Phantom limb phenomenon as an example of body image distortion

Open access

Abstract

Introduction: The perception of one’s own body, its mental representation, and emotional attitude to it are the components of so-called “body image” [1]. The aim of the research was to analyse phantom pain and non-painful phantom sensations as results of limb loss and to explain them in terms of body image distortion.

Material and method: Three methods were used in the study of 22 amputees (7 women and 15 men, between 43 and 76 years old, M = 61, SD = 11.3): (1) a clinical interview; (2) The Questionnaire of Body Experiencing after Limb Amputation; (3) modified version of The Pain Questionnaire based on The McGill Pain Questionnaire.

Results: The prevalence of phantom limb pain was 59%. Some various non-painful phantom sensations after amputation were experienced by 77% of respondents. There was a statistically significant relationship between phantom pain and non-painful phantom sensations in a group of participants experiencing phantom limb phenomenon at the moment of the research.

Conclusions: Deformation of body image in the form of phantom pain and non-painful phantom sensations is a frequent experience after limb loss. We suggest that phantom limb is a form of out-of-date or inadequate body image as an effect of the brain activity trying to keep a kind of status quo. A co-occurrence of non-painful phantom sensations and phantom pain suggests that these both forms of post-amputation sensations may share neural mechanisms. Results indicate, that there exists somatosensory memory which may be manifested in similarities between pre- and post-amputation sensations.

1. Gallagher S, Meltzoff AN. The earliest sense of self and others: Merleau-Ponty and recent developmental studies. Philos. Psychol. 1996;9:213–36.

2. Kułakowska Z. Wczesne uszkodzenie dojrzewającego mózgu. Od neurofizjologii do rehabilitacji. Lublin: Wydawnictwo Folium; 2003.

3. Gallagher S, Cole J. Body image and body schema in a deafferented subject. J. Mind Behav. 1995;16:369–89.

4. Giummarra MJ, Gibson SJ, Georgiou-Karistianis N, Bradshaw JL. Mechanisms underlying embodiment, disembodiment and loss of embodiment. Neurosci. Biobehav. Rev. 2008;32:143–60.

5. Jeannerod M. Visual and action cues contribute to the self-other distinction. Nat. Neurosci. 2004;7:422–3.

6. Churchland PS. Self-representation in nervous systems. Science. 2002;296:308–10.

7. Sirigu A, Grafman J, Bressler K, Sunderland T. Multiple representations contribute to body knowledge processing. Evidence from a case of autotopagnosia. Brain J. Neurol. 1991;114 (Pt 1B):629–42.

8. Schwoebel J, Coslett HB. Evidence for multiple, distinct representations of the human body. J. Cogn. Neurosci. 2005;17:543–53.

9. Maravita A, Iriki A. Tools for the body (schema). Trends Cogn. Sci. 2004;8:79–86.

10. Gallagher S. Body schema and intentionality. In: Bermúdez JL, Eilan N, Marcel A, editors. Body Self. Cambridge MA: The MIT Press; 2001. p. 225–44.

11. Gallgher S. How the body shapes the mind. New York: Oxford University Press; 2005.

12. Cole J, Paillard J. Living without touch and peripheral information about body position and movement: Studies with deafferented subjects. In: Bermúdez JL, Eilan N, Marcel A, editors. Body Self. Cambridge MA: The MIT Press; 2001. p. 245–66.

13. Ehde DM, Czerniecki JM, Smith DG, Campbell KM, Edwards WT, Jensen MP, et al. Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. Arch. Phys. Med. Rehabil. 2000;81:1039–44.

14. Goldenberg G. Disorders of body perception. In: Farah MJ, Feinberg TE, editors. Patient-Based Approaches Cogn. Neurosci. Cambridge MA: The MIT Press; 2000. p. 107–14.

15. Hill A. Phantom limb pain: a review of the literature on attributes and potential mechanisms. J. Pain Symptom Manage. 1999;17:125–42.

16. Kooijman CM, Dijkstra PU, Geertzen JH, Elzinga A, van der Schans CP. Phantom pain and phantom sensations in upper limb amputees: an epidemiological study. Pain. 2000;87:33–41.

17. Nikolajsen L, Jensen TS. Phantom limb pain. Br. J. Anaesth. 2001;87:107–16.

18. Wolff A, Vanduynhoven E, van Kleef M, Huygen F, Pope JE, Mekhail N. 21. Phantom Pain. Pain Pract. 2011;11:403–13.

19. Bosmans JC, Geertzen JHB, Post WJ, van der Schans CP, Dijkstra PU. Factors associated with phantom limb pain: a 31/2-year prospective study. Clin. Rehabil. 2010;24:444–53.

20. Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. 2002;1:182–9.

21. Flor H. Phantom limb pain. In: Ramachandran VS, editor. Encycl. Hum. Brain. New York: Elsevier Science; 2002. p. 831–41.

22. Melzack R. From the gate to the neuromatrix. Pain. 1999;Suppl 6:S121–6.

23. Schott GD. Delayed onset and resolution of pain: some observations and implications. Brain J. Neurol. 2001;124:1067–76.

24. Whyte AS, Niven CA. Psychological distress in amputees with phantom limb pain. J. Pain Symptom Manage. 2001;22:938–46.

25. Whyte AS, Niven CA. Variation in phantom limb pain: results of a diary study. J. Pain Symptom Manage. 2001;22:947–53.

26. Montoya P, Larbig W, Grulke N, Flor H, Taub E, Birbaumer N. The relationship of phantom limb pain to other phantom limb phenomena in upper extremity amputees. Pain. 1997;72:87–93.

27. Hsu E, Cohen SP. Postamputation pain: epidemiology, mechanisms, and treatment. J. Pain Res. 2013;6:121–36.

28. Ramachandran VS, Levi L, Stone L, Rogers-Ramachandran D, McKinney R, Stalcup M, et al. Illusions of body image: What they reveal about human nature. In: Llinás R, Churchalnd PS, editors. Mind-Brain Contin. Sens. Process. Cambridge MA: The MIT Press; 1996. p. 29–61.

29. Giummarra MJ, Georgiou-Karistianis N, Nicholls MER, Gibson SJ, Chou M, Bradshaw JL. Corporeal awareness and proprioceptive sense of the phantom. Br. J. Psychol. 2010;101:791–808.

30. Gontarczyk M. Doświadczanie własnego ciała przez pacjentów po amputacjach kończyn [Unpublished master’s thesis]. [Lublin]: Maria Curie-Sklodowska University; 2006.

31. Dobrogowski J, Kuś M, Sedlak K, Wordliczek J. Ból i jego leczenie. Warszawa: Springer PWN; 1996.

32. Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975;1:277–99.

33. Flor H, Nikolajsen L, Staehelin Jensen T. Phantom limb pain: a case of maladaptive CNS plasticity? Nat. Rev. Neurosci. 2006;7:873–81.

34. Li S, Melton DH, Li S. Tactile, thermal, and electrical thresholds in patients with and without phantom limb pain after traumatic lower limb amputation. J. Pain Res. 2015;8:169–74.

Journal Information

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 377 334 22
PDF Downloads 195 185 13