Complex regional pain syndrome associated with hyperattention rather than neglect for the healthy side: A comprehensive case study

Ann Phys Rehabil Med. 2016 Dec;59(5-6):294-301. doi: 10.1016/j.rehab.2016.10.001. Epub 2016 Nov 23.

Abstract

Complex regional pain syndrome (CRPS) is a dehabilitating chronic condition occurring with peripheral lesions. There is growing consensus for a central contribution to CRPS. Although the nature of this central body representation disorder is increasingly debated, it has been repeatedly argued that CRPS results in motor neglect of the affected side. The present article describes a comprehensive and quantitative case report demonstrating that: (1) not all patients with chronic CRPS exhibit decreased spatial attention for the affected side and (2) patients may actually exhibit a substantial, broad and reliable attentional bias toward the painful side, akin to spatial neglect for the healthy side. This unexpected result agrees with the idea that patients can be hyper-attentive toward their pathological side as a manifestation of lowered pain threshold, allodynia and kinesiophobia.

Keywords: ADL; Body representation; CRPS; Motor neglect; Pain; Prism adaptation; Reference frame; Spatial neglect.

Publication types

  • Case Reports

MeSH terms

  • Attentional Bias*
  • Female
  • Humans
  • Middle Aged
  • Musculoskeletal Pain / etiology
  • Musculoskeletal Pain / psychology*
  • Pain Measurement
  • Perceptual Disorders / etiology
  • Perceptual Disorders / psychology*
  • Reflex Sympathetic Dystrophy / etiology
  • Reflex Sympathetic Dystrophy / psychology*