Impaired spatial body representation in complex regional pain syndrome type 1 (CRPS I)

Abstract

1-way analysis of variance, t-tests, significance level: 0.05. In the dark, CRPS patients displayed a significantly larger leftward spatial bias when estimating their vSM, compared to pain controls and healthy subjects, and also reported lower motor function than pain controls. For right-affected CRPS patients only, the deviation of the vSM correlated significantly with the severity of distorted body perception. Results confirm previous findings of impaired visuospatial perception in CRPS patients, which might be the result of the involvement of supraspinal mechanisms in this pain syndrome. These mechanisms might accentuate the leftward bias that results from a right-hemispheric dominance in visuospatial processing and is known as pseudoneglect. Pseudoneglect reveals itself in the tendency to perceive the midpoint of horizontal lines or the subjective body midline left of the centre. It was observable in all 3 groups, but most pronounced in CRPS patients, which might be due to the cortical reorganisation processes associated with this syndrome.

The rubber hand illusion in complex regional pain syndrome: Preserved ability to integrate a rubber hand indicates intact multisensory integration ☆

“…CRPS patients not only presented with greater motor impairment, but clinical investigation also revealed more signs of sensory abnormalities and SUDOMOTOR dysfunction (all P values > 0.01) (Tables 1 and 2) [50]. Furthermore, right-affected CRPS patients showed significantly greater neglect-like symptoms than left-affected patients (P = 0.02) or right-affected patients in the control group.…”

“…Details on recruitment of all participants and detailed clinical characteristics of both patient groups were previously reported [50] and can in part be found in Table 1. Note that the experiment conducted in this study was independent of the previously published study [50] and that the testing was performed by a different investigator. The study was approved by the Ethics Committee of the Ruhr-University Bochum, Germany (no.…”

“…This is a German Current medications NSAIDs 2 3 5 3 3 6 Antidepressants 2 4 6 3 3 6 Anticonvulsants 2 2 4 2 1 3 Opioids 1 2 3 2 4 6 Other 3 7 10 4 1 5 Sensory abnormalities Tactile hypesthesia 7 translation of a questionnaire originally developed by Galer and Jensen [16] and was previously used in a large case-control study investigating the sensitivity and specificity of the instrument as well as in other clinical studies investigating neglect-like symptoms in CRPS [15,16,26,28,50]. The mean of the questionnaire comprising 5 items such as ''My painful limb feels as though it is not part of the rest of my body'' and '' I need to focus all of my attention on my painful limb to make it move the way I want it to'' indicates the total score.…”

“…These findings imply that brain regions associated with multisensory integration may be preserved in CRPS. Multisensory integration of body signals underlies coherent body representation, which can be distorted in CRPS patients [15][16][17]28,29,38,39,45,49,50]. Unfortunately, there are no studies that directly investigate multisensory integration related to body representation in CRPS.…”

Komplexes regionales Schmerzsyndrom

“…Diese funktionellen Bildgebungsstudien werden ergänzt durch psychophysische Untersuchungen, die belegen, dass viele CRPS-Patienten unter einer Neglect-ähnlichen Symptomatik mit deutlicher Vernachlässigung der betroffenen Extremität leiden [9,36] …”