Flor H. EU - Europäische Union 230249: ERC PHANTOMMIND: Phantom phenomena: A window to the mind and the brain. 01/2009-12/2014.
Phantom experiences occur in almost all amputees but are among the least understood sensory phenomena. Recently changes in the representation of body maps in the brain were found to be related to phantom pain and it has also been demonstrated that there are great similarities between non-painful phantoms and bodily illusions such as the rubber hand illusion. This research has also shown that the brain does not process the physical but the perceived reality, which opens the door to manipulations of the perceived reality in basic research and the treatment of phantom pain. Behavioural intervention methods such as prosthesis, sensory discrimination or mirror training influence phantom limb pain and alter brain function. Thus, phantom phenomena are an excellent tool to study the neural basis of somatosensory and specifically bodily perception and this can lead to new treatment methods such as brain-computer interfaces or virtual reality applications for phantom pain and similar pain states. The aim of this project is (1) an exact assessment and analysis of the interrelationship of various phantom phenomena such as phantom limb awareness, painful phantom sensation, telescoping, prosthesis use and proneness to bodily illusions or plasticity of body image in a large sample of amputees, (2) the analysis of the neural correlates of these phenomena in small subgroups of amputees using functional magnetic resonance imaging as well as transcranial magnetic stimulation, (3) the analysis of determinants and neural correlates of bodily illusions in healthy controls to identify potential common neural mechanisms and (4) use of prosthesis and virtual reality training early after amputation in order to understand how manipulations of the body image and sensory feedback alter the development and the brain correlates of phantoms.
Flor H. BMBF - Bundesministerium für Bildung und Forschung 01EC1010D: LOGIN: Localized and generalized musculoskeletal pain: psychobiological mechanisms and implications for treatment. 02/2011-01/2014.
In this subproject we will examine to what extent enhanced central sensitization and deficient descending inhibition as assessed by stress analgesia are core characteristics of widespread muskuloskeletal pain and how they differ in localized pain. We will also evaluate to what extent early life stress, comorbidity with mental disorder and pain-related resources and coping strategies modulate these centrally mediated responses. To test these hypotheses we will use behavioural and subjective, and psychophysical pain assessments and combine them with functional magnetic resonance imaging of
sensitization and stress analgesia in patients with localized and widespread pain compared to patients with depression, posttraumatic stress disorder and matched healthy controls. By using compounds that modulate the endocannabinoid system we will assess its role in sensitization and descending inhibition. Finally, we will define subgroups of patients with varying extent of these psychobiological markers and
develop mechanism-based treatment interventions that can be tested in the next funding period. In cooperation with #3/Schmelz, we will examine the central effects and nerve growth factor and in cooperation with #7/Becker we will examine treatment-related effects on these core variables.