Imaging and Clinical Evidence of Sensorimotor Problems in CRPS: Utilizing Novel Treatment Approaches

被引:18
作者
Bailey, Jacqueline [1 ,2 ]
Nelson, Sara [1 ,2 ]
Lewis, Jenny [1 ]
McCabe, Candida S. [1 ,2 ]
机构
[1] Royal Natl Hosp Rheumat Dis, Bath Ctr Pain Serv, Bath BA1 1RL, Avon, England
[2] Univ W England, Fac Hlth & Life Sci, Bristol BS16 1QY, Avon, England
关键词
Complex Regional Pain Syndrome; Cortical reorganisation; Sensory system; Motor system; Pain; Body perception disturbances; REGIONAL PAIN SYNDROME; REFLEX SYMPATHETIC DYSTROPHY; SYNDROME TYPE-I; MIRROR VISUAL FEEDBACK; PHANTOM LIMB PAIN; SYNDROME TYPE-1; CORTICAL REORGANIZATION; NEUROPATHIC PAIN; PERCEPTION; TACTILE;
D O I
10.1007/s11481-012-9405-9
中图分类号
Q189 [神经科学];
学科分类号
071006 [神经生物学];
摘要
Inflammation and altered autonomic function are diagnostic signs and symptoms of Complex Regional Pain Syndrome. In the acute stages these are commonly at their most florid accompanied by severe pain and reduced function. Understandably this has directed research towards potential peripheral drivers for the causal mechanisms of this condition. In particular this is now focused on the inflammatory process and the potential role of autoantibodies. More subtle changes also occur in terms of altered tactile processing within the affected limb, disturbances in body perception and motor planning problems that become more evident as the condition progresses. Through careful clinical observation and neuro-imaging techniques, these changes are now thought to be associated with altered cortical processing that includes reorganisation of both the motor and sensory maps. Furthermore, there appears to be a close relationship between the intensity of pain experienced and the extent of cortical re-organisation. This increased knowledge around the peripheral and central mechanisms that may be operating in CRPS has been used to inform novel therapeutic approaches. We discuss here the presenting signs and symptoms of CRPS, with particular focus on sensory and motor changes and consider which mechanisms may drive these changes. Finally, we consider the emerging therapeutic options designed to correct these aberrant mechanisms.
引用
收藏
页码:564 / 575
页数:12
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