Impaired spatial body representation in complex regional pain syndrome type 1 (CRPS I). 2012

Annika Reinersmann, and Julia Landwehrt, and Elena K Krumova, and Sebastian Ocklenburg, and Onur Güntürkün, and Christoph Maier
Department of Pain Management, Ruhr-University Bochum, BG Universitätsklinikum Bergmannsheil GmbH, Bochum, Germany Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr-University Bochum, Bochum, Germany.

Recently, a shift of the visual subjective body midline (vSM), a correlate of the egocentric reference frame, towards the affected side was reported in patients with complex regional pain syndrome (CRPS). However, the specificity of this finding is as yet unclear. This study compares 24 CRPS patients to 21 patients with upper limb pain of other origin (pain control) and to 24 healthy subjects using a comprehensive test battery, including assessment of the vSM in light and dark, line bisection, hand laterality recognition, neglect-like severity symptoms, and motor impairment (disability of the arm, shoulder, and hand). METHODS 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.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010468 Perceptual Disorders Cognitive disorders characterized by an impaired ability to perceive the nature of objects or concepts through use of the sense organs. These include spatial neglect syndromes, where an individual does not attend to visual, auditory, or sensory stimuli presented from one side of the body. Hemispatial Neglect,Hemisensory Neglect,Sensory Neglect,Somatosensory Discrimination Disorder,Discrimination Disorder, Somatosensory,Discrimination Disorders, Somatosensory,Hemisensory Neglects,Hemispatial Neglects,Neglect, Hemisensory,Neglect, Hemispatial,Neglect, Sensory,Neglects, Hemisensory,Perceptual Disorder,Sensory Neglects,Somatosensory Discrimination Disorders
D012019 Reflex Sympathetic Dystrophy A syndrome characterized by severe burning pain in an extremity accompanied by sudomotor, vasomotor, and trophic changes in bone without an associated specific nerve injury. This condition is most often precipitated by trauma to soft tissue or nerve complexes. The skin over the affected region is usually erythematous and demonstrates hypersensitivity to tactile stimuli and erythema. (Adams et al., Principles of Neurology, 6th ed, p1360; Pain 1995 Oct;63(1):127-33) Algodystrophy,Complex Regional Pain Syndrome, Type I,Pain Syndrome Type I, Regional, Complex,Shoulder-Hand Syndrome,Sudek Atrophy,Algodystrophic Syndrome,CRPS Type I,Cervical Sympathetic Dystrophy,Pain Syndrome Type I, Complex Regional,RSD (Reflex Sympathetic Dystrophy),Reflex Sympathetic Dystrophy Syndrome,Sudek's Atrophy,Sympathetic Reflex Dystrophia,Syndrome, Reflex Sympathetic Dystrophy,Type I Complex Regional Pain Syndrome,Algodystrophies,Atrophies, Sudek's,Atrophy, Sudek,Atrophy, Sudek's,CRPS Type Is,Cervical Sympathetic Dystrophies,Dystrophies, Cervical Sympathetic,Dystrophies, Reflex Sympathetic,Dystrophy, Cervical Sympathetic,Dystrophy, Reflex Sympathetic,RSDs (Reflex Sympathetic Dystrophy),Reflex Dystrophia, Sympathetic,Reflex Sympathetic Dystrophies,Shoulder Hand Syndrome,Shoulder-Hand Syndromes,Sudek's Atrophies,Sudeks Atrophy,Sympathetic Dystrophies, Cervical,Sympathetic Dystrophies, Reflex,Sympathetic Dystrophy, Cervical,Sympathetic Dystrophy, Reflex,Sympathetic Reflex Dystrophias,Syndrome, Algodystrophic,Syndrome, Shoulder-Hand,Syndromes, Shoulder-Hand,Type I, CRPS
D001828 Body Image Individuals' concept of their own bodies. Body Identity,Body Representation,Body Schema,Body Images,Body Representations,Body Schemas,Identity, Body,Image, Body,Representation, Body,Schema, Body
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013028 Space Perception The awareness of the spatial properties of objects; includes physical space. Perception, Space,Perceptions, Space,Space Perceptions

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