Francesca Morgante1, Antonino Naro2, Carmen Terranova1, Margherita Russo2, Vincenzo Rizzo1, Giovanni Risitano3, Paolo Girlanda1, Angelo Quartarone4. 1. Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, Messina, Italy. 2. IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy. 3. Unità Funzionale di Ortopedia e Traumatologia, Casa di Cura "Cappellani-GIOMI", Messina, Italy. 4. Department of Biomedical, Dental Sciences, and Morphological and Functional Images, University of Messina, Messina, Italy.
Abstract
BACKGROUND: Movement disorders associated with complex regional pain syndrome type I have been a subject of controversy over the last 10 years regarding their nature and pathophysiology, with an intense debate about the functional (psychogenic) nature of this disorder. The aim of this study was to test sensorimotor plasticity and cortical excitability in patients with complex regional pain syndrome type I who developed a fixed posture of the hand. METHODS: Ten patients with complex regional pain syndrome type I in the right upper limb and a fixed posture of the hand (disease duration less than 24 months) and 10 age-matched healthy subjects were enrolled. The following parameters of corticospinal excitability were recorded from the abductor pollicis brevis muscle of both hands by transcranial magnetic stimulation: resting and active motor thresholds, short-interval intracortical inhibition and facilitation, cortical silent period, and short- and long-latency afferent inhibition. Sensorimotor plasticity was tested using the paired associative stimulation protocol. RESULTS: Short-interval intracortical inhibition and long-latency afferent inhibition were reduced only in the affected right hand of patients compared with control subjects. Sensorimotor plasticity was comparable to normal subjects, with a preserved topographic specificity. CONCLUSIONS: Our data support the view that motor disorder in complex regional pain syndrome type I is not associated with abnormal sensorimotor plasticity, and it shares pathophysiological abnormalities with functional (psychogenic) dystonia rather than with idiopathic dystonia.
BACKGROUND:Movement disorders associated with complex regional pain syndrome type I have been a subject of controversy over the last 10 years regarding their nature and pathophysiology, with an intense debate about the functional (psychogenic) nature of this disorder. The aim of this study was to test sensorimotor plasticity and cortical excitability in patients with complex regional pain syndrome type I who developed a fixed posture of the hand. METHODS: Ten patients with complex regional pain syndrome type I in the right upper limb and a fixed posture of the hand (disease duration less than 24 months) and 10 age-matched healthy subjects were enrolled. The following parameters of corticospinal excitability were recorded from the abductor pollicis brevis muscle of both hands by transcranial magnetic stimulation: resting and active motor thresholds, short-interval intracortical inhibition and facilitation, cortical silent period, and short- and long-latency afferent inhibition. Sensorimotor plasticity was tested using the paired associative stimulation protocol. RESULTS: Short-interval intracortical inhibition and long-latency afferent inhibition were reduced only in the affected right hand of patients compared with control subjects. Sensorimotor plasticity was comparable to normal subjects, with a preserved topographic specificity. CONCLUSIONS: Our data support the view that motor disorder in complex regional pain syndrome type I is not associated with abnormal sensorimotor plasticity, and it shares pathophysiological abnormalities with functional (psychogenic) dystonia rather than with idiopathic dystonia.
Authors: Claudia V Turco; Jenin El-Sayes; Mitchell B Locke; Robert Chen; Steven Baker; Aimee J Nelson Journal: J Physiol Date: 2018-10-03 Impact factor: 5.182
Authors: Sarah Pirio Richardson; Eckart Altenmüller; Katharine Alter; Ron L Alterman; Robert Chen; Steven Frucht; Shinichi Furuya; Joseph Jankovic; H A Jinnah; Teresa J Kimberley; Codrin Lungu; Joel S Perlmutter; Cecília N Prudente; Mark Hallett Journal: Front Neurol Date: 2017-05-03 Impact factor: 4.003