It’s All Just Smoke & Mirrors

Abstract

I t ’ s all just smoke & mirrors B S J Liza Raffi Ever since the invention of the mirror, man has used his reflection as a tool for composing and constructing body image. Research into potential therapies for a novel pain syndrome has taken this age-old practice a step further by exploring whether a mirror’s virtual image can trick the brain into integrating into that body image a limb that no longer exists, allowing one to control and exercise it. Phantom limb pain, which affects over 85% of upper and lower extremity amputees, is at once clinically well documented and etiologically confounding. Written off in the past as a psychological maladjustment to the emotional and practical upheaval resulting from losing a limb, phantom limb pain has been increasingly examined in the last two decades from a neuroscience perspective geared toward understanding its potential physiological underpinnings. Mirror Visual Feedback (MVF) therapy, developed by Dr. Vilayanur Ramachandran, has made preliminary strides both as a therapeutic option for treating phantom limb pain and as a research tool for teasing apart the various causal mechanisms that could be at play. In this article we will take a look at the methods and merits of MVF, as well as interesting insights into the plasticity of adult neural networks that have been uncovered by Ramachandran and others’ work. While the sensations experienced as pain in a phantom limb vary and may depend on numerous factors – the limb removed, the length of time spent with injury before its removal, use of a prosthesis – sensations of cramping, stretching, paralysis, and intermittent sharp pain are among those most frequently described. Medications, such as narcotics and antidepressants, have had some success in slowing or preventing the uncontrolled pain signals but come with a wide array of side effects, including risks of addiction and dependence. Nerve blocks, slightly more invasive, use the injection of a local anaesthetic or corticosteroid between “One patient was even able to eliminate awareness of a phantom limb altogether -- what Ramachandran calls the first amputation of a phantom limb!” 10 • B erkeley S cientific J ournal • S ymmetry • F all 2015 • V olume 20 • I ssue 1