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Altered central sensorimotor processing in patients with complex regional pain syndrome
Kirsi Juottonen1, Maarit Gockel, Teija Silén
1Brain Research Unit, Low Temperature Laboratory, Helsinki University of Technology, P.O. Box 2200, FIN-02015 HUT, Espoo, Finland Department of Physiatry, ORTON Hospital, FIN-00280 Helsinki, Finland Division of Clinical Neurophysiology, Helsinki University Central Hospital, FIN-00290 Helsinki, Finland.
Pain
|July 20, 2002
Summary
Chronic pain, such as complex regional pain syndrome (CRPS), alters tactile processing in the brain. This study found heightened responses and changes in sensory representation in CRPS patients, impacting tactile sensitivity.
Area of Science:
- Neuroscience
- Pain Research
- Somatosensory Processing
Background:
- Tactile sensitivity changes are common in chronic pain patients.
- Brain imaging shows overlap between pain and tactile processing areas.
- The impact of chronic pain on central tactile processing is not well understood.
Purpose of the Study:
- To investigate the effects of chronic pain on central tactile processing.
- To examine somatosensory cortical responses and brain oscillations in patients with complex regional pain syndrome (CRPS).
Main Methods:
- Clinical examination of six CRPS patients with upper limb involvement.
- Whole-head magnetoencephalography (MEG) to record brain activity.
- Tactile stimulation of fingertips to elicit somatosensory cortical responses.
- Monitoring of spontaneous brain oscillations (20-Hz motor cortex rhythm).
Main Results:
- Tactile stimulation activated SI cortex (65 ms) and SII cortices (130 ms).
- SI responses were 25-55% stronger on the painful side compared to the healthy side.
- Reduced distance between SI representations of thumb and little finger in the hemisphere contralateral to the painful limb.
- Altered reactivity of the 20-Hz motor cortex rhythm in CRPS patients, suggesting modified motor cortex inhibition.
Conclusions:
- Chronic pain, exemplified by CRPS, significantly alters central tactile processing.
- Changes in somatosensory cortex activation and representation indicate neuroplasticity in response to chronic pain.
- Modified motor cortex rhythm reactivity suggests that chronic pain impacts motor control mechanisms.