Iftah Biran1,2,3, Andrea Book3,4, Liron Aviram5, Noa Bregman1,6, Einat Bahagali4, Assaf Tripto3,6,7. 1. Neurological Institute, Tel Aviv Medical Center, Tel Aviv-Yafo, Israel. 2. Division of Psychiatry, Tel Aviv Medical Center, Tel Aviv-Yafo, Israel. 3. The Rehabilitation Hospital, Chaim Sheba Medical Center, Ramat Gan, Israel. 4. Department of Psychology, Ari'el University, Ari'el, Israel. 5. Department of Psychology, The Academic College of Tel Aviv - Yaffo, Tel Aviv-Yafo, Israel. 6. Sackler School of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel. 7. Be'eri Clinic, Clalit Health Services, Bnei Brak, Israel.
Abstract
Background: Complex Regional Pain Syndrome (CRPS) is a clinical syndrome composed of chronic pain, motor impairment, and autonomic dysfunction, usually affecting a limb. Although CRPS seems to be a peripheral disorder, it is accompanied by parietal alterations leading to body schema impairments (the online representations of the body). Impairments to body structural description (the topographical bodily map) were not assessed systematically in CRPS. A patient we encountered with severe disruption to her bodily structural description led us to study this domain further. Aims: To document aberrant body structural description in subjects with CRPS using an object assembly task. Methods: Body Schema Study: 6 subjects with CRPS-I and six age and sex-matched healthy controls completed visual puzzles taken from WAIS-III and WAIS-R. The puzzles were either related to the human body or non-human body objects. Mann-Whitney U-tests were performed to compare groups' performances. Results: The CRPS group received relatively lower scores compared to controls for human body objects (u = 3, p < 0.05), whereas the non-human object scoring did not reveal significant differences between groups (u = 9, p > 0.05). Conclusion: CRPS subjects suffer from impaired body structural description, taking the form of body parts disassembly and body parts discontinuity. This impairment can serve as a nidus for aberrant psychological representation of the body.
Background: Complex Regional Pain Syndrome (CRPS) is a clinical syndrome composed of chronic pain, motor impairment, and autonomic dysfunction, usually affecting a limb. Although CRPS seems to be a peripheral disorder, it is accompanied by parietal alterations leading to body schema impairments (the online representations of the body). Impairments to body structural description (the topographical bodily map) were not assessed systematically in CRPS. A patient we encountered with severe disruption to her bodily structural description led us to study this domain further. Aims: To document aberrant body structural description in subjects with CRPS using an object assembly task. Methods: Body Schema Study: 6 subjects with CRPS-I and six age and sex-matched healthy controls completed visual puzzles taken from WAIS-III and WAIS-R. The puzzles were either related to the human body or non-human body objects. Mann-Whitney U-tests were performed to compare groups' performances. Results: The CRPS group received relatively lower scores compared to controls for human body objects (u = 3, p < 0.05), whereas the non-human object scoring did not reveal significant differences between groups (u = 9, p > 0.05). Conclusion: CRPS subjects suffer from impaired body structural description, taking the form of body parts disassembly and body parts discontinuity. This impairment can serve as a nidus for aberrant psychological representation of the body.