Neuropathogenesis of Phantom Pain Syndrome: Overview of Foreign Research

Background. The insufficient systematization of knowledge about PLPS (Phantom Limb Pain Syndrome) and the absence of a coherent pathophysiological theory hinder the development of scientifically-based treatment methods, highlighting the necessity for further research in this area. Objectives. This study aims to identify, critically analyze, and describe the currently relevant theories and models of the neuro-pathogenesis of PLPS to determine the target areas and methods for PLPS correction. Study Participants. The primary sample consisted of 170 scientific studies from the fields of psychology, neuropsychology, and cognitive sciences, focusing on the issue of PLPS neuro-pathogenesis. Methods. Literature search was conducted using the LENS information database. The analysis focused on the works published between 2018 and 2024. The authors employed historical-retrospective and bibliometric analyses. Results. Based on the analysis of scientific data, the neuropathogenesis of PLPS is explained by three main groups of theories. Peripheral models associate PLPS with pathological changes in the peripheral nervous system, including hyperactivity of damaged axons (neuroma model) and residual nociceptive signals. Central models explain PLPS through somatosensory cortex reorganization (“remapping”), persistent activity of cortical representations of the lost limb (persistent representation model), and the concept of an innate “neuromatrix” that shapes pain perception. Mixed models consider PLPS as a result of interactions between peripheral and central factors, including disturbances in body schema and stochastic processes leading to the development of abnormal neural connections. Conclusions. Based on the analyzed theories, the authors identified potential targets for rehabilitation interventions in PLPS. This made it possible to identify theoretically justified goals, objectives and areas of work in the correction of PLPS: methods of neuromodulation, techniques aimed at reducing cortical reorganization, implementation of behavioral and cognitive therapies, biofeedback training, and the use of sensory and motor prostheses.