The four studies in this thesis deal with peripheral and central factors in phantom limb phenomena. Study 1 documents sensations referred to the phantom limb during transcutaneous electrical nerve stimulation (TENS) applied at the outer ears, face, and torso. The results suggest that some phantom sensations are maintained by activity of sympathetic fibers in the stump. Other sensations appear not to involve a peripheral mechanism. Studies 2 and 3 focus on sympathetic nervous system correlates of phantom sensations reported during TENS applied at the outer ears and contralateral leg. The results indicate that TENS significantly reduces the intensity of phantom limb paresthesias whereas a placebo control has no effect. Significant relationships between (a) phantom limb intensity and (b) stump skin conductance and temperature suggest that a cycle of sympathetic-efferent-somatic-afferent activity explains phantom limb paresthesias. Skin temperature was significantly lower at the stump than the intact limb in amputees with phantom limb pain (PLP), but not in those with a painless phantom, or no phantom limb at all, indicating that PLP is associated with reduced blood flow to the stump. Study 4 examines PLP that resembles pain experienced in the limb before amputation. These somatosensory memories constitute compelling evidence of a purely central component of PLP. Finally, amputees with and without PLP could not be differentiated by scores on personality, depression, or anxiety inventories. The results of the four studies indicate that the experience of phantom limb paresthesias involves a central mechanism that acts on peripheral structures whereas others qualities of experience depend exclusively on activation of central neural structures. Implications for treatment, research, and clinical practice are discussed.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.37516 |
| Date | January 1989 |
| Creators | Katz, Joel, 1954- |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (Department of Psychology.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 000927983, proquestno: NN75841, Theses scanned by UMI/ProQuest. |
Page generated in 0.0017 seconds