Phantom limbs in people with congenital limb deficiency or amputation in early childhood

Melzack, Ronald; Israel, R. G.; Lacroix, Renée; Schultz, Gregory S.

doi:10.1093/brain/120.9.1603

Cited by 246 publications

(131 citation statements)

References 3 publications

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“…This idea of a hardwired blueprint is not Table 2 Dreaming about the body as before the amputation (n = 45) Dreaming about the body as after the amputation (n = 30) new. Melzack, Israël, Lacroix, and Schultz (1997) discussed phantom limb sensations in subjects born without limbs. They argued that the basic experience of the body is not solely based on information pathways fed by sensory input, but that the body image is determined also partly by genetic factors.…”

Section: Discussionmentioning

confidence: 99%

Born to adapt, but not in your dreams

Mulder

Hochstenbach

Dijkstra³

et al. 2008

Consciousness and Cognition

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The brain adapts to changes that take place in the body. Deprivation of input results in size reduction of cortical representations, whereas an increase in input results in an increase of representational space. Amputation forms one of the most dramatic disturbances of the integrity of the body. The brain adapts in many ways to this breakdown of the afferent-efferent equilibrium. However, almost all studies focus on the sensorimotor consequences. It is not known whether adaptation takes place also at other ''levels'' in the system. The present study addresses the question whether amputees dream about their intact body, as before the amputation, or about the body after the amputation and whether the dream content was a function of time since the amputation and type of amputation. The results show that the majority of the dreamers reported dreams about their intact body although the mean time that elapsed since the amputation was twelve years. There is no clear relation with the type of amputation. The results give modest evidence for the existence of a basic neural representation of the body that is, at least, partly genetically determined and by this relatively insensitive for changes in the sensory input.

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Section: Discussionmentioning

confidence: 99%

Born to adapt, but not in your dreams

Mulder

Hochstenbach

Dijkstra³

et al. 2008

Consciousness and Cognition

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show abstract

“…We are born with a full-blown potential for imaging body parts" (Abramson and Feibel 1981, p 99). In more moderate terms, a genetically built-in component for a body schema was described by Melzack (1990;Melzack et al 1997). According to this author, a widespread network of thalamocortical and limbic loops (the "neuromatrix") is basically innate, but continuously shaped during a person's life by sensory inputs and motor commands.…”

Section: Phantoms Of Congenitally Absent Limbs As Manifestations Of Amentioning

confidence: 99%

“…There is anecdotal evidence for phantom sensations being triggered by the observation of other people moving their limbs, both in cases of traumatic amputation (Henderson and Smyth 1948) and congenital limb deficiency (Melzack et al 1997). A woman born without arms and legs described how visually observing her sister's movements could evoke feeling these movements as if they were her own: (Frank 1986, p 191) Extensive work with a woman born without forearms and legs (AZ; 44 years old at the time of testing; see Fig.…”

Section: Phantoms Of Congenitally Absent Limbs As Manifestations Of Tmentioning

confidence: 99%

Incarnation and animation: physical versus representational deficits of body integrity

Hilti

Brugger

2009

Exp Brain Res

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Hilti, L; Brugger, P (2010). Incarnation and animation: physical versus representational deficits of body integrity. Experimental Brain Research, 204(3) AbstractTwo apparently disparate phenomena of defective body integrity are reviewed. The first concerns dysmelia, characterized by the congenital absence or deformation of limbs, and the focus of the review is on phantom sensations of people with this kind of physical integrity disorder. The second phenomenon consists of non-psychotic individuals' desire to have a healthy limb amputated, which is interpreted as a mismatch between the physical integrity of a particular limb and its representation in multimodal cortical areas of the brain. We outlined commonalities and differences between the two conditions and note the absence, in both areas of research, of a unified theory that would account for the reported phenomenology. Phantom limbs in dysmelia and the desire for limb amputation most likely are the consequence of very early developmental dissociations between physical and phenomenal body shapes. They are mirror images of one another in that the former constitutes an "animation without incarnation" and, the latter, an "incarnation without animation". Keywords-body integrity identity disorder (BIID) -paraphilias -parietal lobes -body image, body schema -borderlands of psychiatry and neurology 2 This paper examines two apparently disparate phenomena of corporeal awareness. In both, the completeness or integrity of one's own body is hampered. The first is the occurrence of phantom limbs in individuals born with an "incomplete" body, in which the physical body is incomplete, but the missing limb seems to be represented in the subject's brain, at least as can be inferred from its phenomenal presence. The second phenomenon is the strong desire, by non-psychotic and otherwise well-adjusted healthy individuals, to have a fully functional limb removed. In this condition, it can be argued that despite the physical presence of a limb, the lack of acceptance is due to some underrepresentation in the subject's brain. We review the literature on both conditions and propose that phantom sensations of physically absent limbs and the request for removal of normally developed extremities may be mirror images of one another on the conceptual level: an animation without incarnation and an incarnation without animation, respectively.

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“…accident); 100% of these amputees report phantom sensations (Ritchie, 1980; Krane and Heller, 1995), while 83-100% experience phantom pain (Krane and Heller, 1995; Ritchie, 1980, respectively). More recently, Melzack et al (1997) reported that phantoms were experienced by 33% of individuals who were either born without alimb (12%) or underwent surgical amputation prior to 6 years of age (21%). Several attempts have been made to formulate a theoretical basis for phantom sensations and phantom pain.…”

Section: Introductionmentioning

confidence: 99%