Complex regional pain syndrome associated with hyperattention rather than neglect for the healthy side: A comprehensive case study

Abstract

Complex regional pain syndrome (CRPS) is a dehabilitating chronic condition occurring with peripheral lesions. There is growing consensus for a central contribution to CRPS. Although the nature of this central body representation disorder is increasingly debated, it has been repeatedly argued that CRPS results in motor neglect of the affected side. The present article describes a comprehensive and quantitative case report demonstrating that: (1) not all patients with chronic CRPS exhibit decreased spatial attention for the affected side and (2) patients may actually exhibit a substantial, broad and reliable attentional bias toward the painful side, akin to spatial neglect for the healthy side. This unexpected result agrees with the idea that patients can be hyper-attentive toward their pathological side as a manifestation of lowered pain threshold, allodynia and kinesiophobia.

Explicit and Implicit Own's Body and Space Perception in Painful Musculoskeletal Disorders and Rheumatic Diseases: A Systematic Scoping Review

“…The available studies on assessment and treatment described here need to be replicated in larger and higher-methodological quality studies with appropriate control groups, in order to confirm preliminary results emerged, and to determine whether perceptual disorders represent clinical consistent findings. At the same time, we encourage the production of diagnostic case studies/case series and the publication of preliminary validation studies aimed to describe new assessment and treatment methodology in MDRDs as already made in CRPS (Sumitani et al, 2007a;Uematsu et al, 2009;Christophe et al, 2016;Solcà et al, 2018). We think that these two preliminary steps may be useful starting points before large scale data collection, as in the case of Adamczyk et al (2018a,b).…”

“…Evidence emerged across included studies seemed to highlight the absence of SpP dysfunctions, at least for the extra-personal space measured through the CRAF test in a sample of patients with CNP and WAD: errors in SSV and SVO were under the limit of normality or very modest, and were not correlated with disability. The lack of studies conducted in disorders different than CNP and WAD makes it difficult to extent these findings to others MDRDs, or to compare these results with those found in CRPS (Sumitani et al, 2007a,b;Uematsu et al, 2009;Reinersmann et al, 2012;Christophe et al, 2016).…”

Neuropsychological Changes in Complex Regional Pain Syndrome (CRPS)

“…Manual straight-ahead pointing (eyes closed) Bias towards the affected side of space Christophe et al [53], N = 1, NC, BL; Jacquin-Courtois et al [54], N = 1, NC, HC, AL…”

“…Line bisection Bias towards the affected relative to unaffected side of space Christophe et al [53], N = 1, NC, BL; Jacquin-Courtois et al [54], N = 1, HC, NC, AL; Förderreuther et al [37], N = 29, HC, BL Bias away from the affected relative to unaffected side of space Robinson et al [65], N = 1, NC…”

“…Christophe et al [53], N = 1, NC; Jacquin-Courtois et al [54], N = 1, HC, NC; Sumitani et al [67], N = 27, HC [68], N = 36, HC, [69], N = 5, NC; Uematsu et al [70], N = 22, PC Bias towards the left relative to right side of space (in the dark)…”