Hypoesthesia in the distal residual limb of amputees.

To test the emerging hypothesis that there is polymodal fiber degeneration/loss in distal residual limbs (DRL) of amputees. Prospective qualitative and quantitative psychophysical testing. A pain research center at an urban academic rehabilitation hospital. Forty-four amputees (32 with pain, 12 without pain) with a single (upper or lower) limb amputation. Subjects are a clinical "convenience" sample derived from our amputee or prosthetic clinics. Interventions were prospectively acquired psychophysical tests. The primary quantitative test was thermal Quantitative Sensory Testing (tQST) using a Peltier type thermal testing device, assessing sites on the DRL compared with anatomically similar regions on the contralateral "unaffected" extremity. Perceptual responses for several qualitative psychophysical stimuli and perceptual thresholds for tQST cold sensation were significantly reduced in the DRL (t(43)=-2.613, P=.012). There were no significant tQST differences in thresholds for warm perception, cold pain, or hot pain (P>.05). These results show a point prevalence of differential hypoesthesia in distal residual limbs. There was a selective loss of cold, but not warm perception or threshold for hot or cold pain by tQST. There are several possible explanations for this polymodal and selective hypoesthesia; specifically, these data may be indicative of a differential "dying back" peripheral neuropathy of the DRL, which may be operational in such clinical features as postamputation pain.

Harden RN ，Gagnon CM ，Khan A ，Wallach G ，Zereshki A ... -  《PM&R》

Residual limbs of amputees are significantly cooler than contralateral intact limbs.

Harden RN ，Gagnon CM ，Gallizzi M ，Khan AS ，Newman D ... -  《-》

Dissociation of phantom limb phenomena from stump tactile spatial acuity and sensory thresholds.

Hunter JP ，Katz J ，Davis KD 《-》

Phantom pain, residual limb pain, and back pain in amputees: results of a national survey.

Ephraim PL ，Wegener ST ，MacKenzie EJ ，Dillingham TR ，Pezzin LE ... -  《ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION》

Are hot-burning sensations produced by the axonal damage of afferent unmyelinated fibres?

Buonocore M ，Bonezzi C 《-》