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Phantom Limb Pain The Human Brain; Molecules to Metaphor V.S. Ramachandran Center for Brain and Cognition University of California, San Diego Phantom Limb Pain Chan et al., 2007 RSD Pain DeBlasis et al., 2009 Mirror Visual Feedback (MVF) Virtual Reality 1. Phantom Pain Immediate Long Lasting 2. CRPS or RSD 3. Stroke 4. Hand Rehab 5. Trigeminal Neuralgia Mirror Feedback Relieves Phantom Limb Pain •Ramachandran, VS, & Rogers-Ramachandran, D. (1996). Synaesthesia in phantom limbs induced with mirrors. Proceedings of the Royal Society B: Biological Sciences, 263(1369), 377- 86.Sütbeyaz, S. (2007). Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. Archives of physical medicine and rehabilitation, 88(5), 555-9. •Stevens, JA, & Stoykov, ME. (2003). Using motor imagery in the rehabilitation of hemiparesis. Archives of physical medicine and rehabilitation, 84(7), 1090-2. •Chan BL, Witt R, Charrow AP, Magee A, Howard R, Pasquina PF, Heilman KM, & Tsao JW (2007). Mirror therapy for phantom limb pain. N Engl J Med, 357(21):2206-7. Mirror Feedback Aids Stroke Recovery •Altschuler, EL, Wisdom, SB, Stone, L, Ramachandran, V.S. (1999). Rehabilitation of hemiparesis after stroke with a mirror. The Lancet, 353(9169), 2035-6. •Sütbeyaz, S. (2007). Mirror therapy enhances lower-extremity motor recovery and motor functioning after stroke: a randomized controlled trial. Archives of physical medicine and rehabilitation, 88(5), 555-9. •Acerra, N, Souvlis, T, Brauer, S, Moseley, L (2007). Does mirror therapy improve upper limb sensory and motor recovery early post-stoke? A randomized-controlled trial. Physiotherapy, 93(1), 122-123. Mirror Feedback Treatment for RSD •McCabe, CS. (2002). A controlled pilot study of the utility of mirror visual feedback in the treatment of complex regional pain syndrome (type 1). Rheumatology, 42(1), 97-.Acerra, N, Souvlis, T, Brauer, S, Moseley, L (2007). Does mirror therapy improve upper limb sensory and motor recovery early post-stoke? A randomized-controlled trial. Physiotherapy, 93(1), 122-123. •Karmarkar, A., Lieberman, I. (2006). Mirror box therapy for complex regional pain syndrome. •Cacchio A, De Blasis E, Necozione S, di Orio F, Santilli V (2009). Mirror Therapy for Chronic Complex Regional Pain Syndrome Type 1 and Stroke. New England Journal of Medicine, The, 361(6), 634-6. • Cacchio A, De Blasis E, De Blasis V, Santilli V, Spacca G (2009). Mirror Therapy in Complex Regional Pain Syndrome Type 1 of the Upper Limb in Stroke Patients. Journal of neurologic rehabilitation, in press. Mirror Feedback Accelerates Hand Recovery •Rosén, B, & Lundborg, G. (2005). Training with a mirror in rehabilitation of the hand. Scandinavian journal of plastic and reconstructive surgery and hand surgery, 39(2), 104-8. Synesthesia V.S. Ramachandran Ed Hubbard David Brang Center for Brain and Cognition University of California, San Diego • Baron-Cohen • Merikle • Beeli • Palmeri • Blake • Robertson • Bradshaw • Rouw • Cohen Kadosh • Sagiv • Scholte • Day • Simner • Dixon • Smilek • Eagleman • Ward • Mattingley The Seven Pieces of the Puzzle 1) Runs in families 2) Angular gyrus and dyscalculia 3) More common in artists & poets 4) Synthesthetic metaphors 5) Increased emotional reactions 6) Correlation with TLE 7) Evolution of language The Four Key Questions 1) Is synesthesia real? 2) Is it a genuine sensory phenomenon or a cognitive one? 3) What are the precise brain mechanisms? 4) What are its precise broader implications (i.e., what’s the big deal)? Synesthesia as a Sensory Process Dependence on luminance contrast Evoked color can lead to texture segregation and popout (Ramachandran & Hubbard, 2001). Input to apparent motion perception (Ramachandran & Hubbard, 2002; Ramachandran & Azoulai, 2006). Martian colors Even for a single grapheme different regions can be tinged different colors Subjects can adapt to synesthetically induced colors and experience McCollough color after effects (Blake, Palmeri, Marois, Kim, 2005). Higher and Lower Synesthesia Lower Synesthetes Visual shape of graphemes Affected by contrast, flicker, etc. Higher Synesthetes Days of the week Months of the year Numerical sequences Phonemes A Color Blind Synesthete! Martian Colors Imagining Numbers DT Imaging Rouw, R, & Scholte, HS. (2007). Increased structural connectivity in grapheme-color synesthesia. Nature neuroscience, 10(6), 792-7. Pharmacology Galton’s Number Lines: real or bogus? Number Line 1 11 12 13 14 2 10 15 9 3 8 16 4 5 6 7 17 18 19 Ramachandran, VS, & Hubbard, EM (2005a). The emergence of the human mind: Some clues from synesthesia. Robertson and Sagiv, 147-190. Artists, Poets, and Novelists Rich AN, Bradshaw JL, Mattingley JB.(2005). A systematic, large-scale study of synaesthesia: implications for the role of early experience in lexical-colour associations. Cognition. 2005 Nov;98(1):53-84. Ward, J, Yaro, C, Thompson-Lake, D, Sagiv, N (2007). Is synaesthesia associated with particular strengths and weaknesses? UK Synaesthesia association meeting. Domino, G. (1989). Synesthesia and Creativity in Fine Arts Students: An Empirical Look. Creativity research journal, Synesthesia Synesthesia Gene(s) Metaphors Artistic Creativity Penumbra of finite set of Words associations Exotic Forms of Synesthesia Touch Emotion (Brang and Ramachandran, 2007) Tasting Shapes (Cytowic, 1989) Tastes from Words (Simner & Ward 2006) Rizzolatti et al, 2007 .
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