Understanding and Treating Phantom Limb Pain: A Neurotechnological and Neuroscientific Perspective
Doktorsavhandling, 2025
Phantom limb pain (PLP) affects up to 80% of amputees and remains difficult to treat. This dissertation investigates plasticity-guided interventions that target abnormal sensorimotor processing within a unified framework combining transcranial direct current stimulation (tDCS), sensory discrimination training (SDT), and phantom movement (e.g., imagery and execution). A systematic review of PLP/tDCS studies highlights the therapeutic potential of neuromodulation while noting limited mechanistic understanding. Experimental work shows that SDT drives task-specific sensory plasticity (discrimination-based training supports long-lasting somatosensory map refinement, whereas vibration-based training modulates short-term excitability) and that anodal tDCS enhances motor learning relevant to prosthesis control, with potential to reduce PLP. Building on these findings, a clinical protocol integrating tDCS with mindful sensorimotor training is proposed for individuals with PLP to promote durable somatosensory map refinement and pain reduction. Collectively, these studies advance an integrated neuromodulatory and behavioral framework to normalize somatosensory maps and alleviate PLP, while underscoring the need for further mechanistic and rigorous clinical validation.
Phantom Limb Pain
transcranial Direct Current Stimulation
brain plasticity
somatosensory training
plasticity-guided intervention
neuropathic pain
sensory training
pain mechanism
clinical trial
pain treatment and management
neuromodulation
motor training
Opponent: Catherine Mercier, Laval University, Canada
Författare
Shahrzad Damercheli
Chalmers, Mikroteknologi och nanovetenskap, Elektronikmaterial
Imagine losing a limb but still feeling it and sometimes painfully. For many amputees, this phantom limb pain feels as if the missing hand or foot is cramping, burning, or frozen in place. Up to 80% of people who lose a limb experience it yet doctors still struggle to treat it effectively.
My research looks at the problem from the brain’s perspective. After an amputation, the brain’s internal “map” of the body becomes confused, and it continues to expect signals from the missing limb. This mismatch in communication may be what causes the pain in the missing limb. But because the brain is plastic (meaning it can rewire and adapt) it can also be retrained.
I explored ways to guide this plasticity using a combination of gentle brain modulation, tactile exercises that sharpen touch, and movements of the missing limb; yes, it can still feel moveable. The studies show that tactile exercises help refine the brain’s touch maps, while brain modulation enhances motor learning. Together, these methods support the restoration of healthy connections between the brain and body.
Building on these findings, I developed a therapy program that combines brain stimulation with mindful sensorimotor exercises. The goal is to help the brain “update” its body map, reduce confusion, and ultimately ease phantom pain. This work points toward a future where technology and training work hand in hand to help people not just live with limb loss but live comfortably again.
My research looks at the problem from the brain’s perspective. After an amputation, the brain’s internal “map” of the body becomes confused, and it continues to expect signals from the missing limb. This mismatch in communication may be what causes the pain in the missing limb. But because the brain is plastic (meaning it can rewire and adapt) it can also be retrained.
I explored ways to guide this plasticity using a combination of gentle brain modulation, tactile exercises that sharpen touch, and movements of the missing limb; yes, it can still feel moveable. The studies show that tactile exercises help refine the brain’s touch maps, while brain modulation enhances motor learning. Together, these methods support the restoration of healthy connections between the brain and body.
Building on these findings, I developed a therapy program that combines brain stimulation with mindful sensorimotor exercises. The goal is to help the brain “update” its body map, reduce confusion, and ultimately ease phantom pain. This work points toward a future where technology and training work hand in hand to help people not just live with limb loss but live comfortably again.
Ämneskategorier (SSIF 2025)
Nanoteknisk elektronik
Rehabiliteringsmedicin
Neurovetenskaper
Fysioterapi
Neurologi
Annan medicinteknik
DOI
10.63959/chalmers.dt/5768
ISBN
978-91-8103-311-3
Doktorsavhandlingar vid Chalmers tekniska högskola. Ny serie: 5768
Utgivare
Chalmers
Opponent: Catherine Mercier, Laval University, Canada