scholarly journals No evidence of impaired sensorimotor adaptation in Complex Regional Pain Syndrome

2020 ◽  
Author(s):  
Axel D. Vittersø ◽  
Gavin Buckingham ◽  
Antonia F. Ten Brink ◽  
Monika Halicka ◽  
Michael J. Proulx ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Peripersonal Space ◽  
The Body ◽  
Prism Adaptation ◽  
Sensorimotor Adaptation ◽  
Type I ◽  
After Effect ◽  
Pathological Pain ◽  
Effect Phase

AbstractSensorimotor conflict is theorised to contribute to the maintenance of some pathological pain conditions, such as Complex Regional Pain Syndrome (CRPS). We therefore tested whether sensorimotor adaptation is impaired in people with CRPS by characterising their adaption to lateral prismatic shifts in vision. People with unilateral upper limb CRPS Type I (n = 17), and pain-free individuals (n = 18; matched for age, sex, and handedness) completed prism adaptation with their affected/non-dominant and non-affected/dominant arm, in a counterbalanced order. We examined 1) the rate at which participants compensated for the optical shift during prism exposure (i.e. strategic recalibration), 2) endpoint errors made directly after prism adaptation (sensorimotor realignment) and their retention, and 3) kinematic markers associated with feedforward motor control and sensorimotor realignment. We found no evidence that strategic recalibration was different between people with CRPS and controls, including no evidence for differences in a kinematic marker associated with trial-by-trial changes in movement plans. Participants made significant endpoint errors in the prism adaptation after-effect phase, which are indicative of sensorimotor realignment. Overall, the magnitude of this realignment was not found to differ between people with CRPS and pain-free controls. However, people with CRPS made greater endpoint errors when using their affected hand than their non-affected hand, whereas no such difference was seen in controls. Taken together, these findings suggest that strategic control and sensorimotor realignment were not impaired for either arm in people with CRPS. In contrast, they provide some evidence that there is a greater propensity for sensorimotor realignment in CRPS, consistent with more flexible representations of the body and peripersonal space. Our study challenges the theory that sensorimotor conflict might underlie pathological pain that is maintained in the absence of tissue pathology.

scholarly journals Altered updating of bodily and spatial representations following tool-use in Complex Regional Pain Syndrome

2019 ◽  
Author(s):  
Axel D. Vittersø ◽  
Gavin Buckingham ◽  
Monika Halicka ◽  
Michael J. Proulx ◽  
Janet H. Bultitude
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Upper Limb ◽  
Tool Use ◽  
Pain Syndrome ◽  
Peripersonal Space ◽  
The Body ◽  
Lower Limbs ◽  
Spatial Representations ◽  
Hand Temperature ◽  
Free People

AbstractDistorted 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.

Peripheral Nerve and Brachial Plexus Impairment, AMA Guides, Sixth Edition

2017 ◽  
Vol 22 (2) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Complex Regional Pain Syndrome ◽  
Lower Extremities ◽  
Pain Syndrome ◽  
Upper Extremities ◽  
Motor Deficits ◽  
Type I ◽  
Sixth Edition ◽  
Nerve Entrapments

Abstract Physicians use a variety of methodologies within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to rate nerve injuries depending on the type of injury and location of the nerve. Traumatic injuries that cause impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex Regional Pain Syndrome for upper extremities or Section 16.5, Complex Regional Pain Syndrome for lower extremities. The method for grading the sensory and motor deficits is analogous to the method described in previous editions of AMA Guides. Rating the permanent impairment of the peripheral nerves or brachial plexus is similar to the methodology used in the diagnosis-based impairment scheme with the exceptions that the physical examination grade modifier is never used to adjust the default rating and the names of individual nerves or plexus trunks, as opposed to the names of diagnoses, appear in the far left column of the rating grids.

Effect of spinal cord stimulation in Type I complex regional pain syndrome with 2 rare severe cutaneous manifestations

2009 ◽  
Vol 110 (2) ◽  
pp. 274-278
Author(s):  
Kim Rijkers ◽  
Jasper van Aalst ◽  
Erkan Kurt ◽  
Marc A. Daemen ◽  
Emile A. M. Beuls ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Complex Regional Pain Syndrome ◽  
Female Patient ◽  
Spinal Cord Stimulation ◽  
Scientific Literature ◽  
Pain Syndrome ◽  
Type I ◽  
Syndrome Type ◽  
Cutaneous Manifestations ◽  
Giant Bullae

The authors present the case of a 49-year-old female patient with complex regional pain syndrome–Type I (CRPSI) who was suffering from nonhealing wounds and giant bullae, which dramatically improved after spinal cord stimulation (SCS). The scientific literature concerning severe cutaneous manifestations of CRPS-I and their treatment is reviewed. Nonhealing wounds and bullae are rare manifestations of CRPS-I that are extremely difficult to treat. Immediate improvement of both wounds and bullae after SCS, such as in this case, has not been reported previously in literature. Considering the rapidly progressive nature of these severe skin manifestations, immediate treatment, possibly with SCS, is mandatory.

scholarly journals Interaction of Hyperalgesia and Sensory Loss in Complex Regional Pain Syndrome Type I (CRPS I)

PLoS ONE ◽  
2008 ◽  
Vol 3 (7) ◽  
pp. e2742 ◽  
Author(s):  
Volker Huge ◽  
Meike Lauchart ◽  
Stefanie Förderreuther ◽  
Wibke Kaufhold ◽  
Michael Valet ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Sensory Loss ◽  
Type I ◽  
Syndrome Type

Skin biomarkers associated with complex regional pain syndrome (CRPS) Type I: a systematic review

2022 ◽  
Author(s):  
Diana Andronic ◽  
Octavian Andronic ◽  
Astrid Juengel ◽  
Martin C. Berli ◽  
Oliver Distler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Type I
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