r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2023-28-6-4-10r-n-j-498Research ArticleОБЗОРЫREVIEWSФантомная боль: современные представления о механизмах формирования и мишенях терапевтического воздействияPhantom limb pain: actual concepts of pathophysiology and therapeutic targetshttps://orcid.org/0000-0001-5261-3552ИвкинаМ. В.IvkinaM. V.

Москва

Moscow

erekhova_m@mail.ruhttps://orcid.org/0000-0002-7826-5135МокиенкоО. А.MokienkoO. A.

Москва

Olesya А. Mokienko

Moscow

Lesya.md@yandex.ruМосковский медицинский университет «Реавиз»; Московский государственный медико-стоматологический университет имени А.И. ЕвдокимоваРоссияMoscow Medical University “Reaviz”; Moscow State University of Medicine and Dentistry named after A.I. EvdokimovRussian FederationМосковский медицинский университет «Реавиз»; Институт высшей нервной деятельности и нейрофизиологии РАН; Научный центр неврологииРоссияMoscow Medical University “Reaviz”; Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences; Research Center of NeurologyRussian Federation202308012024286410Copyright © Ивкина М.В., Мокиенко О.А., 20242024Ивкина М.В., Мокиенко О.А.Ivkina M.V., Mokienko O.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/498

В обзоре представлены основные патогенетические механизмы развития фантомной боли (ФБ) после ампутации конечности, распространенность которой может достигать 87%. Точный механизм возникновения ФБ на настоящее время не установлен, предполагается вовлечение периферических и центральных механизмов формирования данного синдрома. К периферическим механизмам относятся повышение возбудимости и формирование эктопической активности в образовавшихся невромах и в ганглиозных клетках дорсальных корешков спинного мозга. Центральные механизмы представлены центральной сенситизацией в задних рогах спинного мозга с развитием феномена «взвинчивания», процессами реорганизации в таламусе и коре больших полушарий с изменением схемы тела, проприоцептивной памятью. Значимыми также являются теория нейроматрикса, снижение обратной связи от зрительной и других сенсорных систем после деафферентации. Методами терапии ФБ, направленными на центральные механизмы, являются стимуляция спинного мозга, чрескожная электронейростимуляция, глубокая стимуляция мозга, неинвазивные и инвазивные методы стимуляции коры головного мозга, зеркальная терапия, технологии виртуальной и дополненной реальности, представление движения и его модификация «фантомные упражнения». Кроме того, с учетом механизмов формирования ФБ, могут использоваться фармакологические препараты: антагонисты NMDA-рецепторов, антиконвульсанты, трициклические антидепрессанты, опиоиды.

In the review, we present the main pathogenetic mechanisms of the development of phantom limb pain (PLP) after limb amputation, the prevalence of which can reach 87%. The exact mechanism of PLP remains unknown. The involvement of peripheral and central mechanisms of the formation of PLP is assumed. Peripheral mechanisms include increased excitability and the formation of ectopic activity in the amputation neuromas and in the ganglion cells of the dorsal roots of the spinal cord. The central mechanisms are represented by central sensitization in the dorsal horns of the spinal cord with the development of the “wind up” phenomenon, reorganization processes in the thalamus and cortex with thalamic and cortical remapping, and proprioceptive memory. Also significant is the neuromatrix theory, the reduction of feedback from the visual and other sensory systems after deafferentation. PLP therapy methods focused on central mechanisms are: spinal cord stimulation, transcutaneous electrical neurostimulation, deep brain stimulation, non-invasive and invasive methods of cerebral cortex stimulation, mirror therapy, virtual and augmented reality technologies, movement representation and its modification “phantom exercises”. In addition, pharmacologic treatment options based on PLP mechanisms can be used: NMDA receptor antagonists, anticonvulsants, tricyclic antidepressants, opioids.

фантомная больампутация конечностиболевой синдромпатофизиология болиphantom limb painlimb amputationpain syndromepathophysiology of painReferencesCulp C.J., Abdi S. Current Understanding of Phantom Pain and its Treatment. Pain Physician. 2022;25(7):E941–E957. https://www.painphysicianjournal.com/linkout?issn=&vol=25&page=E941 (дата обращения 01.05.2023).Culp C.J., Abdi S. Current Understanding of Phantom Pain and its Treatment. Pain Physician. 2022;25(7):E941–E957. https://www.painphysicianjournal.com/linkout?issn=&vol=25&page=E941 (дата обращения 01.05.2023).Kaur A., Guan Y. Phantom limb pain: A literature review. Chin J Traumatol. 2018;21(6):366–368. https://doi.org/10.1016/j.cjtee.2018.04.006Kaur A., Guan Y. Phantom limb pain: A literature review. Chin J Traumatol. 2018;21(6):366–368. https://doi.org/10.1016/j. cjtee.2018.04.006Roldan C.J., Lesnick J.S. Phantom organ pain syndrome, a ghostly visitor to the ED. Am J Emerg Med. 2014;32:1152.e1–1152.e2. https://doi.org/10.1016/j.ajem.2014.02.020Roldan C.J., Lesnick J.S. Phantom organ pain syndrome, a ghostly visitor to the ED. Am J Emerg Med. 2014;32:1152.e1–1152.e2. https://doi.org/10.1016/j.ajem.2014.02.020Давыдов А.Т., Тюкавин А.И., Резванцев М.В., Конончук В.В., Шабанов П.Д. Фантомная боль, роль и место различных методов лечения фантомно-болевого синдрома. Обзоры по клинической фармакологии и лекарственной терапии. 2014;12(1):35–58. https://cyberleninka.ru/article/n/patologiya-boli-rol-i-mesto-razlichnyhmetodov-lecheniya-bolevogo-sindroma (дата обращения 01.05.2023).Davydov A.T., Tyukavin A.I., Rezvantsev M.V., Kononchuk V.V., Shabanov P.D. Phantom pain, role and place of different methods of treatment of the phantom pain syndrome. Reviews on Clinical Pharmacology and Drug Therapy. 2014;12(1):35–58. (In Russ.) https://cyberleninka.ru/article/n/patologiya-boli-rol-i-mesto-razlichnyhmetodov-lecheniya-bolevogo-sindroma (дата обращения 01.05.2023).Collins K.L., Russell H.G., Schumacher P.J., Robinson-Freeman K.E., O’Conor E.C., Gibney K.D. et al. A review of current theories and treatments for phantom limb pain. J Clin Invest. 2018;128(6):2168–2176. https://doi.org/10.1172/JCI94003Collins K.L., Russell H.G., Schumacher P.J., Robinson-Freeman K.E., O’Conor E.C., Gibney K.D. et al. A review of current theories and treatments for phantom limb pain. J Clin Invest. 2018;128(6):2168–2176. https://doi.org/10.1172/JCI94003Stankevicius A., Wallwork S.B., Summers S.J., Hordacre B., Stanton T.R. Prevalence and incidence of phantom limb pain, phantom limb sensations and telescoping in amputees: A systematic rapid review. Eur J Pain. 2020;25:23–38. https://doi.org/10.1002/ejp.1657Stankevicius A., Wallwork S.B., Summers S.J., Hordacre B., Stanton T.R. Prevalence and incidence of phantom limb pain, phantom limb sensations and telescoping in amputees: A systematic rapid review. Eur J Pain. 2020;25:23–38. https://doi.org/10.1002/ejp.1657Вакулин А.А., Зотов П.Б., Шапорев Д.Ю., Сахнюк И.И. Болевой синдром у больных с ампутацией бедра: клиническая характеристика и структура. Медицинская наука и образование Урала. 2008;9(3):138–140. https://elibrary.ru/download/elibrary_23416678_81778848.pdf (Дата обращения: 08.08.2023).Vakulin A.A., Zotov P.B., Shaporev D.Yu., Sakhnyuk I.I. Pain syndrome in patients with hip amputation: clinical characteristics and structure. Medical science and education of Ural. 2008;9(3):138–140. (In Russ.) https://elibrary.ru/download/elibrary_23416678_81778848.pdf (Дата обращения: 08.08.2023).Смирнов А.В. Ведущие клинические проявления у больных с посттравматической ампутацией голени. Академический журнал Западной Сибири. 2013;9(5):34–36. https://elibrary.ru/download/elibrary_20425391_40735299.pdf (Дата обращения: 08.08.2023).Smirnov A.V. Leading clinical manifestations in patients with post-traumatic leg amputation. Academic Journal of West Siberia. 2013;9(5):34–36. (In Russ.) https://elibrary.ru/download/elibrary_20425391_40735299.pdf (Дата обращения: 08.08.2023).Limakatso K., Bedwell G.J., Madden V.J., Parker R. The prevalence and risk factors for phantom limb pain in people with amputations: A systematic review and meta-analysis. PLoS One. 2020;(10):e0240431. https://doi.org/10.1371/journal.pone.0240431Limakatso K., Bedwell G.J., Madden V.J., Parker R. The prevalence and risk factors for phantom limb pain in people with amputations: A systematic review and meta-analysis. PLoS One. 2020;(10):e0240431. https://doi.org/10.1371/journal.pone.0240431Юдин В.Е., Ярошенко В.П., Косухин Е.С., Будко А.А., Устинова М.Е., Трубина В.Г. Фантомно-болевой синдром: клиника, диагностика, лечение (обзор литературы). Вестник Медицинского института непрерывного образования. 2023;3(1):39–43. doi: 10.36107/2782-1714_2023-3-1-39-43.Yudin V.E., Yaroshenko V.P., Kosukhin E.S., Budko A.A., Ustinova M.E., Trubina V.G. Phantom limb syndrome: clinic, diagnostic assessment and treatment (literature review). Bulletin of the Medical Institute of Continuing Education. 2023;3(1):39–43. (In Russ.) doi: 10.36107/2782-1714_2023-3-1-39-43.McCormick Z., Chang-Chien G., Marshall B., Huang M., Harden R.N. Phantom limb pain: a systematic neuroanatomical-based review of pharmacologic treatment. Pain Med. 2014;15(2):292–305. https://doi.org/10.1111/pme.12283McCormick Z., Chang-Chien G., Marshall B., Huang M., Harden R.N. Phantom limb pain: a systematic neuroanatomical-based review of pharmacologic treatment. Pain Med. 2014;15(2):292–305. https://doi.org/10.1111/pme.12283Hyung B., Wiseman-Hakes C. A scoping review of current non-pharmacological treatment modalities for phantom limb pain in limb amputees. Disabil Rehabil. 2022;44(19):5719–5740. https://doi.org/10.1080/09638288.2021.1948116Hyung B., Wiseman-Hakes C. A scoping review of current non-pharmacological treatment modalities for phantom limb pain in limb amputees. Disabil Rehabil. 2022;44(19):5719–5740. https://doi.org/10.1080/09638288.2021.1948116Давыдов О.С., Яхно Н.Н., Кукушкин М.Л., Чурюканов М.В., Абузарова Г.Р., Амелин А.В. и др. Невропатическая боль: клинические рекомендации по диагностике и лечению Российского общества по изучению боли. Российский журнал боли. 2018;58(4):5–41. doi: 10.25731/RASP.2018.04.025Davydov O.S., Yakhno N.N., Kukushkin M.L., Churukanov M.V., Abuzarova G.R., Amelin A.V. et al. Neuropathic pain: clinical guidelines on the diagnostics and treatment from the Russian Association for the Studying of Pain. Russian Journal of Pain. 2018;58(4):5–41. (In Russ.) doi: 10.25731/RASP.2018.04.025Рязанкина А.А., Карелов А.Е., Розенгард С.А., Глущенко В.А., Рогачев М.В. Выбор схемы терапии фантомной боли после хирургического лечения. Вопросы онкологии. 2018;64(1):126– 130. https://elibrary.ru/download/elibrary_34869217_37237527.pdf (дата обращения 08.08.2023).Ryazankina A.A., Karelov A.E., Rozengard S.А., Glushchenko V.А., Rogachev М.V. Problems in oncology. 2018;64(1):126–130. (In Russ.) https://elibrary.ru/download/elibrary_34869217_37237527.pdf (дата обращения 08.08.2023).Andoh J., Milde C., Tsao J.W., Flor H. Cortical plasticity as a basis of phantom limb pain: Fact or fiction? Neuroscience. 2018;387:85–91. https://doi.org/10.1016/j.neuroscience.2017.11.015Andoh J., Milde C., Tsao J.W., Flor H. Cortical plasticity as a basis of phantom limb pain: Fact or fiction? Neuroscience. 2018;387:85–91. https://doi.org/10.1016/j.neuroscience.2017.11.015Katz J., Melzack R. Pain ‘memories’ in phantom limbs: review and clinical observations. Pain. 1990;43(3):319–336. https://doi.org/10.1016/0304-3959(90)90029-DKatz J., Melzack R. Pain ‘memories’ in phantom limbs: review and clinical observations. Pain. 1990;43(3):319–336. https://doi.org/10.1016/0304-3959(90)90029-DRamachandran V.S., Hirstein W. The perception of phantom limbs. The D. O. Hebb lecture. Brain. 1998;121(Pt9):1603–30. https://doi.org/10.1093/brain/121.9.1603Ramachandran V.S., Hirstein W. The perception of phantom limbs. The D. O. Hebb lecture. Brain. 1998;121(Pt9):1603–30. https://doi.org/10.1093/brain/121.9.1603Melzack R. Pain and the neuromatrix in the brain. J Dent Educ. 2001;65(12):1378–82. https://doi.org/10.1002/j.0022-0337.2001.65.12.tb03497.xMelzack R. Pain and the neuromatrix in the brain. J Dent Educ. 2001;65(12):1378–82. https://doi.org/10.1002/j.0022-0337.2001.65.12.tb03497.xAnderson-Barnes V.C., McAuliffe C., Swanberg K.M., Tsao J.W. Phantom limb pain — a phenomenon of proprioceptive memory? Med Hypotheses. 2009;73(4):555–8. https://doi.org/10.1016/j.mehy.2009.05.038Anderson-Barnes V.C., McAuliffe C., Swanberg K.M., Tsao J.W. Phantom limb pain — a phenomenon of proprioceptive memory? Med Hypotheses. 2009;73(4):555–8. https://doi.org/10.1016/j.mehy.2009.05.038Subedi B., Grossberg G.T. Phantom limb pain: mechanisms and treatment approaches. Pain Res Treat. 2011;2011:864605. https://doi.org/10.1155/2011/864605Subedi B., Grossberg G.T. Phantom limb pain: mechanisms and treatment approaches. Pain Res Treat. 2011;2011:864605. https://doi.org/10.1155/2011/864605Nikolajsen L. Postamputation pain: studies on mechanisms. Dan Med J. 2012;59(10):B4527. https://www.painphysicianjournal.com/linkout?issn=&vol=25&page=E941 (дата обращения 01.05.2023).Nikolajsen L. Postamputation pain: studies on mechanisms. Dan Med J. 2012;59(10):B4527. https://www.painphysicianjournal.com/linkout?issn=&vol=25&page=E941 (дата обращения 01.05.2023).Issa C.J., Svientek S.R., Dehdashtian A., Cederna P.S., Kemp S.W.P. Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature. Plast Reconstr Surg Glob Open. 2022;10(9):e4549. https://doi.org/10.1097/GOX.0000000000004549Issa C.J., Svientek S.R., Dehdashtian A., Cederna P.S., Kemp S.W.P. Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature. Plast Reconstr Surg Glob Open. 2022;10(9):e4549. https://doi.org/10.1097/GOX.0000000000004549Ma R.S.Y., Kayani K., Whyte-Oshodi D., Whyte-Oshodi A., Nachiappan N., Gnanarajah S., Mohammed R. Voltage gated sodium channels as therapeutic targets for chronic pain. J Pain Res. 2019;12:2709–2722. https://doi.org/10.2147/JPR.S207610Ma R.S.Y., Kayani K., Whyte-Oshodi D., Whyte-Oshodi A., Nachiappan N., Gnanarajah S., Mohammed R. Voltage gated sodium channels as therapeutic targets for chronic pain. J Pain Res. 2019;12:2709–2722. https://doi.org/10.2147/JPR.S207610Schone H.R., Baker C.I., Katz J., Nikolajsen L., Limakatso K., Flor H., Makin T.R. Making sense of phantom limb pain. J Neurol Neurosurg Psychiatry. 2022;93(8):833–43. https://doi.org/10.1136/jnnp-2021-328428Schone H.R., Baker C.I., Katz J., Nikolajsen L., Limakatso K., Flor H., Makin T.R. Making sense of phantom limb pain. J Neurol Neurosurg Psychiatry. 2022;93(8):833–43. https://doi.org/10.1136/jnnp-2021-328428Dumanian G.A., Ko J.H., O’Shaughnessy K.D., Kim P.S., Wilson C.J., Kuiken T.A. Targeted reinnervation for transhumeral amputees: current surgical technique and update on results. Plast Reconstr Surg. 2009;124(3):863–869. https://doi.org/10.1097/PRS.0b013e3181b038c9Dumanian G.A., Ko J.H., O’Shaughnessy K.D., Kim P.S., Wilson C.J., Kuiken T.A. Targeted reinnervation for transhumeral amputees: current surgical technique and update on results. Plast Reconstr Surg. 2009;124(3):863–869. https://doi.org/10.1097/PRS.0b013e3181b038c9Valerio I.L., Dumanian G.A., Jordan S.W., Mioton L.M., Bowen J.B., West J.M. et al. Preemptive Treatment of Phantom and Residual Limb Pain with Targeted Muscle Reinnervation at the Time of Major Limb Amputation. J Am Coll Surg. 2019;228(3):217–226. https://doi.org/10.1016/j.jamcollsurg.2018.12.015Valerio I.L., Dumanian G.A., Jordan S.W., Mioton L.M., Bowen J.B., West J.M. et al. Preemptive Treatment of Phantom and Residual Limb Pain with Targeted Muscle Reinnervation at the Time of Major Limb Amputation. J Am Coll Surg. 2019;228(3):217–226. https://doi.org/10.1016/j.jamcollsurg.2018.12.015Létourneau S.G., Hendry J.M. Managing Neuroma and Phantom Limb Pain in Ontario: The Status of Targeted Muscle Reinnervation. Plast Reconstr Surg Glob Open. 2020;8(12):e3287. https://doi.org/10.1097/GOX.0000000000003287Létourneau S.G., Hendry J.M. Managing Neuroma and Phantom Limb Pain in Ontario: The Status of Targeted Muscle Reinnervation. Plast Reconstr Surg Glob Open. 2020;8(12):e3287. https://doi.org/10.1097/GOX.0000000000003287Graham R.D., Sankarasubramanian V., Lempka S.F. Dorsal Root Ganglion Stimulation for Chronic Pain: Hypothesized Mechanisms of Action. J Pain. 2022;23(2):196–211. https://doi.org/10.1016/j.jpain.2021.07.008Graham R.D., Sankarasubramanian V., Lempka S.F. Dorsal Root Ganglion Stimulation for Chronic Pain: Hypothesized Mechanisms of Action. J Pain. 2022;23(2):196–211. https://doi.org/10.1016/j.jpain.2021.07.008Aternali A., Katz J. Recent advances in understanding and managing phantom limb pain. F1000Res. 2019;8:F1000 Faculty Rev-1167. https://doi.org/10.12688/f1000research.19355.1Aternali A., Katz J. Recent advances in understanding and managing phantom limb pain. F1000Res. 2019;8:F1000 Faculty Rev-1167. https://doi.org/10.12688/f1000research.19355.1Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. 2002;1(3):182–9. https://doi.org/10.1016/s1474-4422(02)00074-1Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. 2002;1(3):182–9. https://doi.org/10.1016/s1474-4422(02)00074-1Loy B.M., Britt R.B., Brown J.N. Memantine for the Treatment of Phantom Limb Pain: A Systematic Review. J Pain Palliat Care Pharmacother. 2016;30(4):276–283. https://doi.org/10.1080/15360288.2016.1241334Loy B.M., Britt R.B., Brown J.N. Memantine for the Treatment of Phantom Limb Pain: A Systematic Review. J Pain Palliat Care Pharmacother. 2016;30(4):276–283. https://doi.org/10.1080/15360288.2016.1241334Nikolajsen L., Hansen C.L., Nielsen J., Keller J., Arendt-Nielsen L., Jensen T.S. The effect of ketamine on phantom pain: a central neuropathic disorder maintained by peripheral input. Pain. 1996;67(1):69–77. https://doi.org/10.1016/0304-3959(96)03080-1Nikolajsen L., Hansen C.L., Nielsen J., Keller J., Arendt-Nielsen L., Jensen T.S. The effect of ketamine on phantom pain: a central neuropathic disorder maintained by peripheral input. Pain. 1996;67(1):69–77. https://doi.org/10.1016/0304-3959(96)03080-1Nikolajsen L., Finnerup N.B., Kramp S., Vimtrup A.S., Keller J., Jensen T.S. A randomized study of the effects of gabapentin on postamputation pain. Anesthesiology. 2006;105(5):1008–15. https://doi.org/10.1097/00000542-200611000-00023Nikolajsen L., Finnerup N.B., Kramp S., Vimtrup A.S., Keller J., Jensen T.S. A randomized study of the effects of gabapentin on postamputation pain. Anesthesiology. 2006;105(5):1008–15. https://doi.org/10.1097/00000542-200611000-00023Bone M., Critchley P., Buggy D.J. Gabapentin in postamputation phantom limb pain: a randomized, double-blind, placebo-controlled, cross-over study. Reg Anesth Pain Med. 2002;27(5):481–6. https://doi.org/10.1053/rapm.2002.35169Bone M., Critchley P., Buggy D.J. Gabapentin in postamputation phantom limb pain: a randomized, double-blind, placebo-controlled, cross-over study. Reg Anesth Pain Med. 2002;27(5):481–6. https://doi.org/10.1053/rapm.2002.35169Sindrup S.H., Otto M., Finnerup N.B., Jensen T.S. Antidepressants in the treatment of neuropathic pain. Basic Clin Pharmacol Toxicol. 2005;96(6):399–409. https://doi.org/10.1111/j.1742-7843.2005. pto_96696601.xSindrup S.H., Otto M., Finnerup N.B., Jensen T.S. Antidepressants in the treatment of neuropathic pain. Basic Clin Pharmacol Toxicol. 2005;96(6):399–409. https://doi.org/10.1111/j.1742-7843.2005. pto_96696601.xErgenzinger E.R., Glasier M.M., Hahm J.O., Pons T.P. Cortically induced thalamic plasticity in the primate somatosensory system. Nat Neurosci. 1998;1(3):226–9. https://doi.org/10.1038/673Ergenzinger E.R., Glasier M.M., Hahm J.O., Pons T.P. Cortically induced thalamic plasticity in the primate somatosensory system. Nat Neurosci. 1998;1(3):226–9. https://doi.org/10.1038/673Davis K.D., Kiss Z.H., Luo L., Tasker R.R., Lozano A.M., Dostrovsky J.O. Phantom sensations generated by thalamic microstimulation. Nature. 1998;391(6665):385–7. https://doi.org/10.1038/34905Davis K.D., Kiss Z.H., Luo L., Tasker R.R., Lozano A.M., Dostrovsky J.O. Phantom sensations generated by thalamic microstimulation. Nature. 1998;391(6665):385–7. https://doi.org/10.1038/34905Kikkert S., Johansen-Berg H., Tracey I., Makin T.R. Reaffirming the link between chronic phantom limb pain and maintained missing hand representation. Cortex. 2018;106:174–184. https://doi.org/10.1016/j.cortex.2018.05.013Kikkert S., Johansen-Berg H., Tracey I., Makin T.R. Reaffirming the link between chronic phantom limb pain and maintained missing hand representation. Cortex. 2018;106:174–184. https://doi.org/10.1016/j.cortex.2018.05.013Pacheco-Barrios K., Meng X., Fregni F. Neuromodulation Techniques in Phantom Limb Pain: A Systematic Review and Meta-analysis. Pain Med. 2020;21(10):2310–2322. https://doi.org/10.1093/pm/pnaa039Pacheco-Barrios K., Meng X., Fregni F. Neuromodulation Techniques in Phantom Limb Pain: A Systematic Review and Meta-analysis. Pain Med. 2020;21(10):2310–2322. https://doi.org/10.1093/pm/pnaa039Garcia-Pallero M.Á., Cardona D., Rueda-Ruzafa L., Rodriguez-Arrastia M., Roman P. Central nervous system stimulation therapies in phantom limb pain: a systematic review of clinical trials. Neural Regen Res. 2022;17(1):59–64. https://doi.org/10.4103/1673-5374.314288Garcia-Pallero M.Á., Cardona D., Rueda-Ruzafa L., Rodriguez-Arrastia M., Roman P. Central nervous system stimulation therapies in phantom limb pain: a systematic review of clinical trials. Neural Regen Res. 2022;17(1):59–64. https://doi.org/10.4103/1673-5374.314288Huse E., Larbig W., Flor H., Birbaumer N. The effect of opioids on phantom limb pain and cortical reorganization. Pain. 2001;90(1–2):47–55. https://doi.org/10.1016/s0304-3959(00)00385-7Huse E., Larbig W., Flor H., Birbaumer N. The effect of opioids on phantom limb pain and cortical reorganization. Pain. 2001;90(1–2):47–55. https://doi.org/10.1016/s0304-3959(00)00385-7Xie H.M., Zhang K.X., Wang S., Wang N., Wang N., Li X., Huang L.P. Effectiveness of Mirror Therapy for Phantom Limb Pain: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2022;103(5):988–997. https://doi.org/10.1016/j.apmr.2021.07.810Xie H.M., Zhang K.X., Wang S., Wang N., Wang N., Li X., Huang L.P. Effectiveness of Mirror Therapy for Phantom Limb Pain: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2022;103(5):988–997. https://doi.org/10.1016/j.apmr.2021.07.810Rothgangel A., Braun S., Winkens B., Beurskens A., Smeets R. Traditional and augmented reality mirror therapy for patients with chronic phantom limb pain (PACT study): results of a three-group, multicentre single-blind randomized controlled trial. Clin Rehabil. 2018;32(12):1591–1608. https://doi.org/10.1177/0269215518785948Rothgangel A., Braun S., Winkens B., Beurskens A., Smeets R. Traditional and augmented reality mirror therapy for patients with chronic phantom limb pain (PACT study): results of a three-group, multicentre single-blind randomized controlled trial. Clin Rehabil. 2018;32(12):1591–1608. https://doi.org/10.1177/0269215518785948Anaforoğlu Külünkoğlu B., Erbahçeci F., Alkan A. A comparison of the effects of mirror therapy and phantom exercises on phantom limb pain. Turk J Med Sci. 2019;49(1):101–109. https://doi.org/10.3906/sag-1712-166Anaforoğlu Külünkoğlu B., Erbahçeci F., Alkan A. A comparison of the effects of mirror therapy and phantom exercises on phantom limb pain. Turk J Med Sci. 2019;49(1):101–109. https://doi.org/10.3906/sag-1712-166Brunelli S., Morone G., Iosa M., Ciotti C., De Giorgi R., Foti C., Traballesi M. Efficacy of progressive muscle relaxation, mental imagery, and phantom exercise training on phantom limb: a randomized controlled trial. Arch Phys Med Rehabil. 2015;96(2):181–7. https://doi.org/10.1016/j.apmr.2014.09.035Brunelli S., Morone G., Iosa M., Ciotti C., De Giorgi R., Foti C., Traballesi M. Efficacy of progressive muscle relaxation, mental imagery, and phantom exercise training on phantom limb: a randomized controlled trial. Arch Phys Med Rehabil. 2015;96(2):181–7. https://doi.org/10.1016/j.apmr.2014.09.035Mallik A.K., Pandey S.K., Srivastava A. et al. Comparison of Relative Benefits of Mirror Therapy and Mental Imagery in Phantom Limb Pain in Amputee Patients at a Tertiary Care Center. Arch Rehabil Res Clin Transl. 2020;2(4):100081. https://doi.org/10.1016/j.arrct.2020.100081Mallik A.K., Pandey S.K., Srivastava A. et al. Comparison of Relative Benefits of Mirror Therapy and Mental Imagery in Phantom Limb Pain in Amputee Patients at a Tertiary Care Center. Arch Rehabil Res Clin Transl. 2020;2(4):100081. https://doi.org/10.1016/j.arrct.2020.100081Limakatso K., Madden V.J., Manie S., Parker R. The effectiveness of graded motor imagery for reducing phantom limb pain in amputees: a randomised controlled trial. Physiotherapy. 2020;109:65–74. https://doi.org/10.1016/j.physio.2019.06.009Limakatso K., Madden V.J., Manie S., Parker R. The effectiveness of graded motor imagery for reducing phantom limb pain in amputees: a randomised controlled trial. Physiotherapy. 2020;109:65–74. https://doi.org/10.1016/j.physio.2019.06.009Rierola-Fochs S., Varela-Vásquez L.A., Merchán-Baeza J.A., Minobes-Molina E. Development and Validation of a Graded Motor Imagery Intervention for Phantom Limb Pain in Patients with Amputations (GraMI Protocol): A Delphi Study. Int J Environ Res Public Health. 2021;18(22):12240. https://doi.org/10.3390/ijerph182212240Rierola-Fochs S., Varela-Vásquez L.A., Merchán-Baeza J.A., Minobes-Molina E. Development and Validation of a Graded Motor Imagery Intervention for Phantom Limb Pain in Patients with Amputations (GraMI Protocol): A Delphi Study. Int J Environ Res Public Health. 2021;18(22):12240. https://doi.org/10.3390/ijerph182212240Ишинова В.А., Алтухов С.В., Сусляев В.Г., Горчанинов О.Н., Сидоров К.Г. Гендерные различия в восприятии фантомной боли: особенности взаимоотношений между психогенным компонентом в ее структуре и эмоционально-личностными характеристиками. Российский журнал боли. 2018;2(56):144–145. https://www.elibrary.ru/download/elibrary_34966930_93028848.pdf (дата обращения 08.08.2023)Ishinova V.A., Altukhov S.V., Suslyaev V.G., Gorchaninov O.N., Sidorov K.G. Gender differences in the perception of phantom pain: features of the relationship between the psychogenic component in its structure and emotional and personal characteristics. Russian Journal of Pain. 2018;2(56):144–145. (In Russ.) https://www.elibrary.ru/download/elibrary_34966930_93028848.pdf (дата обращения 08.08.2023)Ткаченко Г.А., Степанова А.М., Мерзлякова А.М. Психологическая коррекция фантомной боли у онкологических больных. Саркомы костей, мягких тканей и опухоли кожи. 2017;(3):38–42. https://elibrary.ru/download/elibrary_30796646_11449868.pdf (дата обращения 08.08.2023).Tkachenko G.A., Stepanova A.M., Merzlyakova A.M. Psychological correction of phantom pain in cancer patients. Bone and soft tissue sarcomas, tumors of the skin. 2017;(3):38–42. (In Russ.) https://elibrary.ru/download/elibrary_30796646_11449868.pdf (дата обращения 08.08.2023).Ишинова В.А. Оценка изменений цвета зрительных ощущений при хронической боли в процессе сеансов эмпатотехники. Сенсорные системы. 2020;34(2):91–99. https://elibrary.ru/download/elibrary_42687770_62258889.pdf (дата обращения 08.08.2023).Ishinova V.A. Evaluation of color changes in visual sensations in chronic pain during empathotechnics sessions. Sensory Systems. 2020;34(2):91–99. (In Russ.) https://elibrary.ru/download/elibrary_42687770_62258889.pdf (дата обращения 08.08.2023).

The authors declare that there are no conflicts of interest present.