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Prevalence of Phantom Phenomena in Congenital and Early-Life Amputees

  • Martin Diers
    Correspondence
    Address reprint requests to Martin Diers, PhD, Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Alexandrinenstrasse 1-3, 44791 Bochum, Germany.
    Affiliations
    Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
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  • Xaver Fuchs
    Affiliations
    Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Department of Psychology, Paris-Lodron-University of Salzburg, Centre for Cognitive Neuroscience, Salzburg, Austria
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  • Robin Bekrater-Bodmann
    Affiliations
    Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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  • Herta Flor
    Affiliations
    Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, SMI®, Aalborg University, Aalborg, Denmark
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Published:October 20, 2022DOI:https://doi.org/10.1016/j.jpain.2022.10.010

      Highlights

      • Investigation of painful and non-painful phantom phenomena in 99 unilateral congenital amputees
      • Comparison to 153 persons with an amputation before the age of seven
      • Lower prevalence and intensity of phantom limb pain in congenital amputees
      • Comparable results for residual pain and non-painful phantom limb sensations

      Abstract

      Phantom limb pain (PLP) is a common consequence of the amputation of a limb. Persons with congenital limb absence (congenital amputees) or an acquired limb amputation at an early age seem to rarely experience PLP. However, the number of available studies and their sample sizes are low. In the present cross-sectional study, we assessed the presence of several phantom phenomena in a sample of 99 adult unilateral congenital amputees (con) of whom 34 had a limb correction later in life (limbc) and 153 adult participants with a unilateral amputation before the age of 6 years (subgroups: amputation between birth and 2 years (0-2y; n = 48), 3-4 years (3-4y; n = 46), and 5 to 6 years (5–6y; n = 59)). We found a higher prevalence and intensity of PLP in the 5-6y group compared to the other groups. Residual limb pain (RLP) intensity was higher in the 3 to 4 y and 5 to 6 y groups compared to the con group. Non-painful phantom limb sensation (PLS) intensity and telescoping intensity were higher in the 5 to 6 y group compared to the con and 0 to 2 y groups. Our results indicate that PLP prevalence as well as intensity is low when the limb loss happened before the age of 5 years.

      Perspective

      The prevalence of phantom limb pain, residual limb pain, and non-painful phantom limb sensation in congenital amputees and participants with an amputation early in life is low. This might be due to the missing or reduced nociceptive input from the residual limb to the brain and higher development-associated adaptability of the somatosensory system.

      Key words

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