Jörg Trojan1,2, Verena Speck3, Dieter Kleinböhl2, Justus Benrath4, Herta Flor2, Christian Maihöfner5,6. 1. Department of Psychology, University of Koblenz-Landau, Landau, Germany. 2. Department of Cognitive und Clinical Neuroscience, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany. 3. Department of Neurology, University Medical Center Mainz, Mainz, Germany. 4. Center of Pain Therapy, Clinic of Anaesthesia and Intensive Care, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany. 5. Department of Neurology, Fürth General Hospital, Fürth, Germany. 6. Department of Physiology and Pathophysiology, University of Erlangen-Nuremberg, Erlangen, Germany.
Abstract
BACKGROUND: In complex regional pain syndrome (CRPS), altered perception of the affected hand and neglect-like symptoms of the affected body side are common features. In this study, we presented tactile stimuli to the affected hands in CRPS patients and matched healthy controls. METHODS: The participants' task was to point at the perceived positions of the stimuli using a tracking device. The spatial coordinates of the perceived positions were analysed for accuracy and consistency. We also presented patterns consisting of two stimuli at distinct positions with a delay of 100 ms. These patterns are known to induce spatiotemporal integration ("sensory saltation"). RESULTS: CRPS patients were less accurate and less consistent in the spatial perception of tactile stimuli on their hands. Furthermore, they showed increased spatiotemporal integration, although these effects were smaller than expected. These deficiencies were related to the clinically assessed intensity of recurrent pain episodes. Surprisingly, the intensity of clinically assessed ongoing pain was associated with increased precision. CONCLUSIONS: In line with earlier reports, our findings indicate that the representation of the affected hands in CRPS patients is less accurate than in healthy people, probably reflecting reorganization in somatosensory cortices. The exact relationships between these findings and other aspects of CRPS remain to be elucidated. SIGNIFICANCE: CRPS patients performed poorly in localizing positions on their affected hands via pointing and exhibited increased spatiotemporal integration. The presented method may prove useful in diagnostics as well as psychophysical and neurofunctional research on CRPS and other chronic pain disorders.
BACKGROUND: In complex regional pain syndrome (CRPS), altered perception of the affected hand and neglect-like symptoms of the affected body side are common features. In this study, we presented tactile stimuli to the affected hands in CRPSpatients and matched healthy controls. METHODS: The participants' task was to point at the perceived positions of the stimuli using a tracking device. The spatial coordinates of the perceived positions were analysed for accuracy and consistency. We also presented patterns consisting of two stimuli at distinct positions with a delay of 100 ms. These patterns are known to induce spatiotemporal integration ("sensory saltation"). RESULTS:CRPSpatients were less accurate and less consistent in the spatial perception of tactile stimuli on their hands. Furthermore, they showed increased spatiotemporal integration, although these effects were smaller than expected. These deficiencies were related to the clinically assessed intensity of recurrent pain episodes. Surprisingly, the intensity of clinically assessed ongoing pain was associated with increased precision. CONCLUSIONS: In line with earlier reports, our findings indicate that the representation of the affected hands in CRPSpatients is less accurate than in healthy people, probably reflecting reorganization in somatosensory cortices. The exact relationships between these findings and other aspects of CRPS remain to be elucidated. SIGNIFICANCE: CRPSpatients performed poorly in localizing positions on their affected hands via pointing and exhibited increased spatiotemporal integration. The presented method may prove useful in diagnostics as well as psychophysical and neurofunctional research on CRPS and other chronic pain disorders.
Authors: Gudrun Gossrau; Anna Klimova; Hanna Sophie Lapp; Marie Frost; Elisabeth Peschel; Kerstin Weidner; Thea Koch; Rainer Sabatowski; Ilona Croy Journal: Pain Rep Date: 2021-06-30