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We present a novel combined behavioral and neuroimaging protocol employing real-time video projection for the purpose of characterizing the neural correlates associated with mirror therapy within the magnetic resonance imaging scanner environment in leg amputee subjects with phantom limb pain.
Mirror therapy (MT) has been proposed as an effective rehabilitative strategy to alleviate pain symptoms in amputees with phantom limb pain (PLP). However, establishing the neural correlates associated with MT therapy have been challenging given that it is difficult to administer the therapy effectively within a magnetic resonance imaging (MRI) scanner environment. To characterize the functional organization of cortical regions associated with this rehabilitative strategy, we have developed a combined behavioral and functional neuroimaging protocol that can be applied in participants with a leg amputation. This novel approach allows participants to undergo MT within the MRI scanner environment by viewing real-time video images captured by a camera. The images are viewed by the participant through a system of mirrors and a monitor that the participant views while lying on the scanner bed. In this manner, functional changes in cortical areas of interest (e.g., sensorimotor cortex) can be characterized in response to the direct application of MT.
PLP refers to the sensation of pain perceived within the area corresponding to the missing limb postamputation1,2. This condition is a significant chronic health care burden and can have a dramatic impact on an individual's quality of life3,4. It has been suggested that alterations in the brain structure and function play a fundamental role in the development and neuropathophysiology of PLP5,6. However, the underlying neural correlates of how pain symptoms develop and how they can be allevi....
1. Preparation of the subject
Generating the sensation associated with MT using real-time video projection is feasible. Participants have subjectively reported that the video image perceived is life-like and the sensation is immersive.
Furthermore, the patterns of cortical activation associated with MT (i.e., movement of the leg and viewing the projected mirror image) in the scanner environment are robust. In a pilot study, the cortical responses to MT were .......
This protocol describes a novel, feasible procedure that allows investigators to accurately characterize the neural correlates associated with MT in individuals with PLP.
As previously mentioned, past studies have attempted to investigate the neural correlates associated with MT treatment by incorporating various techniques such as video recording, virtual reality, and prerecorded animations9,33,34. H.......
This study was supported by an NIH RO1 grant (1R01HD082302).
....Name | Company | Catalog Number | Comments |
Scanner | Phillips | NA | 3 Tesla Philips Acheiva MRI scanner |
Camera | Logitech | NA | HD Pro Webcam C910 |
Monitor | Cambridge Research Systems | NA | 3D BOLD screen for MRI |
Mirror | TAP Plastics | 99999 | Mirrored Acrylic Sheets (CuttoSize) Clear 1/8 (.118)" Thick, 10" Wide, 40" Long |
Mirror stand | NA | Mirror stand was built by the co-investigators from a rectangular piece of wood | |
Headphones | Westone Sensimetrics | PN 79245 | Replacement comply foam tips for universal-fit earphones. Canal size: Standard 6 pieces/ 3 pair |
MR compatible in ear headphones | |||
MRI Scanner | Phillips | 3.0 T Philips Achieva System |
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