From phantom pain to body schema: Bringing new insight to neuropathic pain through neuro-psychomotor reconstruction of amputees’ body schema

Swiss partners

• HES-SO, HETS Genève: Chantal Junker-Tschopp (main applicant)

Partners in the MENA region

• Université Saint-Joseph de Beyrouth, Lebanon: Joseph Maarrawi (main applicant), Gemma Gebrael Matta, Sandra Kobaiter Maarrawi
• Hôpital Hôtel Dieu de France, Beirut, Lebanon: Hicham Abou Zeid 

Presentation of the project

This project quickly became evident as the main applicant closely collaborates since 2019 with the Institute of Psychomotor therapy (IPM) at Saint Joseph University of Beirut (USJ) under the direction of Prof. Gemma Gebrael Matta. Indeed, for the last 50 years, wars, landmines, the Beirut port explosion, and a precarious healthcare system have severely impacted the population, shattering the bodily integrity of many civilians and soldiers. Lebanon, through its history, has internalized the trauma of amputation!

On the other hand, the main applicant has developed a phantom pain therapy designed to specifically act on amputees’ disturbed body schema. In the pain clinic set up in Haiti, over 200 amputees have been treated reporting chronic phantom pain recovery. Our 12 years of experience in this country enabled us to offer patient care that is both effective and low-cost, in line with the current Lebanese socio-economic collapse.

Neuro-psychomotor therapy could thus be considered as a straightforward remedy offering a novel non-pharmacological/surgical treatment of phantom pain. Yet clinical results obtained in Haiti are still lacking of scientific proof such as MRI evaluation for their medical significancy to be recognized. It is also difficult to implement the results into the Swiss medical research field because of low number of Swiss amputees. Despite the ongoing economic crisis, Lebanon's relatively functional hospital and university infrastructures was considered as a sufficient basis to confidently envision such a project.

The institutional framework offered by the MENA-Leading House gave the final input to our initial duo, Prof. Gebrael Matta and the Swiss main applicant, to ground this project in reality. As a reminder, HES-SO was mandated by the State Secretariat for Education, Research and Innovation (SEFRI) as a Leading House to develop scientific collaborations with the Middle East and North Africa, known as the MENA region. Among the goals were to develop cooperation tools while promoting knowledge. To better address the medical and strategic challenges of such a project, two colleagues of Prof. Gebrael Matta were invited to join our duo: Dr. Joseph Maarrawi, a neurosurgeon specialized in neuroscience and director of the Pain Laboratory, and Prof. Sandra Kobaiter Maarrawi, also working at the Pain Laboratory. Dr. Hicham Abou Zeid, an algologist specialized in pain treatment, joined our group on their recommendation as the project submission to the MENA-Leading House call was close by.

A funding request was submitted with these five partners to the MEMA-Leading House in early January 2022 and accepted in early May 2022. Four other funders, including the Genevan International Solidarity Service (Service de la Solidarité Internationale de la République et du Canton de Genève), the two municipalities of Cologny and Vandoeuvres, and HES-SO, also supported the project allowing to have the necessary funds for its plain realization.