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Impaired hand size estimation in CRPS.

Elena Peltz¹, Frank Seifert, Stefan Lanz

¹Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.

The Journal of Pain

|July 12, 2011

Summary

Patients with complex regional pain syndrome (CRPS) overestimate the size of their affected hand. This perception distortion correlates with disease duration and sensory deficits, suggesting central nervous system involvement.

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Area of Science:

Neuroscience
Pain Medicine
Psychology

Background:

Complex Regional Pain Syndrome (CRPS) is characterized by autonomic, motor, and sensory dysfunctions.
Sensory dysfunction in CRPS includes altered pain perception and potential disturbances in body schema representation.
Previous research suggests central nervous system (CNS) involvement in CRPS, indicated by altered somatotopic maps.

Purpose of the Study:

To investigate body schema disturbances in patients with upper extremity CRPS.
To examine the accuracy of hand size estimation in CRPS patients compared to healthy controls.
To identify correlations between hand size overestimation and clinical factors in CRPS.

Main Methods:

Patients with upper extremity CRPS and healthy controls estimated hand sizes using schematic drawings.

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Objective measurements of hand size were used for comparison.

Correlations were analyzed between hand size estimation errors and disease duration, neglect scores, and two-point discrimination thresholds (TPDT).

Main Results:

CRPS patients significantly overestimated the size of their affected hand compared to objective measurements.
The degree of overestimation correlated positively with disease duration and neglect scores.
Increased TPDT in CRPS patients also correlated with hand size overestimation.

Conclusions:

CRPS patients exhibit a disrupted body schema, perceiving their affected hand as larger than it is.
The findings support the involvement of the CNS in CRPS-related body schema disturbances.
Potential neural substrates include the primary somatosensory and posterior parietal cortices.