Imaging and Clinical Evidence of Sensorimotor Problems in CRPS: Utilizing Novel Treatment Approaches

Bailey, Jacqueline; Nelson, Sara; Lewis, Jenny; McCabe, Candy

doi:10.1007/s11481-012-9405-9

Cited by 23 publications

(13 citation statements)

References 76 publications

(69 reference statements)

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“…peripersonal) space are characteristic of certain neurological conditions, and can be present in chronic pain [23,68,79]. For instance, aside from pain, motor deficits, and autonomic symptoms, people with Complex Regional Pain Syndrome (CRPS) typically perceive their affected limb to be larger than its physical size, and can report feelings of missing body parts [1,51,59,67]. There is also evidence of attentional biases away from the CRPS-affected side of peripersonal space [9,21,56,62], which are predicted by body representation distortions [9].…”

Section: Introductionmentioning

confidence: 99%

Characterising sensorimotor adaptation in Complex Regional Pain Syndrome

Vitterso

Buckingham²,

Halicka

et al. 2019

Preprint

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Distorted representations of the body and peripersonal space are common in Complex Regional Pain Syndrome (CRPS), and might modulate its symptoms (e.g. asymmetric limb temperature). In pain-free people, such representations are malleable, and update when we interact with objects in our environment (e.g. during tool-use). Distortions are also common after immobilisation, but quickly normalise once movement is regained. We tested the hypothesis that people with CRPS have problems updating bodily and spatial representations, which contributes to the maintenance of their distorted representations by preventing normalization. We also explored spatially defined modulations of hand temperature asymmetries, and any influence of updating bodily and spatial representations on this effect. Thirty-six people with unilateral CRPS (18 upper limb, 18 lower limb) and 36 pain-free controls completed tool-use tasks considered to alter body and peripersonal space representations (measured using tactile distance judgements and a visuotactile crossmodal congruency task, respectively). We also tested how the arrangement (crossed, uncrossed) of the hands and tools affected hand temperature. In upper limb CRPS the non-affected arm representation updated normally, but the affected arm representation updated in the opposite to normal direction. A similar pattern was seen in lower limbs CRPS, although not significant. Furthermore, people with CRPS showed more pronounced updating of peripersonal space than the controls. We did not observe any modulation of hand temperature asymmetries by the arrangement of hands or tools. Our findings suggest enhanced malleability of bodily and spatial representations in CRPS, potentially implicating central mechanisms in the aetiology of this condition.

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Section: Introductionmentioning

confidence: 99%

Characterising sensorimotor adaptation in Complex Regional Pain Syndrome

Vitterso

Buckingham²,

Halicka

et al. 2019

Preprint

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“…However, there are no available data, to our knowledge, that define the relationships among personality, emotional reaction to a magnified image of the body, and changes in pain perception induced by visualization of a magnified image of the body. Furthermore, distortion of subjective body size is one of the factors that influences chronic pain (Moseley, 2005; Lewis et al, 2007; Peltz et al, 2011; Bailey et al, 2013). For example, Moseley (2005) were the first to report that patients with CRPS estimated their own affected hand to be larger than it actually was.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the modulation of pain by visual distortion of body size

Osumi

Imai

Ueta

et al. 2014

Front. Hum. Neurosci.

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Modulation of pain using visual distortion of body size (VDBS) has been the subject of various reports. However, the mechanism underlying the effect of VDBS on pain has been less often studied. In the present study, factors associated with modulation of pain threshold by VDBS were investigated. Visual feedback in the form of a magnified image of the hand was provided to 44 healthy adults to examine changes in pain. In participants with a higher pain threshold when visual feedback of a magnified image of the hand was provided, the two-point discrimination threshold decreased. In contrast, participants with a lower pain threshold with visual feedback of a magnified image of the hand experienced unpleasant emotions toward the magnified image of the hand. Interestingly, this emotional reaction was strongly associated with negative body consciousness in several subjects. These data suggested an analgesic effect of visual feedback in the form of a magnified image of the hand is only when tactile perception is vivid and the emotional reaction toward the magnified image is moderate. The results also suggested that negative body consciousness is important for the modulation of pain using VDBS.

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“…It is well established in phantom limb pains and CRPS that there is a correlation between levels of perceived pain intensity and the extent of cortical reorganization, with pain reducing as cortical maps normalize . Changes in the primary sensory and motor maps in CRPS are thought to contribute to disrupted motor planning, altered sensory perceptions, referred sensations and body perception disturbances (see for review). All of these clinically observed problems have shown some improvement with nonpharmacological strategies that have targeted correction, but perhaps these benefits could be further enhanced in the presence of NMDA antagonists.…”

Section: The Role Of Ketamine In the Treatment Of Complex Regional Pamentioning

confidence: 99%

Prolonged ketamine infusion as a therapy for complex regional pain syndrome: synergism with antagonism?

Pickering

McCabe

2014

Brit J Clinical Pharma

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Imaging and Clinical Evidence of Sensorimotor Problems in CRPS: Utilizing Novel Treatment Approaches

Cited by 23 publications

References 76 publications

Characterising sensorimotor adaptation in Complex Regional Pain Syndrome

Characterising sensorimotor adaptation in Complex Regional Pain Syndrome

Factors associated with the modulation of pain by visual distortion of body size

Prolonged ketamine infusion as a therapy for complex regional pain syndrome: synergism with antagonism?

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