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Figure 1. Reorganization in primary somatosensory and motor cortex in a group of people with unilateral upper limb amputation and phantom limb pain (left), and persons after amputation of one arm without phantom limb pain (right). The participants had the task to puck their lips at a metronome paced speed while functional MRI were taken. Note that only in people with actions and phantom limb pain a shift of the cortical mouth representation into the hand representation has occurred, whereas the people with amputation and without pain do not display a similar shift.
(Figure omitted. See article PDF.)
Figure 2. Schematic diagram incorporating the main factors thought to be relevant for the development of phantom limb pain.
(Figure omitted. See article PDF.)
Phantom limb pain or phantom pain is defined as pain felt in the place of a missing body part. It may be related to a certain position or movement of the phantom and may be elicited or exacerbated by a range of physical (e.g., changes in weather or pressure on the residual limb) and psychological factors (e.g., emotional stress). It seems to be more intense in the distal portions of the phantom and may have a number of different qualities such as stabbing, throbbing, burning or cramping. Phantom limb pain is often confused with pain in the area adjacent to the amputated body part. This phenomenon is referred to as residual limb pain or stump pain, and is usually positively correlated with phantom limb pain. In addition, post-amputation pain at the site of the wound must be distinguished from acute postoperative pain in the residual limb and phantom limb pain, which may all co-occur in the early phase after amputation and may contribute to later (chronic) phantom limb pain. It may also be useful to assess acute and chronic pre-amputation pain, which was found to be related to the incidence, type and severity of phantom limb pain in the phase following amputation. Phantom pain must be viewed in the context of nonpainful phantom sensation that involves phantom limb awareness as well as discrete phantom sensations, phantom limb movement and body perception, as well as body ownership in general [1]. Phantom limb pain is commonly classified as neuropathic pain and is assumed to...