scholarly journals Cognitive Models of Limb Embodiment in Structurally Varying Bodies: A Theoretical Perspective

2021 ◽  
Vol 12 ◽  
Author(s):  
Adna Bliek ◽  
Robin Bekrater-Bodmann ◽  
Philipp Beckerle
Keyword(s):  
Theoretical Perspective ◽  
Basic Research ◽  
Body Representation ◽  
Peripersonal Space ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Specific Situation ◽  
Cognitive Integration ◽  
Modeling Framework ◽  
Artificial Limb

Using the seminal rubber hand illusion and related paradigms, the last two decades unveiled the multisensory mechanisms underlying the sense of limb embodiment, that is, the cognitive integration of an artificial limb into one's body representation. Since also individuals with amputations can be induced to embody an artificial limb by multimodal sensory stimulation, it can be assumed that the involved computational mechanisms are universal and independent of the perceiver's physical integrity. This is anything but trivial, since experimentally induced embodiment has been related to the embodiment of prostheses in limb amputees, representing a crucial rehabilitative goal with clinical implications. However, until now there is no unified theoretical framework to explain limb embodiment in structurally varying bodies. In the present work, we suggest extensions of the existing Bayesian models on limb embodiment in normally-limbed persons in order to apply them to the specific situation in limb amputees lacking the limb as physical effector. We propose that adjusted weighting of included parameters of a unified modeling framework, rather than qualitatively different model structures for normally-limbed and amputated individuals, is capable of explaining embodiment in structurally varying bodies. Differences in the spatial representation of the close environment (peripersonal space) and the limb (phantom limb awareness) as well as sensorimotor learning processes associated with limb loss and the use of prostheses might be crucial modulators for embodiment of artificial limbs in individuals with limb amputation. We will discuss implications of our extended Bayesian model for basic research and clinical contexts.

scholarly journals Mind over matter: Perceived phantom/prosthesis co-location contributes to prosthesis embodiment in lower limb amputees

2021 ◽  
Author(s):  
Robin Bekrater-Bodmann
Keyword(s):  
Lower Limb ◽  
Body Representation ◽  
Phantom Limb ◽  
Negative Consequences ◽  
Cognitive Integration ◽  
Underlying Mechanisms ◽  
Phantom Limbs ◽  
The Relationship ◽  
Theoretical Considerations ◽  
Lower Limb Amputees

Prosthesis embodiment (PEmb) – the cognitive integration of a prosthesis into an amputees’ body representation – has been identified as key feature of prosthetic rehabilitation. However, the underlying mechanisms remain unclear. There is reason to assume that phantom limbs that are experienced as part of the bodily self (phantom self-consciousness, PSC) can affect PEmb, but only if the phantom and the prosthesis can be brought into perceived co-location (phantom prosthesis tolerance, PPT). In the present study, phantom-prosthesis interactions were examined in lower limb amputees, and a PPT component was psychometrically extracted. Mediation analysis revealed an indirect-only effect, where the relationship between PSC and PEmb was mediated by PPT, indicating that phantom limbs can transfer their immanent vividness to the artificial limb. Subsequent analyses suggested that this effect can compensate for negative consequences that arise from phantom limb awareness. These results shape theoretical considerations about the cognitive processes contributing to the bodily self.

Phantom limb, phantom pain and stump pain in amputees during the first 6 months following limb amputation

Pain ◽  
1983 ◽  
Vol 17 (3) ◽  
pp. 243-256 ◽  
Author(s):  
Troels S. Jensen ◽  
Børge Krebs ◽  
Jørn Nielsen ◽  
Peter Rasmussen
Keyword(s):  
Phantom Limb ◽  
Limb Amputation ◽  
Phantom Pain ◽  
Stump Pain

Psychosocial predictors of long-term adjustment to lower-limb amputation and phantom limb pain

2004 ◽  
Vol 26 (14-15) ◽  
pp. 882-893 ◽  
Author(s):  
Marisol A Hanley ◽  
Mark P Jensen ◽  
Dawn M Ehde ◽  
Amy J Hoffman ◽  
David R Patterson ◽  
...  
Keyword(s):  
Lower Limb ◽  
Phantom Limb Pain ◽  
Lower Limb Amputation ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Psychosocial Predictors ◽  
Limb Pain

scholarly journals Effect of tool-use observation on metric body representation and peripersonal space

2020 ◽  
Vol 148 ◽  
pp. 107622 ◽  
Author(s):  
M. Galigani ◽  
N. Castellani ◽  
B. Donno ◽  
M. Franza ◽  
C. Zuber ◽  
...  
Keyword(s):  
Tool Use ◽  
Body Representation ◽  
Peripersonal Space

scholarly journals Phantom Limb Pain: Low Frequency Repetitive Transcranial Magnetic Stimulation in Unaffected Hemisphere

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Andrea Di Rollo ◽  
Stefano Pallanti
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Motor Cortex ◽  
Magnetic Stimulation ◽  
Pain Treatment ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Low Frequency ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Limb Pain

Phantom limb pain is very common after limb amputation and is often difficult to treat. The motor cortex stimulation is a valid treatment for deafferentation pain that does not respond to conventional pain treatment, with relief for 50% to 70% of patients. This treatment is invasive as it uses implanted epidural electrodes. Cortical stimulation can be performed noninvasively by repetitive transcranial magnetic stimulation (rTMS). The stimulation of the hemisphere that isn't involved in phantom limb (unaffected hemisphere), remains unexplored. We report a case of phantom limb pain treated with 1 Hz rTMS stimulation over motor cortex in unaffected hemisphere. This stimulation produces a relevant clinical improvement of phantom limb pain; however, further studies are necessary to determine the efficacy of the method and the stimulation parameters.

Surgical Treatment of Chronic Phantom Limb Sensation and Limb Pain after Lower Limb Amputation

2006 ◽  
Vol 118 (7) ◽  
pp. 1562-1572 ◽  
Author(s):  
Lukas Prantl ◽  
Stephan Schreml ◽  
Norbert Heine ◽  
Marita Eisenmann-Klein ◽  
Peter Angele
Keyword(s):  
Surgical Treatment ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Limb Pain

scholarly journals Research priorities for lower limb amputation in patients with vascular disease

2021 ◽  
Author(s):  
David Bosanquet ◽  
Sandip Nandhra ◽  
Kitty Wong ◽  
Judith Long ◽  
Ian Chetter ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Lower Limb ◽  
Healthcare Professionals ◽  
Research Priorities ◽  
Lower Limb Amputation ◽  
Nominal Group ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Specific Research ◽  
Research Questions

Introduction Lower limb amputation is a life-changing event for patients and can be associated with high mortality and morbidity rates. Research into this critical part of vascular surgery is limited. The Vascular Society of Great Britain and Ireland (VSGBI) in partnership with the James Lind Alliance (JLA) process, aimed to identify and develop key research priorities for amputation. Methods A modified JLA Priority Setting Partnership was undertaken, encompassing all vascular practice. Two separate Delphi processes to identify research topics were undertaken with healthcare professionals, patients and carers, led by the VSGBI. The priorities were then ranked by the same participants and amalgamated to produce a list for final prioritisation. The final consensus meeting was attended by patients, carers and healthcare professionals from a variety of backgrounds involved in the care of people with amputation. Using a nominal group technique, the top ten research priorities were identified. Results A total of 481 clinicians submitted 1231 research questions relating to vascular surgery in general. 63 amputation-specific research questions were combined into 5 final clinical questions. 373 patients or carers submitted 582 research questions related to vascular surgery in general. Nine amputation-specific research questions were identified after combining similar questions. Amalgamating both the clinician and patient questions, 12 questions were discussed at the final prioritisation meeting and the top 10 identified. These related to amputation prevention, supporting rehabilitation, improving clinical outcomes following amputation (preventing/treating pain including phantom limb pain and improving wound healing) and research into information provision for patients undergoing amputation. Conclusion The top 10 research priority areas in vascular amputation provide guidance for researchers, clinicians, and funders on the direction of future research questions that are important to both healthcare professionals and patients.

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