Massage illusion helps amputees

story from news.bbc.co.uk/1/hi/health/7305207.stm


Amputees can feel relief from phantom limb pain just by watching someone else rub their hands together, a study says.
The treatment appears to fool the brain that it is their missing hand being massaged, California researchers say.

New Scientist magazine reports that it harnesses nerve cells in the brain which become active when watching someone else carry out an action.

UK experts said this kind of therapy may help amputees, as long as they can go along with the illusion.

Mirror neurons in the brain fire up when a person performs an intentional action, such as waving, and also when they observe someone else performing the same action.

They are thought to help predict the intentions of others by simulating the action in the mind.

Similar cells exist for touch, and become active both when a person is being touched and when they watch someone else being touched.

Researchers at the University of California, San Diego, say the reason people do not constantly feel what they observe happening to others is that a person's sensory cells do not give the right signals, so they know it is not happening to them.

Ex-soldiers tested

In the study, Vilayanur Ramachandran tested the therapy on ex-soldiers.

His first test used a device called a mirror box, which he developed. An amputee puts their remaining limb, in this case their hand, in front of the mirror and their brain is tricked into thinking the mirror image is actually another working limb.

Two amputees had their normal hand touched while using the mirror box, and felt the sensation of being touched on their missing hand.

In a second experiment, when amputees watched a volunteer's hand being stroked, they also began to experience a stroking sensation arising from their missing limb.

One even said their pain disappeared for between 10 and 15 minutes.

Potential uses

Dr Ramachandran suggested the amputees \"felt\" the actions of others because their missing limb provided no feedback to prevent their mirror neurons being stimulated, and therefore not telling them they were not \"literally\" being touched.

He said: \"If an amputee experiences pain in their missing limb, they could watch a friend or partner rub their hand to get rid of it.\"

But Dr Ramachandran said there could be other uses for the therapy, including helping people who have had strokes.

\"If performed early enough, it may also be used to help stroke patients regain movements by watching others perform their lost actions.\"

Kate McIver, of the Pain Research Institute at Liverpool University, said work done there on helping amputees create mental images of pain-free limbs - which operated on the same basic principle as the US research - had also proved effective.

She said watching massage could help, but added: \"With something external like this, the patient has to accept that the illusion is real for it to work.\"

i have to say that i find this really interesting.

as the report says, this is not just relevant for amputees, but for anyone sufferering from brain damage, eg those having had strokes, multiple sclerosis sufferers,neurosarcoid sufferers to name but a few.



The brain is truly awesome...

xx suzan xx

Mirror Box Therapy: www.mirrorboxtherapy.com/phantom-limb-pain.htm

Phantom Limb Pain:

Phantom sensations are said to be present in in all amputees and in children born with missing limbs.

It is thought that since the sensations are present in children born with missing limbs the human brain is \"hard wired\" in the somatosensory cortex (the strip of brain that runs between the ears) to expect sensation from all 4 limbs.

Phantom pain occurs in up to 80% amputees and unfortunately tends to be therapy resistant and chronic.

Indeed the limb does not need to be lost, phantom pains may occur after a disconnect injury such as a spinal cord injury or brachial plexus avulsion which are common after motorbike accidents.

Phantom pain is typically described as burning aching or as if the limb, foot, hand is being crushed or held in a vice like grip

Mechanism: www.mirrorboxtherapy.com/phantom-limb-pain.htm

Historically the causes of phantom pain have focused on the stump.

Pain has often been ascribed to local nerve stump irritation, however as our knowledge of the nervous system improved the proposed causes of phantom pain have migrated centrally, initially to integration of information in the spinal cord, and then to the central processing of information in the higher centres of the brain especially the somatosensory and motor cortex.

It has recently been postulated that Phantom limb pain is a manifestation of a need like state of the mind to \"feel and see\" the limb move.

This hypothesis is backed by the work that demonstrated reduced pain after use of an electric prosthetic limb, which showed normalisation of the somatosensory cortex in the pain relieved state.

It is also validated by the use of mirror box therapy in the management of phantom pain states.

This concept of phantom pain arising out of an imbalance between the sensory evaluation of incoming information from the missing limb and the motor co-ordination of the limb is now central to both the efficacy of mirror therapy and the modern concept of phantom pain as a central (brain) problem rather than a stump or peripheral problem.

Stroke Rehabilitation: www.mirrorboxtherapy.com/stroke-rehabilitation.htm

Stroke arises from an acute interruption of blood (oxygen and glucose) supply to the brain tissue.

A new and possibly more descriptive term for stroke which has a similar meaning and emphasis as heart attack is \"brain attack\", indeed some hospitals are now organising \"brain attack teams\" to manage the immediate stroke episode in a similar fashion to the more familiar cardiac arrest and trauma teams.

By the nature of the injury and dependant upon the area of damage within the brain, stroke can cause a variety of loss in the motor pathways that control movement.

Within the last few years functional magnetic resonance imaging alongside non-invasive methods of cortical stimulation have begun to reveal the importance of the functional integration of the motor and somatosensory cortex in limb movement.

The evidence for bilateral movement training especially in upper limb rehabilitation is beginning to build.

It has been suggested that visualising and undertaking symmetrical bilateral movements post stroke enhance neuroplastic changes within the brain.

The theories suggest increased disinhibition of the motor cortex allowing increased use of spared pathways within the damaged hemisphere, increased activity of motor command pathways in the affected hemisphere running to the spinal nerves and increased activation of the pathways from the unaffected hemisphere to supplement the damaged crossed corticospinal pathways.

The role of mirror box / visual therapy in this bilateral movement training is central to its success.

Neurosarcoidosis sufferer -

As part of my neuro-physiotherapy, visualisation techniques were a part of my therapeutic programme.

i have had to learn to make this technique a part of my daily living, and use it frequently to gain control when my limbs,fingers etc take on a mind of their own...or when a part of my body is feeling numbness or weakness

It demands a belief that it will succeed, and also an ability to allmost automatically relax inside yr head, before using the technique.

I go through these 3stages many times each day...

xx suzan xx