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During my PhD, I would like to investigate phantom limb pain (PLP), a chronic pain syndrome that occurs after amputation, and affects the majority of amputees. The research project involves three studies, which would explore both peripheral and central contributions to PLP, and be the first set of studies to look at the relationship between peripheral signals and how they are exasperated by cognitive mechanisms. For the first study, I would use TMS combined with EMG to elicit phantom hand sensations, which have been shown to be one of the most common factors positively associated with PLP. This would aid our understanding of the shared mechanisms and potential mechanistic association to PLP. The second study would focus on how cognitive biases in pain learning relate to PLP, building on computational models from reinforcement learning to see how people gather peripheral evidence. Using thermal stimulation to deliver stimuli and recording EMG activity during phantom movements, I will gather empirical evidence to explore amputees' expectations of pain and experienced pain. The third study will aim to causally test the models built in the first study by seeing the effect of a novel surgical procedure that reduces PLP - targeted muscle reinnervation (TMR). By conducting a within-subjects experiment, testing before and after the procedure, we can additionally provide objective evidence on TMR reducing the processing of pain.
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