ArticleClinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology2020
Structural and functional motor cortex asymmetry in unilateral lower limb amputation with phantom limb pain.
Article in Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Neural correlates of phantom motor execution: A functional neuroimaging systematic review and meta-analysis.Cortex; a journal devoted to the study of the nervous system and behavior · 2024Pooled it
- The Analgesic Effect of Transcranial Direct Current Stimulation in Fibromyalgia: A Systematic Review, Meta-Analysis, and Meta-Regression of Potential Influencers of Clinical Effect.Neuromodulation : journal of the International Neuromodulation Society · 2023Pooled it
- [Randomized Controlled Trial of the Effects of Repetitive Transcranial Magnetic Stimulation and Mirror Therapy on Phantom Limb Pain in Amputees].Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2022Trial
- Increased motor cortex inhibition as a marker of compensation to chronic pain in knee osteoarthritis.Scientific reports · 2021Trial
- Effects of Combined and Alone Transcranial Motor Cortex Stimulation and Mirror Therapy in Phantom Limb Pain: A Randomized Factorial Trial.Neurorehabilitation and neural repair · 2021Trial
- Understanding intracortical excitability in phantom limb pain: A multivariate analysis from a multicenter randomized clinical trial.Neurophysiologie clinique = Clinical neurophysiology · 2021Trial
- Ipsilateral inhibitory rTMS restores interhemispheric motor cortex balance and reduces phantom limb pain: an exploratory longitudinal nTMS mapping study.Journal of neuroengineering and rehabilitation · 2026Article
- Functional-Structural Plasticity Associated With the Duration of Sports Participation in Lower Limb Amputees: A Multimodal Neuroimaging Study.Neural plasticity · 2026Article
- Compensatory Failure of Autonomic Regulation in Phantom Limb Pain and Its Correlation with Maladaptive Plasticity: A Cross-Sectional HRV Study in Amputees.Biomedicines · 2025Article
- Maladaptive Compensatory Neural Mechanisms Associated with Activity-Related Osteoarthritis Pain: Dissociation of Psychological and Activity-Related Neural Mechanisms of WOMAC Pain and VAS Pain.Journal of clinical medicine · 2025Article
- Defective Intracortical Inhibition as a Marker of Impaired Neural Compensation in Amputees Undergoing Rehabilitation.Biomedicines · 2025Article
- Neurophysiological Markers of Adaptation and Compensation Following Lower Limb Amputation: An Analysis of EEG Oscillations and Clinical Predictors from the DEFINE Cohort Study.Neurology international · 2025Article
- A Dissociation Between Primary Motor Cortex Reorganization and Correlation with Pain Intensity in Phantom Limb Pain: A Systematic Review of fMRI Studies.International journal of general medicine · 2025Review
- Alterations in spontaneous brain activity of maintenance hemodialysis patients with restless legs syndrome: a cross-sectional case-control study.BMC neurology · 2024Article
- Disruptive compensatory mechanisms in fibromyalgia syndrome and their association with pharmacological agents.Experimental brain research · 2024Article
- Neuropsychiatric drugs and a neurophysiological marker as predictors of health-related quality of life in patients with phantom limb pain.Pain medicine (Malden, Mass.) · 2024Article
- The Endogenous Pain Modulatory System as a Healing Mechanism: A Proposal on How to Measure and Modulate It.NeuroSci · 2024Review
- The Impact of Obesity as a Peripheral Disruptor of Brain Inhibitory Mechanisms in Fibromyalgia: A Cross-Sectional Study.Journal of clinical medicine · 2024Article
- Real-time motion-enabling positron emission tomography of the brain of upright ambulatory humans.Communications medicine · 2024Article
- Developing transcranial direct current stimulation as a treatment for phantom limb pain: from pilot mechanistic studies to large clinical studies.Principles and practice of clinical research (2015) · 2024Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectiveThe role of motor cortex reorganization in the development and maintenance of phantom limb pain (PLP) is still unclear. This study aims to evaluate neurophysiological and structural motor cortex asymmetry in patients with PLP and its relationship with pain intensity.
methodsCross-sectional analysis of an ongoing randomized-controlled trial. We evaluated the motor cortex asymmetry through two techniques: i) changes in cortical excitability indexed by transcranial magnetic stimulation (motor evoked potential, paired-pulse paradigms and cortical mapping), and ii) voxel-wise grey matter asymmetry analysis by brain magnetic resonance imaging.
resultsWe included 62 unilateral traumatic lower limb amputees with a mean PLP of 5.9 (SD = 1.79). We found, in the affected hemisphere, an anterior shift of the hand area center of gravity (23 mm, 95% CI 6 to 38, p = 0.005) and a disorganized and widespread representation. Regarding voxel-wise grey matter asymmetry analysis, data from 21 participants show a loss of grey matter volume in the motor area of the affected hemisphere. This asymmetry seems negatively associated with time since amputation. For TMS data, only the ICF ratio is negatively correlated with PLP intensity (r = -0.25, p = 0.04).
conclusionThere is an asymmetrical reorganization of the motor cortex in patients with PLP, characterized by a disorganized, widespread, and shifted hand cortical representation and a loss in grey matter volume in the affected hemisphere. This reorganization seems to reduce across time since amputation. However, it is not associated with pain intensity. SIGNIFICANCE: These findings are significant to understand the role of the motor cortex reorganization in patients with PLP, showing that the pain intensity may be related with other neurophysiological factors, not just cortical reorganization.
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