Pathophysiology of Post Amputation Pain.

摘要

Post amputation pain (PAP) is highly prevalent and a prominent factor in disability, yet we know little about the specific pathophysiology. The number of amputees in the United States is over 450,000 with an estimated 1,300 from Operations Iraqi and Enduring Freedom. Studies indicate an incidence of PAP ranging between 64- 100% and prevalence over 80%. Conversely, only 1% of veterans with PAP reported lasting benefit from any treatment attempted. It is very likely that this failure to identify effective treatments stems from the lack of a coherent or comprehensive theory of pathophysiology; thus the rationale for this proposal. Based on our preliminary data we hypothesized that there is distinct and measurable pathophysiology(s) of the peripheral, central and sympathetic nervous systems that occur in response to the amputation of a limb. New technologies and novel implementation of standard techniques allowed us to clarify these explicit mechanisms. The study was designed using validated psychometric, psychophysical and biometric testing correlated with standard (afferent) regional nerve/neuroma and (efferent) sympathetic nerve blocks, in the final results, we will report descriptive statistics and pain reports, and report on brain anatomical reorganization with phantom limb pain.