Bilateral motor cortex disinhibition in complex regional pain syndrome (CRPS) type I of the hand

被引:203
作者
Schwenkreis, P
Janssen, F
Rommel, O
Pleger, B
Völker, B
Hosbach, I
Dertwinkel, R
Maier, C
Tegenthoff, M
机构
[1] Ruhr Univ Bochum, BG Kliniken Bergmannsheil, Dept Neurol, D-44789 Bochum, Germany
[2] Ruhr Univ Bochum, BG Kliniken Bergmannsheil, Dept Anesthesiol Intens Care & Pain Treatment, D-4630 Bochum, Germany
[3] Ruhr Univ Bochum, BG Kliniken Bergmannsheil, Dept Pain Treatment, D-4630 Bochum, Germany
关键词
D O I
10.1212/WNL.61.4.515
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Complex regional pain syndrome type I ( CRPS I) develops as a consequence of trauma affecting the limbs, without obvious nerve lesion. Its features include pain, edema, autonomic dysfunction, movement disorder, and trophic changes. CNS involvement is suggested by the symptoms, but the pathophysiology of CRPS I is unknown. Objective: To assess excitability changes in the motor cortex in patients with CRPS I. Methods: The authors studied 25 patients with unilateral CRPS I involving the hand by means of transcranial magnetic stimulation using a paired-pulse paradigm. Motor threshold (MT) and intracortical inhibition and facilitation were determined on the affected and the clinically unaffected side. A control group of 20 healthy subjects was studied. Results: The authors found a significant reduction of intracortical inhibition on both sides of patients with CRPS compared with control subjects, whereas intracortical facilitation and MT did not differ significantly. However, in the patients' group, the presence of allodynia significantly decreased MT. Conclusions: The authors showed a bilateral disinhibition of the motor cortex in patients with complex regional pain syndrome.
引用
收藏
页码:515 / 519
页数:6
相关论文
共 49 条
  • [11] KIM SH, 1992, PAIN, V50, P355, DOI 10.1016/0304-3959(92)90041-9
  • [12] Does the right side know what the left is doing?
    Koltzenburg, M
    Wall, PD
    McMahon, SB
    [J]. TRENDS IN NEUROSCIENCES, 1999, 22 (03) : 122 - 127
  • [13] REFLEX SYMPATHETIC DYSTROPHY SYNDROME .1. CLINICAL AND HISTOLOGIC STUDIES - EVIDENCE FOR BILATERALITY, RESPONSE TO CORTICOSTEROIDS AND ARTICULAR INVOLVEMENT
    KOZIN, F
    MCCARTY, DJ
    SIMS, J
    GENANT, H
    [J]. AMERICAN JOURNAL OF MEDICINE, 1976, 60 (03) : 321 - 331
  • [14] CORTICOCORTICAL INHIBITION IN HUMAN MOTOR CORTEX
    KUJIRAI, T
    CARAMIA, MD
    ROTHWELL, JC
    DAY, BL
    THOMPSON, PD
    FERBERT, A
    WROE, S
    ASSELMAN, P
    MARSDEN, CD
    [J]. JOURNAL OF PHYSIOLOGY-LONDON, 1993, 471 : 501 - 519
  • [15] NORADRENALINE HYPERALGESIA IS MEDIATED THROUGH INTERACTION WITH SYMPATHETIC POSTGANGLIONIC NEURON TERMINALS RATHER THAN ACTIVATION OF PRIMARY AFFERENT NOCICEPTORS
    LEVINE, JD
    TAIWO, YO
    COLLINS, SD
    TAM, JK
    [J]. NATURE, 1986, 323 (6084) : 158 - 160
  • [16] Motor cortex disinhibition in Alzheimer's disease
    Liepert, J
    Bär, KJ
    Meske, U
    Weiller, C
    [J]. CLINICAL NEUROPHYSIOLOGY, 2001, 112 (08) : 1436 - 1441
  • [17] Patterns of spread in complex regional pain syndrome, type I (reflex sympathetic dystrophy)
    Maleki, J
    LeBel, AA
    Bennett, GJ
    Schwartzman, RJ
    [J]. PAIN, 2000, 88 (03) : 259 - 266
  • [18] SPATIAL PATTERNS OF SPINAL-CORD [C-14] 2-DEOXYGLUCOSE METABOLIC-ACTIVITY IN A RAT MODEL OF PAINFUL PERIPHERAL MONONEUROPATHY
    MAO, JR
    PRICE, DD
    COGHILL, RC
    MAYER, DJ
    HAYES, RL
    [J]. PAIN, 1992, 50 (01) : 89 - 100
  • [19] Intracortical facilitation and inhibition after transcranial magnetic stimulation in conscious humans
    Nakamura, H
    Kitagawa, H
    Kawaguchi, Y
    Tsuji, H
    [J]. JOURNAL OF PHYSIOLOGY-LONDON, 1997, 498 (03): : 817 - 823
  • [20] Cerebral activation patterns in patients with writer's cramp: a functional magnetic resonance imaging study
    Preibisch, C
    Berg, D
    Hofmann, E
    Solymosi, L
    Naumann, M
    [J]. JOURNAL OF NEUROLOGY, 2001, 248 (01) : 10 - 17