Cognitive correlates of 鈥渘eglect-like syndrome鈥?in patients with complex regional pain syndrome

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• 作者：Leonie Kolb^a ; Christoph Lang^a ; Frank Seifert^a ; Christian Maihö ; fner^a ; ^b ; ^{christian.maihoefner@uk-erlangen.de}
• 关键词：Complex regional pain syndrome ; CRPS ; Neglect ; Body schema ; Neuropathic pain ; Central sensitization
• 刊名：Pain
• 出版年：2012
• 期刊代码：214_03043959
• 类别：med
• 出版时间：May, 2012
• 卷：153
• 期：5
• 页码：1063-1073
• 文件大小：271 K

摘要

Patients with complex regional pain syndrome (CRPS) often show distinct neurocognitive dysfunctions, which were initially termed 鈥渘eglect-like symptoms.鈥?So far, particularly the patients鈥?feelings about the affected extremity, motor, and sensory aspects of the 鈥渘eglect-like symptoms鈥?have been investigated, possibly pointing to a disturbed body schema. Because patients with classical neurological neglect show diminished awareness regarding the perception of their body, as well as of the space around them, our hypothesis was that CRPS patients exhibit some signs of personal neglect and extrapersonal visuospatial problems over and beyond those seen in patients simply suffering from limb pain. We used quantitative sensory testing and motor assessment aimed at detecting motor and sensory loss, a standardized questionnaire calculating a neglect score, and applied a detailed neuropsychological test battery assessing different parietal lobe functions, including visual neglect. We examined 20 CRPS patients and 2 matched control groups, one consisting of healthy subjects and the other one of patients with limb pain other than CRPS. Results show significant higher neglect scores for CRPS patients and the pain control group, but interestingly, CRPS patients and pain patients were indistinguishable. The results of the neuropsychological test battery did not demonstrate systematic variances, which would be indicative of a classical neurological neglect in CRPS patients, even though there were 3 CRPS patients who differed 猢? SD from the mean of our healthy control group, with poorer results in 猢? different tests. We assume that the 鈥渘eglect-like syndrome鈥?in most CRPS patients is different from typical neglect.