Altered resting activity patterns and connectivity in individuals with complex regional pain syndrome
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Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder that typically occurs in the limbs, usually the upper limb. CRPS usually develops from a peripheral event but its maintenance relies on changes within the central nervous system. While functional abnormalities in the thalamus and primary somatosensory cortex (S1) of the brain are some of the most consistently reported brain findings in CRPS, the mechanisms are yet to be explored in full, not least of all how these two regions interact and how they might relate to clinical deficits, such as the commonly reported poor tactile acuity in this condition. This study recruited 15 upper-limb CRPS subjects and 30 healthy controls and used functional magnetic resonance imaging (fMRI) to investigate infra-slow oscillations (ISOs) in critical pain regions of the brain in CRPS. As hypothesised, we found CRPS was associated with increases in resting signal intensity ISOs (0.03–0.06 Hz) in the thalamus contralateral to the painful limb in CRPS subjects. Interestingly, there was no such difference between groups in S1, however CRPS subjects displayed stronger thalamo-S1 functional connectivity than controls, and this was related to pain. As predicted, CRPS subjects displayed poor tactile acuity on the painful limb which, interestingly, was also related to thalamo-S1 functional connectivity strength. Our findings provide novel evidence of altered patterns of resting activity and connectivity in CRPS which may underlie altered thalamocortical loop dynamics and the constant perception of pain.
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Lee, B.; Henderson, L.A.; Rae, C.D.; Di Pietro, Flavia (2020)© 2020 Lee et al. Complex regional pain syndrome (CRPS) is a debilitating chronic pain disorder typically in the upper or lower limbs. While CRPS usually develops from a peripheral event, it is likely maintained by CNS ...
An exploration into the cortical reorganisation of the healthy hand in upper-limb complex regional pain syndromePietro, Flavia ; Stanton, T.R.; Moseley, G.L.; Lotze, M.; McAuley, J.H. (2017)© 2016 Scandinavian Association for the Study of Pain. Recent evidence demonstrated that complex regional pain syndrome (CRPS) is associated with a larger than normal somatosensory (S1) representation of the healthy hand. ...
Harrington, Flavia ; Stanton, T.R.; Moseley, G.L.; Lotze, M.; Mcauley, J.H. (2015)© 2014 Wiley Periodicals, Inc. It is widely accepted that complex regional pain syndrome (CRPS) is associated with shrinkage of the primary somatosensory cortex (S1) representation of the affected limb. However, supporting ...