Clinical issue theory presented: Nuero-phantom theory of phantom-limb pain. Applications from electrical engineering adopted to explain neurological deficit or phenomena of phantom limb pain.
Clinical issues: NeuroPhantom psychological theory through explanations adopted from electrical engineering.
1. LESSONS IN PSYCHOLOGY FROM CLINICAL ISSUES OF CHRONIC ILLNESS:
AMPUTATION AND PHANTOM-LIMB PAIN
Psychology of Neuro-phantom theory; psychological theory derived from theories in electrical engineering
(April, 2019)
NEURO-PHANTOM THEORY
We see that relevant psychological and neuro-divisional heuristics that are set in place within
the elementary structures of psychology are numerous. We know some about phantom pain –
while it is a well-known phenomenon in modern medicine. How we approach this problem is
with normal analgesics, yet through neuropsychology, and neurofeedback there is potential to
assist with this “disorder” by brain training or positive / forward neurofeedback training /
strategies. We could believe that this phenomena is due to both – the structures and neuronal
pathways that make the brain recognize the pain in the missing limb is still active, and intact
(except for the missing limb) because the brain has not had time or the proper experience to
differentiate the network of nerves and neurons, as the brain is continuously balancing the
neuromatrix / neuro-network that this limb does exist. Other hypothesis we must admit are
theories that the encoding of the brain such as specificity coding, population coding and sparse
coding theories have some congruency or relevance with this anomaly / dysfunction (Goldstein
& Brockmole, 2017, P. 364)
In theory this pain makes sense to come from such severe damage to tissue that neuropathic
messages are permanently adrift, therefore the person “ends up” with a neurological disorder of
“damage induced population coding” yet subordinately a “defect” to the population coding.
Defining this term as where the brain is reading from the body that there has been defect
induced, and the body reads this neurologically compound with mnemonic factors that tell the
body only “defected.”
If in fact there is population coding within these neurons or nerves that once connected these
limbs, we could theorize that the population coding (in which entails a bundle, or many neurons
firing to relay or decode the message) is a potentially faulty system because there are not
“specific” neurons firing for the exact location of the pain. Where we see that the sparse coding
(focusing the brain on exact neuronal connections) would solve the problem; if in fact the
neurons involved were using sparse coding the connection would be cut off / wiring would be
inexistent. But in fact, since the “population” of neurons are portraying a generalized message,
since there is no way to pinpoint the actual pain, the body cannot actualize that there is no limb,
it instead relays a generalized message of pain echoing from that proximity - defected and
approximated.
BIO-PLASTICITY TREATMENT
Generalized Biofeedback or neurofeedback processes would be prime interventions for these
anomalies / for these nociceptive pain reactions, because of streamlining psychological concepts
that we believe so entirely. We can use biofeedback strategies to assist in the changes of brain
function and neurology (within the cortex) by teaching and using psychological heuristics /
methods, and using these methods as navigational leverage points for instigating these brain
2. changes. We can use thus: the practice effect, cortical responding affect by attention,
neuropsychological plasticity, “site specific visual feedback” (Diers, 2013); the gate theory
model by Melzak and Patrick wall (1965, 1983, 1988) we can also use Mullers concept of
specific nerve energies, Rachlin (2005) [where nerves and neurons have one function at a time,
even if bimodal, and the body may have no other connection to the world but neuronal activity
and movements thereof].
We could also introduce strengthening brain connectivity between the Dorsal anterior cingulate
cortex and the somatosensory areas (which are known modules in the recognition of pain) and
the prefrontal cortex (in which was found if lesioned, would botch the ability to make decisions;
as well PC as processes sensory stimuli linked to planning of the dorsolateral prefrontal cortex)
(Suny Orange, 2019). We also could strengthen the idealization and visualization of perceptual
response vs. speed of responding to stimulus in biofeedback sessions (with EEG and EMG )–
perhaps and in hopes to bypass the autonomic response to the pain and to adjust the neural
network to obey the CNS network, that involves that the limb does not exist, doing so with
biofeedback both by nerve response and connection and psycho-plasticity. (Goldstein &
Brockmole, 2017, P. 132, 351).
Maybe the best treatment goal is to initiate excitatory response changes to be read as
"inhibitory."
Diers, M. (2013). Site-specific visual feedback reduces pain perception. Pain. 154. (6).
P.890-896. Retrieved March 7, 2019
from http://vh7qx3xe2p.search.serialssolutions.com/?ctx_ver=Z39.88-
2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-
8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2
Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Site-
specific+visual+feedback+reduces+pain+perception&rft.jtitle=Pain&rft.au=Diers%2C
+Martin&rft.au=Zieglg%C3%A4nsberger%2C+Walter&rft.au=Trojan%2C+J%C3%B
6rg&rft.au=Drevensek%2C+Annika+Mira&rft.date=2013&rft.issn=0304-
3959&rft.eissn=1872-
6623&rft.volume=154&rft.issue=6&rft.spage=890&rft.epage=896&rft_
id=info:doi/10.1016%2Fj.pain.2013.02.022&rft.externalDBID=n%2Fa&rft.externalDo
cID=52532328&paramdict=en-US (Links to an external site.)Links to an external site..
Goldstein, B. & Brockmole, J. (2017). Sensation and Perception, 10, P. 132, 351. Cengage
Learning. ISBN 978-1-305-58029-9.
Rachlin, H. (2005). What Muller’s law of specific nerve energies says about the mind. Behavior
and Philosophy, 33, P. 41-54. Cambridge Center for Behavioral Studies. Stony Brook University.
Retrieved April 15, 2019 from http://www.behavior.org/resources/171.pdf (Links to an external
site.)Links to an external site. .
Suny Orange. (2019). Prefrontal cortex. Orange County Community College, [online article].
Retrieved April 15, 2019
from http://bio.sunyorange.edu/updated2/THINKING_EVOLUTION/disorders/web/prefrontal.ht
m (Links to an external site.)Links to an external site. .
from Amputation
3. Apr 15, 2019 10:59pm
Jacob Stotler
To Whom it may,
What a good post, this makes me wonder where we would find such a clinician / acupuncturist.
I presumed that acupuncture was an Ancient art, but still rare. I could acknowledge the utility of
the device on a CNS level, or spinal cord level, where we know that motor neurons reach out
from the spinal cord and sensory neurons reach back from the skin, to the spinal cord, and then to
the brain. So if we can rehabilitate somewhere along this pathway, and train the body to
recognize that it loses sensitivity and location to the phantom limb somewhere along these two
paths, we may have a good chance of shaping a better / more responsive circuit. The person
needs to know, the brain needs to know, the spinal cord needs to know, and the receptors and
neurons on the limb (where the limb ends) need to know clearly that the path ends where in fact
the path ends.
My question is do you think there are any factors that can be one at surgery, or changes to
surgical procedures that may assist with the problem of phantom limb pain?
from
Apr 15, 2019 11:05pm
Jacob Stotler
P.S. I had never read anything like this. Good work!
from
Apr 15, 2019 11:27pm
Jacob Stotler
Good article, the stories that you brought to the discussion were very valuable glimpses
of what makes up the seriousness of phantom pain, and what kind of realism is
involved. I had never heard of strength training for this, and I appreciate hearing it now,
this seems viable psychologically and physiologically. For your question, I do think that
neurology is one answer that would assist for sanative treatment.
My question is do you think that virtual reality could ever be an effective application for
this? Do we have any brain scan domains of these phenomena in people? Are these
pains in the same location as the pains were with the actual limb?
I wanted to introduce one article from my post - "Nuero-phantom theory." - M. Diers
(2013) found numerous things. One large finding within the study was that biofeedback
involving a "gaud" enlarged hand helped mitigate the feeling of pain when people saw
the big hand go over the area in which was in pain.
References
Diers, M. (2013). Site-specific visual feedback reduces pain perception. Pain. 154. (6).
4. P.890-896. Retrieved March 7, 2019
from http://vh7qx3xe2p.search.serialssolutions.com/?ctx_ver=Z39.88-
2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-
8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Ao
fi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Site-
specific+visual+feedback+reduces+pain+perception&rft.jtitle=Pain&rft.au=Dier
s%2C+Martin&rft.au=Zieglg%C3%A4nsberger%2C+Walter&rft.au=Trojan%2
C+J%C3%B6rg&rft.au=Drevensek%2C+Annika+Mira&rft.date=2013&rft.i
ssn=0304-3959&rft.eissn=1872-
6623&rft.volume=154&rft.issue=6&rft.spage=890&rft.epage=896&a
mp;rft_id=info:doi/10.1016%2Fj.pain.2013.02.022&rft.externalDBID=n%2Fa&r
ft.externalDocID=52532328&paramdict=en-US (Links to an external site.)Links to
an external site..