Investigations on maladaptive plasticity in the sensorimotor cortex of unilateral upper limb CRPS I patients.
Adult
Aged
Brain Mapping
Cohort Studies
Complex Regional Pain Syndromes
/ diagnostic imaging
Discrimination, Psychological
Female
Fingers
/ physiopathology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multimodal Imaging
Neuronal Plasticity
/ physiology
Pinch Strength
Sensorimotor Cortex
/ diagnostic imaging
Touch Perception
Transcranial Magnetic Stimulation
Complex regional pain syndrome
high resolution fMRI
neuropathic pain
sensorimotor cortex
short-latency intra cortical inhibition
Journal
Restorative neurology and neuroscience
ISSN: 1878-3627
Titre abrégé: Restor Neurol Neurosci
Pays: Netherlands
ID NLM: 9005499
Informations de publication
Date de publication:
2019
2019
Historique:
pubmed:
17
4
2019
medline:
10
7
2019
entrez:
17
4
2019
Statut:
ppublish
Résumé
Patients with a complex regional pain syndrome (CRPS) in the upper limb show a sensory and motor impairment of the hand. Decreased intra-cortical-inhibition (ICI) of the motor representation of the affected hand muscle and decreased somatosensory hand representation size were related to maladaptive plasticity. To achieve new insights about CRPS we examined whether these alterations were present in a single cohort. We used a multi-modal approach comprising behavioral testing, transcranial magnetic stimulation, and high resolution fMRI combined with a new analysis technique for improved neuronal specificity. We found a decreased pinch-grip performance, two-point discrimination on the fingertips, ICI in the motor cortex, and representation size of the hand in Brodmann Area 3b (BA3b) in the somatosensory cortex. Our analysis further showed that correlations with ICI on the non-affected side were absent on the affected side. This study is the first to gather behavioral, neurophysiologic and imaging measurements for one patient cohort and it therefore enables a comprehensive view of collapsed associations of function and representation focused on the hemisphere contralateral to the affected hand.
Sections du résumé
BACKGROUND
Patients with a complex regional pain syndrome (CRPS) in the upper limb show a sensory and motor impairment of the hand. Decreased intra-cortical-inhibition (ICI) of the motor representation of the affected hand muscle and decreased somatosensory hand representation size were related to maladaptive plasticity.
OBJECTIVE
To achieve new insights about CRPS we examined whether these alterations were present in a single cohort.
METHODS
We used a multi-modal approach comprising behavioral testing, transcranial magnetic stimulation, and high resolution fMRI combined with a new analysis technique for improved neuronal specificity.
RESULTS
We found a decreased pinch-grip performance, two-point discrimination on the fingertips, ICI in the motor cortex, and representation size of the hand in Brodmann Area 3b (BA3b) in the somatosensory cortex. Our analysis further showed that correlations with ICI on the non-affected side were absent on the affected side.
CONCLUSIONS
This study is the first to gather behavioral, neurophysiologic and imaging measurements for one patient cohort and it therefore enables a comprehensive view of collapsed associations of function and representation focused on the hemisphere contralateral to the affected hand.
Identifiants
pubmed: 30988242
pii: RNN180886
doi: 10.3233/RNN-180886
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM