Abstract
Many neuropsychological theories agree that the brain maintains a relatively persistent representation of one’s own body, as indicated by vivid “phantom” experiences. It remains unclear how the loss of sensory and motor information contributes to the presence of this representation. Here, we focus on new empirical and theoretical evidence of phantom sensations following damage to or an anesthetic block of the brachial plexus. We suggest a crucial role of this structure in understanding the interaction between peripheral and central mechanisms in health and in pathology. Studies of brachial plexus function have shed new light on how neuroplasticity enables “somatotopic interferences”, including pain and body awareness. Understanding the relations among clinical disorders, their neural substrate, and behavioral outcomes may enhance methods of sensory rehabilitation for phantom limbs.
Highlights
Deafferentation, or limb loss, has a dramatic impact on the neural representation of the body [1], silencing all sensory and proprioceptive signals that flow in the primary somatosensory and primary motor cortex to enable limb control [2,3]
We suggest a crucial role of this structure in understanding the interaction between peripheral and central mechanisms in health and in pathology
Experiencing the sensation of a missing body part, which is known as a “phantom limb sensation”, is an extremely common condition in people experiencing any type of deafferentation—i.e., amputation, spinal cord injury, and other neurologic conditions [4]
Summary
Deafferentation, or limb loss, has a dramatic impact on the neural representation of the body [1], silencing all sensory and proprioceptive signals that flow in the primary somatosensory and primary motor cortex to enable limb control [2,3]. Experiencing the sensation of a missing body part, which is known as a “phantom limb sensation”, is an extremely common condition in people experiencing any type of deafferentation—i.e., amputation, spinal cord injury, and other neurologic conditions [4]. Phantom limb sensations elicited by the stimulation of body sites neurally adjacent to the affected limb are reported in 60–95% of individuals with amputated limbs [13,14] This phenomenon is frequently reported in cases of an intact limb with a loss of sensory and motor innervation, either due to nerve avulsion [15] or a spinal cord injury [16]. There is a paucity of research regarding the brachial plexus, which may instead serve as a model to investigate important questions regarding somatotopy, pain, embodiment, and neural reorganization
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