Background:Patients with brachial plexus avulsion (BPA) usually experience phantom sensations and phantom limb pain (PLP) in the deafferented limb. It has been suggested that evoking the sensation of touch in the deafferented limb by stimulating referred sensation areas (RSAs) on the cheek or shoulder might alleviate PLP. However, feasible rehabilitation techniques using this approach have not been reported. Objective:The present study sought to examine the analgesic effects of simple electrical stimulation of RSAs in BPA patients with PLP. Methods:Study 1: Electrical stimulation of RSAs for 60 minutes was conducted for six BPA patients suffering from PLP to examine short-term analgesic effects. Study 2: A single case design experiment was conducted with two BPA patients to investigate whether electrical stimulation of RSAs was more effective for alleviating PLP than control electrical stimulation (electrical stimulation of sites on side opposite to the RSAs), and to elucidate the long-term effects of electrical stimulation of RSAs. Results:Study 1: Electrical stimulation of RSAs evoked phantom touch sensations in the deafferented limb, and significantly alleviated PLP (p < 0.05). Study 2: PLP was alleviated more after electrical stimulation on RSAs compared with control electrical stimulation (p < 0.05). However, the analgesic effects of electrical stimulation on RSAs were observed only in the short term, not in the long term (p > 0.05). Conclusions:Electrical stimulation of RSAs not only evoked phantom touch sensation but also alleviated PLP in the short term. The results indicate that electrical stimulation of RSAs may provide a useful practical rehabilitation technique for PLP. Future studies will be required to clarify the mechanisms underlying immediate PLP alleviation via electrical stimulation of RSAs.

中文翻译：

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电刺激牵涉感觉区减轻幻肢痛

背景：臂丛神经撕脱伤 (BPA) 患者通常在传入神经的肢体中出现幻觉和幻肢痛 (PLP)。有人提出，通过刺激脸颊或肩部的参考感觉区 (RSA) 来唤起听障肢体的触觉可能会减轻 PLP。然而，尚未报道使用这种方法的可行康复技术。目的：本研究旨在检验单纯电刺激 RSA 对 BPA 合并 PLP 患者的镇痛作用。方法：研究 1：对 6 名患有 PLP 的 BPA 患者进行 RSA 电刺激 60 分钟，以检查短期镇痛效果。研究 2：对两名 BPA 患者进行了单例设计实验，以研究 RSA 的电刺激是否比对照电刺激（对 RSA 对面的部位进行电刺激）在缓解 PLP 方面更有效，并阐明了长期影响RSA 的电刺激。结 研究 2：与对照电刺激相比，对 RSA 进行电刺激后 PLP 的缓解更多（p < 0.05）。然而，电刺激对 RSA 的镇痛作用仅在短期内观察到，而不是在长期内观察到 (p > 0.05)。结论：RSA 的电刺激不仅引起幻觉触觉，而且在短期内减轻了 PLP。结果表明 RSA 的电刺激可能为 PLP 提供有用的实用康复技术。未来的研究将需要阐明通过电刺激 RSA 立即缓解 PLP 的机制。