Phantom Sensations Research Articles

Phantom vibration and ringing syndromes among Indian medical students

Mobile phones are now crucial to our everyday routines, transforming how we interact, granting immediate access to information, fostering social bonds, facilitating shopping, advancing healthcare, enriching education, increasing productivity, and broadening entertainment choices. However, excessive phone usage can result in a higher prevalence of physical or psychological disorders. Phantom sensations, such as Phantom Vibration Syndrome (PVS) and Phantom Ringing Syndrome (PRS), describe the experience of feeling vibrations or hearing ringing from a phone when it is not actually vibrating or ringing. The objectives of the present study are a) to develop a self-administered smartphone addiction scale (SAS) among medical students at a tertiary care facility and b) to find out the aggravating factors for PVS and PRS among medical students in a tertiary care hospital. Our study was a cross-sectional observational survey conducted among 473 medical undergraduate students, using stratified random sampling to select the participants. The self-administered questionnaire was developed based on the Smartphone Addiction Scale (SAS), which is validated and efficient for evaluating smartphone addiction. Among the participants, 46% were males and 54% were females. Our study reported that 60% of the students experienced phantom vibration/ringing syndrome, 53% had poor sleep patterns due to excessive use of mobile phones, 58% felt their lives would be empty without phones, 57% thought about mobile phones even when they were not in their hands, and 56% felt the urge to use their smartphones again right after they stopped using them. About 58% of the students preferred talking with smartphone buddies to hanging out with real-life friends or other family members, reflecting poor socialization among young adults. We recommend a qualitative analysis of behavioural and psychological components to explore the root cause of this issue. Literature on the causes of phantom sensations/vibrations has been limited, with existing theories lacking a comprehensive perspective.

Comparison of Two Different Dexmedetomidine Doses and Their Effect on the Duration of Spinal Anesthesia in Lower Limb Amputation Surgeries

Abstract Background Spinal anesthesia is a very common technique used in lower limb surgeries. Dexmedetomidine is a highly selective α2-adrenergic agonist which has been used as pre-medication and as an adjuvant to general anesthesia. It is found that injection of dexmedetomidine intrathecally prolongs both sensory and motor block and has antinociceptive action for both visceral and somatic pain by depressing the release of nociceptive C fibers transmission and hyperpolarization of post synaptic dorsal horn cells. Objective To compare the effect of addition of different doses of dexmedetomidine to bupivacaine on the duration of spinal anesthesia, quality of block, intraoperative and postoperative complications and postoperative analgesia in patients undergoing lower limb amputation surgeries. Methods This prospective double blind randomized controlled clinical trial was done on sixty six adult patients of both sexes, aging from 21 to 60 years old, ASA I and II presented to Ain Shams University Hospitals for lower limb amputation surgeries were involved in this study during the period from July 2021 till May 2022. Results The addition of dexmedetomidine to bupivacaine in spinal anesthesia significantly prolonged both sensory and motor blockades duration compared with bupivacaine alone. It was significantly faster in group B (2.1 ± 0.124) compared with A and C groups (2.64 ± 0.34) and (4.72± 0.31) respectively and in group A compared with group C. They also prolonged the time of postoperative analgesia as evidenced by significantly longer time to first rescue analgesia Time to first call for rescue analgesia was significantly longer in group B (350 ± 45 mins) compared with A(287.41 ± 40.83 mins) and C(192 ± 42 mins) groups and in group B compared with group A. Also, there was significant difference in number of analgesic doses in group B compared to A and C groups and in group B compared to group A. Lower VAS scores with minimal adverse effects and hemodynamic stability. Comparing two different doses of dexmedetomidine showed that 15μg dexmedetomidine caused more prolongation of the spinal block duration and the time of postoperative analgesia than dexamethasone. It also decreased shivering during spinal anesthesia with only 4 patients compared to group A with 8 patients and group C with 9 patients. Conclusion 5μg dexmedetomidine seems to be an attractive as an adjuvant to spinal bupivacaine in surgical procedures. It provided good quality of intraoperative analgesia, hemodynamically stable conditions, minimal side effects, and excellent quality of postoperative analgesia. Unfortunately, it had not any effect on incidence or severity of phantom pain and sensation in lower limb amputation surgery, but 15μg had better time of analgesia and longer time till the patient needed rescue analgesia with lower VAS score with no remarkable difference in the side effect as revealed.

Phantom sensation in genital gender-affirming surgery: a narrative review.

To review findings related to phantom genital sensation, emphasizing phantom sensation in the transgender and gender diverse (TGD) population. We discuss prevalence, presentation and potential implications for sensory outcomes in genital gender-affirming surgery. There is a high prevalence of phantom genital sensations in the TGD population. The prevalence varies by body part, approaching 50% in the most frequently reported transgender phantom - the phantom penis. Unlike genital phantoms that occur after trauma or surgery which are often painful, transgender phantoms are typically neutral and often erogenous in experience. Phantom sensation in the TGD population can be an affirming experience and important part of sexual well being and embodiment. Recent studies have begun to characterize the prevalence and presentations of phantom genital sensations in TGD people, informing our evolving understanding of the sensory experiences of the transgender and gender diverse population. Targeting integration of these centrally-mediated phantom genital sensations with the peripherally generated sensation from genital stimulation may represent one potential avenue to improve sensation and embodiment following genital gender-affirming surgical procedures. Additionally, emerging techniques in modern peripheral nerve surgery targeting phantom pain may offer potential treatment options for painful phantom sensation seen after cases of genital surgery or trauma.

Patients After Mastectomy: The Prevalence of Phantom Breast Syndrome and Its Effect on Depression

Background: Phantom breast syndrome (PBS) following mastectomy has been believed to be a complex psychological reaction to mastectomy but studies on PBS are limited. The study aims to determine the prevalence of phantom breast syndrome and the impact of phantom breast syndrome on patients suffering from depression following mastectomy. Methods: A total of 272 women who had undergone mastectomy were interviewed using a structured questionnaire related to phantom breast sensation and depression caused by its effect by using ‘’Hamilton Depression Scale’. SPSS Statistics v27 was used to analyze the data. Results: Out of 272 females, 7.4% of the participants in our study reported having phantom sensations following surgery, 64.7% had Phantom Breast Syndrome,37.5% had mild, 5.1% had moderate, and 0.7% had severe depression according to ‘Hamilton Depression Scale’. Univariate logistic regression revealed that females under 45 have a higher likelihood of developing phantom breast syndrome compared to those over 45 (OR=2.012, p=0.038). Conclusion: Females with depression have a higher likelihood of experiencing phantom breast syndrome compared to females without depression.

Phantom sensation: Threshold and quality indicators of a tactile illusion of motion

Utilizing a randomized, blind, controlled experiment, and the ascending method of limits, we determined the minimum amplitude of motion at which individuals perceive a tactile illusion called moving phantom sensation, the perceived level of clarity and continuity of motion. Implementing tactile illusions in virtual/augmented reality, sensory substitution systems, and other human–computer interaction technologies results in interfaces with improved resolution, using two vibrating actuators only. The actuators are attached to the skin in different locations to render a moving phantom sensation. The intensity of vibrations increases in one actuator while decreases in the other according to the envelope of the voltage supply signals. This intensity variation creates the illusion of a vibrating point moving between the actuators. We gradually increased the amplitude of motion until the participant reported perceiving the illusion, for eight values of duration of the stimulus from 0.1 to 6.0 s. Participants perceived the illusion at a minimum amplitude of motion of 20%; being 100% the motion from one actuator to the other. The median level of clarity of the perceived illusion at the minimum amplitude of motion was 2 (not so clear). Finally, we found a positive correlation between duration and continuity of motion.

Women's Experiences of Sequelae After Mastectomy: A 3, 6, and 12 Months' Follow-up Study.

Postoperative experiences after breast cancer surgery, such as lymphedema, phantom breast sensations, persistent chronic pain, and changes in body image and sexuality, can negatively impact women's quality of life. To investigate women's experiences of sequelae at 3, 6, and 12 months after mastectomy. A survey including women ≥18 years, cognitively intact, and Danish speaking was conducted from May 2021 to October 2021. The researchers contacted the participants by telephone using 4 validated questionnaires investigating phantom sensation, body image, quality of life, and sexuality. Forty-four women were eligible for participation, and 23 (14 women aged ≤65 years and 9 women aged >66 years) were included in the analysis. The results showed an overall decrease in the severity of physical sequelae and an improvement in body image and sexual function. However, the women reported concerns about the future and decreased sexual enjoyment. Nearly half of the women received information about sexuality from healthcare professionals. The study demonstrated decreased sequelae during the follow-up period. Still, there seem to be unanswered questions concerning the quality of life and the content of information regarding sexuality. The findings require attention and further research to benefit the individual woman and her partner in accommodating the consequences after mastectomy. Persistent pain and concerns for the future are present for half of the women after 1 year. Information about possible changes in sexuality is not standard. A nurse-patient dialogue that discusses hospitalization and sexuality on an individual level can be a way to address concerns and challenges.

Application of AR technology in the treatment of Phantom Limb Pain

In recent years, with the continuous occurrence of accidents such as car accidents, wars, engineering accidents, natural disasters, tumors and vascular diseases, the number of patients with limb disability due to amputations or accidental injuries is also increasing. phantom limb pain (PLP), one of the main complications after amputation, has attracted increasing attention. Phantom limb pain, also known as phantom limb pain, refers to the subjective feeling that the amputated limb still exists, and is accompanied by varying degrees of pain, and the pain is mostly in the distal end of the amputated limb. Most phantom pain is combined with stump pain or phantom sensation. There are as many as 37 treatments for PLP, considering the high frequency of its occurrence and how much it affects patients. They can be broadly categorized as pharmacotherapy, physical therapy, and psychotherapy. Each of these therapies has its own drawbacks, which AR technology is well equipped to make up for.

A Case of Upper Limb Amputation Managed with USG-guided Continuous Infraclavicular Nerve Block for Improved Postoperative Analgesia

Phantom Limb Pain (PLP) is defined as any perceived painful sensation localised to the region of the amputated body part, while phantom limb sensations are non painful sensations emanating from the phantom limb, including proprioceptive awareness, kinetic, exteroceptive, and superadded sensations. The mode of anaesthesia administered during amputation is an important factor in determining the emergence of PLP or phantom sensations. The majority of patients requiring emergency care are victims of traumatic injuries to the upper limbs, which are most often treated conservatively. The authors present the case of a 67-yearold male patient who sustained a fall on his arm while carrying a metal container, resulting in a laceration to his left arm that led to disruption of brachial artery blood flow, necessitating amputation. Although upper limb injuries are relatively common, concurrent vascular injuries are rare. However, when a major vessel such as the brachial artery is injured, amputation may be required. This loss of a limb can result in PLP. To prevent this, the authors used a unique and rare protocol of Continuous Peripheral Nerve Block (CPNB) in the present case. It not only underscored the importance of intraoperative analgesia in preventing PLP but also proved to be a crucial anaesthetic tool in facilitating the surgery and providing the patient with a more comfortable postoperative recovery.

The prevalence of phantom pain among limb amputee patients in Saudi Arabia

Objective: This study aimed to assess the prevalence of phantom pain among limb amputee patients in Saudi Arabia, in addition to assess the limb amputee patients' perception of phantom pain, and to assess limb amputee patients in Saudi Arabia current challenges. Methods: This was a questionnaire-based cross-sectional survey that was conducted between March and July 2023, among the limb amputee patients in Saudi Arabia, aged above 18 years. The study used the snowball sampling technique to recruit the participants. An electronic survey was distributed using social media platforms. Results: A total of 120 patients participated in this study comprising of 54.2% males, 33.3% aged 36–45 years, and 95.0% Saudis. Diabetes mellitus was the most common reason for amputation among the patients (35.0%). More than half (67.5%) reported of phantom sensation in the extremities, and a similar percentage (65.8%) suffered from phantom pain in the extremities. Conclusion: Overall, phantom pain is a common issue among amputees, with diabetes mellitus being the most common cause for amputation. Most patients reported having phantom sensation and suffering from phantom pain, especially among patients aged 36-45 years, it was six times higher than the other participants. However, patients with amputation levels below the knee were less likely to suffer from phantom pain.

HapticPilot

The emergence of vibrotactile feedback in hand wearables enables immersive virtual reality (VR) experience with whole-hand haptic rendering. However, existing haptic rendering neglects inconsistent sensations caused by hand postures. In our study, we observed that changing hand postures alters the distribution of vibrotactile signals which might degrade one's haptic perception. To address the issues, we present HapticPilot which allows an in-situ haptic experience design for hand wearables in VR. We developed an in-situ authoring system supporting instant haptic design. In the authoring tool, we applied our posture-adaptive haptic rendering algorithm with a novel haptic design abstraction called phantom grid. The algorithm adapts phantom grid to the target posture and incorporates 1D & 2D phantom sensation with a unique actuator arrangement to provide a whole-hand experience. With this method, HapticPilot provides a consistent haptic experience across various hand postures is available. Through measuring perceptual haptic performance and collecting qualitative feedback, we validated the usability of the system. In the end, we demonstrated our system with prospective VR scenarios showing how it enables an intuitive, empowering, and responsive haptic authoring framework.

Prevalence, temporal course and risk factors for phantom eye symptoms in uveal melanoma

BackgroundPhantom eye symptoms (PES), particularly phantom visual sensations (PVS) and phantom eye pain (PEP), are common in enucleated patients and can lead to psychological distress. Current cross-sectional studies cannot examine the temporal course of symptoms, nor can they identify dynamic risk factors or consequences of PES.MethodsCohort study of 105 enucleated uveal melanoma patients returning self-report questionnaires, within 4 weeks of diagnosis and 6-, 12- and 24-months post-treatment. Questionnaires measuring PVS and PEP symptoms in the week prior to completion, pain severity, Hospital Anxiety and Depression Scale scores and the Functional Assessment of Cancer Therapy scale (FACT-G) measuring quality of life.ResultsPVS and PEP emerged after 6 months, were relatively stable over the study and did not remit. PVS showed 6-, 12- and 24-month prevalence rates of 44.6%, 48.2% and 30.2%, and PEP 16.1%, 18.4% and 17.5% respectively. PVS were generally elementary, with only 10–15% of the total cohort experiencing complex sensations. PEP was generally neither prolonged nor intense, except in a small proportion. PVS and PEP were showed moderate associations but did not predict each other prospectively. Anxiety within 4 weeks of diagnosis was a risk factor for the initiation of PEP. Neither PVS nor PEP prospectively predicted anxiety, depression or quality of life.ConclusionsPES were prevalent and non-remitting, beginning within 6 months of enucleation. PVS and PEP may not represent symptoms of a coherent syndrome. We discuss findings with reference to theories of phantom sensations, and directions for clinical practise and research.

Targeted Nipple Reinnervation in Gender-affirming Mastectomy Using Autologous Nerve Graft.

Our team recently described targeted nipple reinnervation (TNR) during female-to-male gender-affirming mastectomy with free nipple grafting using either direct nerve coaptation or nerve allograft. The goals of TNR are to improve sensation (including erogenous sensation) and prevent numbness, paresthesias, chronic pain, and phantom sensation. Here, we describe our modified technique, which has evolved to use autologous intercostal nerve branches as donor nerves for reinnervation if direct nerve coaptation cannot be achieved. During TNR, the T3-T5 sensory branches are preserved and coapted to the repositioned nipple-areolar complex (NAC). In patients with donor nerves that were not adequate in length to allow for direct coaptation, autologous intercostal nerve branches were not used for coaptation (branches present along the chest wall that would otherwise be lost) or one of the T3-T5 branches were harvested. An end-to-end nerve repair between the autograft and donor nerves was done, and the donor nerve/autograft complex was coapted to the NAC. Targeted muscle reinnervation was performed after autograft harvest to prevent neuroma formation. TNR with intercostal nerve autograft is technically feasible in female-to-male gender-affirming mastectomy with free nipple grafting when direct coaptation is not possible. Chest reinnervation using autologous intercostal nerve branches as donor nerves is another option for reinnervation when the nerves are too short for direct coaptation. Because the collection of long-term data is ongoing, the effectiveness of NAC reinnervation using our technique will be described in a future publication.

Investigating gait variability in amputees with phantom sensation

Investigating gait variability in amputees with phantom sensation

Effect of feeling the phantom sensation during gait on spatiotemporal gait characteristics in individuals with transtibial amputation

Effect of feeling the phantom sensation during gait on spatiotemporal gait characteristics in individuals with transtibial amputation

The neuroanatomical hallmarks of chronic tinnitus in comorbidity with pure-tone hearing loss

Tinnitus is one of the main hearing impairments often associated with pure-tone hearing loss, and typically manifested in the perception of phantom sounds. Nevertheless, tinnitus has traditionally been studied in isolation without necessarily considering auditory ghosting and hearing loss as part of the same syndrome. Hence, in the present neuroanatomical study, we attempted to pave the way toward a better understanding of the tinnitus syndrome, and compared two groups of almost perfectly matched individuals with (TIHL) and without (NTHL) pure-tone tinnitus, but both characterized by pure-tone hearing loss. The two groups were homogenized in terms of sample size, age, gender, handedness, education, and hearing loss. Furthermore, since the assessment of pure-tone hearing thresholds alone is not sufficient to describe the full spectrum of hearing abilities, the two groups were also harmonized for supra-threshold hearing estimates which were collected using temporal compression, frequency selectivity und speech-in-noise tasks. Regions-of-interest (ROI) analyses based on key brain structures identified in previous neuroimaging studies showed that the TIHL group exhibited increased cortical volume (CV) and surface area (CSA) of the right supramarginal gyrus and posterior planum temporale (PT) as well as CSA of the left middle-anterior part of the superior temporal sulcus (STS). The TIHL group also demonstrated larger volumes of the left amygdala and of the left head and body of the hippocampus. Notably, vertex-wise multiple linear regression analyses additionally brought to light that CSA of a specific cluster, which was located in the left middle-anterior part of the STS and overlapped with the one found to be significant in the between-group analyses, was positively associated with tinnitus distress level. Furthermore, distress also positively correlated with CSA of gray matter vertices in the right dorsal prefrontal cortex and the right posterior STS, whereas tinnitus duration was positively associated with CSA and CV of the right angular gyrus (AG) and posterior part of the STS. These results provide new insights into the critical gray matter architecture of the tinnitus syndrome matrix responsible for the emergence, maintenance and distress of auditory phantom sensations.

The effect of dorsal column lesions in the primary somatosensory cortex and medulla of adult rats

Spinal cord injury is a devastating condition that haunts human lives. Typically, patients experience referred phantom sensations on the hand when they are touched on the face. In adult monkeys, massive deafferentations such as chronic dorsal column lesions at higher cervical levels result in the large-scale expansion of face inputs into the deafferented hand cortex of area 3b. However, adult rats with thoracic dorsal column lesions do not demonstrate such large-scale reorganization. The large-scale face expansion in area 3b of monkeys is driven by the reorganization of the cuneate nucleus in the medulla. The sprouting of afferents from the trigeminal nucleus to the adjacent deafferented cuneate nucleus is facilitated by close proximity and compactness of the medulla in primates. Previously, in adult rats with thoracic lesions, the cuneate nucleus was not deafferented and its functional organization was not explored. The extent of the deafferentation and the duration of the recovery period are two major factors that determine the extent of reorganization. Hence, higher cervical (C3-C4) dorsal column lesions were performed, which cause massive deafferentations, and physiological maps were obtained after prolonged recovery periods (3 weeks -18 months). In spite of the above, the expansion of the intact face inputs was not observed in the deafferented zones of the primary somatosensory cortex (SI) and medulla of adult rats. The deafferented forelimb and hindlimb representations in SI were unresponsive to cutaneous stimulation of any part of the body. The cuneate and gracile nuclei in rats with complete dorsal column lesions remained mostly inactive except for a few sites which responded to stimulation of the spared upper arm. Hence, dorsal column lesions have different effects on the adult primate and rodent somatosensory systems. Appreciating this inter-species difference can aid in identifying the underlying neural substrates and restrict maladaptive reorganizations to cure phantom sensations.

Frequency of phantom limb pain, limb sensation and stump pain among amputees

Objective: To quantify the frequency of phantom limb pain, limb sensation and stump pain among amputees aging 20–75 years. Methods: An observational cross-sectional study was done. A population of 75 amputees were selected using non-probability convenient sampling and after setting the inclusion and exclusion criteria. Standard questionnaires; Groningen Questionnaire Problems after Arm Amputation (GQPAA) and Groningen Questionnaire Problems after Leg Amputation (GQPLA), were filled by interviewing the patients. All the patients were approached in the hospitals. Data was collected from Pakistan Institute of Medical Sciences, Islamabad and Fauji Foundation Hospital, Rawalpindi. The duration of study was 6 months from June 2021 to December 2021. Results: After compiling all the results from the questionnaires, it was unveiled that among 75 amputees, mean age was 43.12±11.43 years. Out of these amputees, 53.3% were upper limb amputees and 46.7% were lower limb amputees. the frequency of phantom sensation was 62.7%, 57.3% reported phantom limb pain and 84% experienced stump pain. Conclusion: The study concluded that most prevalent among the population was stump pain, which was followed by phantom limb sensations and the least prevalent of these three was phantom limb pain among the population.

An insight into phantom sensation and the application of ultrasound imaging to the study of gesture motions for transhumeral prosthesis

An insight into phantom sensation and the application of ultrasound imaging to the study of gesture motions for transhumeral prosthesis

Phantom sensation with painful stimuli

Phantom sensation with painful stimuli

An insight into phantom sensation and the application of ultrasound imaging to the study of gesture motions for transhumeral prosthesis

An insight into phantom sensation and the application of ultrasound imaging to the study of gesture motions for transhumeral prosthesis