Montoya P, Ritter K, Huse E, Larbig W, Braun C, Töpfner S, Lutzenberger W, Grodd W, Flor H, Birbaumer N
Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Germany.
Eur J Neurosci. 1998 Mar;10(3):1095-102. doi: 10.1046/j.1460-9568.1998.00122.x.
The extent of the cortical somatotopic map and its relationship to phantom phenomena was tested in five subjects with congenital absence of an upper limb, four traumatic amputees with phantom limb pain and five healthy controls. Cortical maps of the first and fifth digit of the intact hand, the lower lip and the first toe (bilaterally) were obtained using neuroelectric source imaging. The subjects with congenital upper limb atrophy showed symmetric positions of the left and right side of the lower lip and the first toe, whereas the traumatic amputees with pain showed a significant shift (about 2.4 cm) of the cortical representation of the lower lip towards the hand region contralateral to the amputation side but no shift for the toe representation. In healthy controls, no significant hemispheric differences between the cortical representation of the digits, lower lip or first toe were found. Phantom phenomena were absent in the congenital but extensive in the traumatic amputees. These data confirm the assumption that congenital absence of a limb does not lead to cortical reorganization or phantom limbs whereas traumatic amputations that are accompanied by phantom limb pain show shifts of the cortical areas adjacent to the amputation zone towards the representation of the deafferented body part.
在五名先天性上肢缺失患者、四名患有幻肢痛的创伤性截肢者和五名健康对照者中，测试了皮质躯体定位图的范围及其与幻肢现象的关系。使用神经电源成像获得了完整手部的食指和小指、下唇以及（双侧）大脚趾的皮质图。先天性上肢萎缩患者的下唇和大脚趾左右两侧显示出对称位置，而患有疼痛的创伤性截肢者的下唇皮质表征向截肢侧对侧的手部区域有显著移位（约2.4厘米），但脚趾表征没有移位。在健康对照者中，未发现手指、下唇或大脚趾的皮质表征存在明显的半球差异。先天性患者不存在幻肢现象，而创伤性截肢者中幻肢现象广泛存在。这些数据证实了以下假设：先天性肢体缺失不会导致皮质重组或幻肢，而伴有幻肢痛的创伤性截肢会使截肢区相邻的皮质区域向去传入身体部位的表征发生移位。
