Neural Bases of Phantom Pain After Amputation

Study Overview
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Brief Summary
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The amputation of a limb results in chronic pain associated with the lost limb in the majority of patients, which persists over time. Despite a large number of studies conducted in an attempt to elucidate the neural basis of phantom pain, these are still not elucidated and current treatments often fail to relieve patients' pain.

Official Title
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Experimental Study of the Neural Bases of Phantom Pain After Amputation and Their Modification by Proprioceptive Training: MRI Study of the Brain and Spinal Cord

Conditions
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Phantom Pain

Intervention / Treatment
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* Other: Questionnaires
* Device: Brain and Spinal Cord functional Magnetic Resonance Imaging
* Other: Proprioceptive training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Between 18 and 65 years old For the amputees with phantom pain group: patients who have been amputated for more than 2 years and have chronic phantom pain For the amputees without phantom pain group: patients who have been amputated for more than 2 years and do not have chronic phantom pain For the healthy participants group: healthy participants with no neurological history Exclusion Criteria: Clinically significant pathology (gastrointestinal, renal, hepatic, endocrine, cardiovascular or respiratory) Progressive psychiatric or neurological pathology On psychotropic medication Pregnant or nursing woman Inadequate level of French language

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Amputees with phantom pain<br>Adult patients who have been amputated for more than 2 years and have chronic phantom pain | Other: Questionnaires<br>* Short-Form McGill Pain Questionnaire (SF-MPQ) Pain Disability Index (PDI) Prosthesis Evaluation Questionnaire (PEQ) Psychological Inflexibility to Pain Scale (PIPS) Chronic Pain Acceptance Questionnaire (CPAQ) Cognitive Difficulties Scale (CDS) Amputee Body Image Scale (ABIS) Trinity Amputation and Prosthesis Experience Scales (TAPES) Pain Catastrophizing Scale (PCS) Hospital Anxiety and Depression Scale (HAD) Credibility/Expectancy Questionnaire (CEQ) Short-Form Edinburgh Handedness Inventory (SF-EHI) Patient's Global Impression of Change (PGIC)<br>Device: Brain and Spinal Cord functional Magnetic Resonance Imaging<br>* Brain and Spinal Cord functional Magnetic Resonance Imaging<br>Other: Proprioceptive training<br>* Proprioceptive muscular training via a mechanical vibration of low amplitude and frequency between 60 and 80 Hz applied to the tendons.<br>|
| Amputees without phantom pain<br>Adult patients who have been amputated for more than 2 years and do not have chronic phantom pain | Other: Questionnaires<br>* Short-Form McGill Pain Questionnaire (SF-MPQ) Pain Disability Index (PDI) Prosthesis Evaluation Questionnaire (PEQ) Psychological Inflexibility to Pain Scale (PIPS) Chronic Pain Acceptance Questionnaire (CPAQ) Cognitive Difficulties Scale (CDS) Amputee Body Image Scale (ABIS) Trinity Amputation and Prosthesis Experience Scales (TAPES) Pain Catastrophizing Scale (PCS) Hospital Anxiety and Depression Scale (HAD) Credibility/Expectancy Questionnaire (CEQ) Short-Form Edinburgh Handedness Inventory (SF-EHI) Patient's Global Impression of Change (PGIC)<br>Device: Brain and Spinal Cord functional Magnetic Resonance Imaging<br>* Brain and Spinal Cord functional Magnetic Resonance Imaging<br>|
| Healthy participants<br>Healthy adult participants with no neurological history | Device: Brain and Spinal Cord functional Magnetic Resonance Imaging<br>* Brain and Spinal Cord functional Magnetic Resonance Imaging<br>Other: Proprioceptive training<br>* Proprioceptive muscular training via a mechanical vibration of low amplitude and frequency between 60 and 80 Hz applied to the tendons.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in brain activity, measured through fMRI, following proprioceptive training | Brain activity (BOLD hemodynamic response) will be measured via fMRI before and after proprioceptive training sessions. | Up to 3 months | 
| Change in spinal cord activity, measured through spinal fMRI, following proprioceptive training | Spinal cord activity (BOLD hemodynamic response) will be measured via spinal fMRI before and after proprioceptive training sessions. | Up to 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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fMRI, spinal fMRI