University of Oxford
Following hand amputation, individuals face an incredible challenge to adapt to
their disability. Moreover, medical rehabilitation provides them with limited help,
particularly for those amputees who suffer from ‘phantom limb pain’ - pain which is
perceived to come from the amputated limb. It has been estimated to occur in up
to 80% of amputees, and therefore poses a significant medical problem. The
unusual problem that medical staff face in treating phantom limb pain, is that the
pain arises from a part of the body that no longer exists.
How can we perceive pain from an already amputated hand? It is possible that
even though the hand is no longer a part of the body, the brain still ‘remembers’ it.
Indeed, sensory deprevation, such as following hand amputation, leads to a
‘recruitment’ of the recently-deprived cortex by neighbouring areas, so that brain
cells that responded to a touch on the hand, will now respond to a similar touch on
the face – the cortical neighbour of the hand. The practical everyday
consequences of these massive changes are not clear to us. It is possible that
those body parts which benefit from additional responses in the brain will now
enjoy enhanced sensory abilities, thus allowing the amputee to develop keener
sensations. Alternatively, it has been suggested that this extensive reorganization
is mal-adaptive, and might therefore contribute to the generation of phantom pain.
My project will take a fresh approach to study the “domino effects” in the brain
following hand amputation, and its adaptive and mal-adaptive consequences,
using the latest brain imaging techniques. For example, I would like to investigate
whether the intact hand can benefit from the newly ‘unemployed’ brain areas.
Once we have characterized the brain changes that follow hand amputation we
could guide the amputees to take advantage of these changes, rather than to
suffer from them.
Interests and expertise (Subject groups)