周和中枢因素在理解幻肢痛和幻肢现象中的作用。
