Phantom limb syndrome: from pathogenesis to treatment. A narrative review.

Giuseppe Granata, Sara Ilari, Riccardo Di Iorio, Benedetta Maria Angeloni, Fabiola Tomasello, Angelo Tiziano Cimmino, Claudia Carrarini, Antonio Marrone, Francesco Iodice

Journal: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology 2024;45(10):4741-4755

PMID: 38853232

Abstract

Phantom Limb Syndrome (PLS) can be defined as the disabling or painful sensation of the presence of a body part that is no longer present after its amputation. Anatomical changes involved in Phantom Limb Syndrome, occurring at peripheral, spinal and brain levels and include the formation of neuromas and scars, dorsal horn sensitization and plasticity, short-term and long-term modifications at molecular and topographical levels. The molecular reorganization processes of Phantom Limb Syndrome include NMDA receptors hyperactivation in the dorsal horn of the spinal column leading to inflammatory mechanisms both at a peripheral and central level. At the brain level, a central role has been recognized for sodium channels, BDNF and adenosine triphosphate receptors. In the paper we discuss current available pharmacological options with a final overview on non-pharmacological options in the pipeline.

© 2024. Fondazione Società Italiana di Neurologia.

Address: Institute of Neurology, Fondazione Policlinico Gemelli IRCCS, Rome, Italy.; Laboratory of Physiology and Pharmacology of Pain, IRCCS San Raffaele, Rome, Italy.; Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy.; Department of Neuroscience, Catholic University of the Sacred Heart, Rome, Italy.; Institute of Neurology and Neurorehabilitation, IRCCS San Raffaele, Via Della Pisana 235, 00160, Rome, Italy.; Institute of Neurology and Neurorehabilitation, IRCCS San Raffaele, Via Della Pisana 235, 00160, Rome, Italy.; Institute of Neurology and Neurorehabilitation, IRCCS San Raffaele, Via Della Pisana 235, 00160, Rome, Italy. [email protected].

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MeSH Terms: Phantom Limb, Humans
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