Dorsal Root Ganglion (DRG) Stimulation in the Treatment of Phantom Limb Pain (PLP)

Phantom limb pain (PLP) is a neuropathic condition in which pain is perceived as arising from an amputated limb. PLP is distinct from, although associated with, pain in the residual limb and nonpainful phantom sensations of the missing limb. Its treatment is extremely challenging; pharmaceutical options, while commonly employed, may be insufficient or intolerable. Neuromodulatory interventions such as spinal cord stimulation have generated mixed results and may be limited by poor somatotopic specificity. It was theorized that dorsal root ganglion (DRG) neuromodulation may be more effective.

[1]  E. Krane,et al.  The prevalence of phantom sensation and pain in pediatric amputees. , 1995, Journal of pain and symptom management.

[2]  Patrick D. Wall,et al.  Ongoing activity in peripheral nerves: The physiology and pharmacology of impulses originating from a neuroma ☆ , 1974 .

[3]  M. Hanley,et al.  Self-reported treatments used for lower-limb phantom pain: descriptive findings. , 2006, Archives of physical medicine and rehabilitation.

[4]  J. Czerniecki,et al.  Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. , 2000, Archives of physical medicine and rehabilitation.

[5]  N. Bolognini,et al.  Motor and parietal cortex stimulation for phantom limb pain and sensations , 2013, PAIN®.

[6]  H. Kehlet,et al.  Do we have the tools to prevent phantom limb pain? , 2011, Anesthesiology.

[7]  P. Dijkstra,et al.  Phantom pain and phantom sensations in upper limb amputees: an epidemiological study , 2000, Pain.

[8]  M. Devor,et al.  Simulation in sensory neurons reveals a key role for delayed Na+ current in subthreshold oscillations and ectopic discharge: implications for neuropathic pain. , 2009, Journal of neurophysiology.

[9]  José Carlos Pereira,et al.  The labelled-lines principle of the somatosensory physiology might explain the phantom limb phenomenon. , 2011, Medical hypotheses.

[10]  N Birbaumer,et al.  Effects of Regional Anesthesia on Phantom Limb Pain Are Mirrored in Changes in Cortical Reorganization , 1997, The Journal of Neuroscience.

[11]  J. Miles Prevention of phantom pain after major lower limb amputation by epidural infusion of diamorphine, clonidine and bupivacaine. , 1995, Annals of the Royal College of Surgeons of England.

[12]  A. Kasuya EuroQol--a new facility for the measurement of health-related quality of life. , 1990, Health policy.

[13]  T. Jensen,et al.  Immediate and long-term phantom limb pain in amputees: Incidence, clinical characteristics and relationship to pre-amputation limb pain , 1985, Pain.

[14]  J. McAuley,et al.  Spinal Cord Stimulation for Intractable Pain Following Limb Amputation , 2013, Neuromodulation : journal of the International Neuromodulation Society.

[15]  T. Aziz,et al.  Thalamic deep brain stimulation for neuropathic pain after amputation or brachial plexus avulsion. , 2013, Neurosurgical focus.

[16]  D. Solanki,et al.  Pulsed Radiofrequency Treatment of Lower Extremity Phantom Limb Pain , 2008, The Clinical journal of pain.

[17]  Mark I. Johnson,et al.  Transcutaneous Electrical Nerve Stimulation for Phantom Pain and Stump Pain in Adult Amputees , 2013, Pain practice : the official journal of World Institute of Pain.

[18]  M. Bone,et al.  Gabapentin in Postamputation Phantom Limb Pain: A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Study , 2002, Regional Anesthesia & Pain Medicine.

[19]  T. Deer,et al.  A Prospective Study of Dorsal Root Ganglion Stimulation for the Relief of Chronic Pain , 2013, Neuromodulation : journal of the International Neuromodulation Society.

[20]  B. Simpson Spinal cord stimulation in 60 cases of intractable pain. , 1991, Journal of neurology, neurosurgery, and psychiatry.

[21]  Herta Flor,et al.  Phantom-limb pain: characteristics, causes, and treatment , 2002, The Lancet Neurology.

[22]  H. Flor,et al.  Phantom limb pain: a case of maladaptive CNS plasticity? , 2006, Nature Reviews Neuroscience.

[23]  M. Noreng,et al.  Phantom limb pain in amputees during the first 12 months following limb amputation, after preoperative lumbar epidural blockade , 1988, Pain.

[24]  T. Riechert,et al.  Spinal cord stimulation in post-amputation pain. , 1975, Surgical neurology.

[25]  Steven P. Cohen,et al.  Treatment of Post‐Amputation Pain With Peripheral Nerve Stimulation , 2014, Neuromodulation : journal of the International Neuromodulation Society.

[26]  C. Aldrich,et al.  Phantom limb pain. , 1982, American family physician.

[27]  T. Cameron,et al.  Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review. , 2004, Journal of neurosurgery.

[28]  J. Ewalt,et al.  The Phantom Limb* , 1947, Psychosomatic medicine.

[29]  P. McGrath,et al.  Phantom limb sensations and phantom limb pain in child and adolescent amputees , 1998, Pain.

[30]  P. Kiekkas,et al.  Optimized perioperative analgesia reduces chronic phantom limb pain intensity, prevalence, and frequency: a prospective, randomized, clinical trial. , 2011, Anesthesiology.

[31]  Katharina Wolf,et al.  Spinal Cord Stimulation of the Dorsal Root Ganglion for Groin Pain—A Retrospective Review , 2015, Pain practice : the official journal of World Institute of Pain.

[32]  T. Nurmikko,et al.  Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery , 2008, Brain : a journal of neurology.

[33]  Robert Levy,et al.  A Multicenter, Prospective Trial to Assess the Safety and Performance of the Spinal Modulation Dorsal Root Ganglion Neurostimulator System in the Treatment of Chronic Pain , 2013, Neuromodulation : journal of the International Neuromodulation Society.

[34]  R. Melvill,et al.  Spinal cord stimulation for the management of pain: Recommendations for best clinical practice. , 2013, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[35]  Kenneth M Heilman,et al.  Mirror therapy for phantom limb pain. , 2007, The New England journal of medicine.

[36]  T. Simopoulos,et al.  Pulsed radiofrequency of lumbar dorsal root ganglia for chronic post-amputation stump pain. , 2008, Pain physician.

[37]  J. Gómez-Moreta,et al.  Spinal cord stimulation in deafferentation pain. , 1989, Stereotactic and functional neurosurgery.

[38]  P. McHardy,et al.  Pulsed Radiofrequency Under Ultrasound Guidance for Persistent Stump‐Neuroma Pain , 2011, Pain practice : the official journal of World Institute of Pain.

[39]  V. Tronnier,et al.  Current and future options for the management of phantom-limb pain , 2012, Journal of pain research.

[40]  M. Litt Self-efficacy and perceived control: cognitive mediators of pain tolerance. , 1988, Journal of personality and social psychology.

[41]  John N. Wood,et al.  Parallel “Pain” Pathways Arise from Subpopulations of Primary Afferent Nociceptor , 2005, Neuron.

[42]  S. Kim,et al.  Mirror Therapy for Phantom Limb Pain , 2012, The Korean journal of pain.

[43]  J. Katz,et al.  Methadone for Phantom Limb Pain , 2002, The Clinical journal of pain.

[44]  A. Burton,et al.  Use of Spinal Cord Stimulation in the Treatment of Phantom Limb Pain: Case Series and Review of the Literature , 2010, Pain practice : the official journal of World Institute of Pain.

[45]  V. Ramachandran,et al.  The perception of phantom limbs. The D. O. Hebb lecture. , 1998, Brain : a journal of neurology.

[46]  Y. Hosobuchi,et al.  Phantom limb pain. Treatment with dorsal column stimulation. , 1975, Journal of neurosurgery.

[47]  M. Devor Ectopic discharge in Aβ afferents as a source of neuropathic pain , 2009, Experimental Brain Research.

[48]  C. Woolf Central sensitization: Implications for the diagnosis and treatment of pain , 2011, PAIN.

[49]  I. Curelaru,et al.  Long‐Term Intrathecal Infusion of Opioid and/or Bupivacaine in the Prophylaxis and Treatment of Phantom Limb Pain , 1998, Neuromodulation : journal of the International Neuromodulation Society.

[50]  T. Nurmikko,et al.  A prospective study of factors associated with the presence of phantom limb pain six months after major lower limb amputation in patients with peripheral vascular disease. , 2007, The journal of pain : official journal of the American Pain Society.

[51]  C. Braun,et al.  The cortical somatotopic map and phantom phenomena in subjects with congenital limb atrophy and traumatic amputees with phantom limb pain , 1998, The European journal of neuroscience.

[52]  A. Craig,et al.  Pain mechanisms: labeled lines versus convergence in central processing. , 2003, Annual review of neuroscience.

[53]  F. Bowling,et al.  Phantom limb pain after amputation in diabetic patients does not differ from that after amputation in nondiabetic patients , 2013, PAIN®.

[54]  H. Flor,et al.  Effect of sensory discrimination training on cortical reorganisation and phantom limb pain , 2001, The Lancet.

[55]  Niels Birbaumer,et al.  The effect of opioids on phantom limb pain and cortical reorganization , 2001, Pain.

[56]  G. Broggi,et al.  Italian multicentric study on pain treatment with epidural spinal cord stimulation. , 1994, Stereotactic and functional neurosurgery.

[57]  T. Riechert,et al.  Pain reduction in amputees by long-term spinal cord stimulation. Long-term follow-up study over 5 years. , 1980, Journal of neurosurgery.

[58]  S. Lipton,et al.  Phantom limb pain treated by electrical stimulation , 1978, Pain.

[59]  A. Bandura,et al.  Perceived self-efficacy and pain control: opioid and nonopioid mechanisms. , 1987, Journal of personality and social psychology.

[60]  X. Navarro,et al.  Neural plasticity after peripheral nerve injury and regeneration , 2007, Progress in Neurobiology.

[61]  Krishna Kumar,et al.  Epidural spinal cord stimulation for treatment of chronic pain--some predictors of success. A 15-year experience. , 1998, Surgical neurology.

[62]  Blair H. Smith,et al.  Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis , 2015, The Lancet Neurology.

[63]  F. Huygen,et al.  Lack of Body Positional Effects on Paresthesias When Stimulating the Dorsal Root Ganglion (DRG) in the Treatment of Chronic Pain , 2015, Neuromodulation : journal of the International Neuromodulation Society.

[64]  C. Yampolsky,et al.  Is spinal cord stimulation safe? A review of its complications. , 2014, World neurosurgery.

[65]  M. Devor,et al.  Peripheral nervous system origin of phantom limb pain , 2014, PAIN®.

[66]  M. Maclachlan,et al.  Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation , 2010, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[67]  Jon H Kaas,et al.  The effects of long-standing limb loss on anatomical reorganization of the somatosensory afferents in the brainstem and spinal cord , 2002, Somatosensory & motor research.

[68]  Marc Russo,et al.  Stimulation of Dorsal Root Ganglia for the Management of Complex Regional Pain Syndrome: A Prospective Case Series , 2015, Pain practice : the official journal of World Institute of Pain.

[69]  L. C. Russell,et al.  Pain response to perineuromal injection of normal saline, epinephrine, and lidocaine in humans , 1992, Pain.

[70]  Steven P. Cohen,et al.  The contribution of sympathetic mechanisms to postamputation phantom and residual limb pain: a pilot study. , 2011, The journal of pain : official journal of the American Pain Society.

[71]  G. Schott Delayed onset and resolution of pain: some observations and implications. , 2001, Brain : a journal of neurology.

[72]  T. Jensen,et al.  Randomised trial of epidural bupivacaine and morphine in prevention of stump and phantom pain in lower-limb amputation , 1997, The Lancet.

[73]  Stephen T Wegener,et al.  Phantom pain, residual limb pain, and back pain in amputees: results of a national survey. , 2005, Archives of physical medicine and rehabilitation.

[74]  A. Buness,et al.  Differential Transcriptional Profiling of Damaged and Intact Adjacent Dorsal Root Ganglia Neurons in Neuropathic Pain , 2015, PloS one.

[75]  T. Elbert,et al.  Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation , 1995, Nature.