In this issue, Johnson and Gohil raise some interesting points in their article on a technique, mirror therapy, which can modify brain function to assist in rehabilitation in a number of diverse clinical situations . Although they did not show any effect in their experimental paradigm, the literature does indicate effects in patients with chronic pain (phantom limb pain, complex regional pain syndrome (CRPS)) and in healthy volunteers exposed to experimental pain. In the studies in healthy volunteers where the mirror image is changed from normal, the effects are ambiguous, often opposite to the effects seen in patients as the authors point out .1Mirror therapy has effects on abnormal cortical representation (in fMRI) of a longstanding painful limbWhat is most striking in the pain patients is the fMRI evidence that cortical changes induced by the clinical problems can be partially reversed with this therapy . This is a somewhat unique proof of the central mechanisms involved in both the pain and pain reduction, and in the case of CRPS, improved function as well . As the authors correctly state there is a significant difference between the clinical situation and their volunteer subjects . In patients with an absent limb
Scandinavian Journal of Pain – de Gruyter
Published: Dec 29, 2017
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