Patterns of cortical reorganization in complex regional pain syndrome
Patterns of cortical reorganization in complex regional pain syndrome
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DOI：
10.1212/01.wnl.0000098939.02752.8e
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发表时间：
2003-12-23
期刊：
影响因子：
9.9
通讯作者：
Birklein, F
中科院分区：
文献类型：
--
作者：
Maihöfner, C;Handwerker, HO;Birklein, F
目的：应用脑磁图评价复杂性区域疼痛综合征(CRPS)患者初级躯体感觉皮层(S1)可能的皮质重组。背景：CRPS的疼痛和感觉症状的模式可能表明中枢神经系统的可塑性变化。方法：应用磁源成像技术对12例患者健侧和患侧CRPS患者的第1、5指(D)与下唇的皮质关系进行研究。结果：作者发现CRPS患侧的手部皮质区伸展明显缩小。手的中心移向嘴唇的皮质表示。皮层重组与麦吉尔问卷测量的CRPS疼痛程度(r=0.792)和机械性痛觉过敏程度(r=0.860)相关。通过多元回归分析发现，机械性痛觉过敏是可塑性改变的最佳预测因子。此外，与健侧相比，触觉刺激后CRPS侧的S1信号源显著增加。结论：本研究显示了CRPS患侧对侧S1皮质的重组。重组似乎与神经病理性疼痛的主诉有关。
Objective: To use magnetoencephalography to assess possible cortical reorganization in the primary somatosensory cortex (S1) of patients with complex regional pain syndrome (CRPS). Background: Patterns of pain and sensory symptoms in CRPS may indicate plastic changes of the CNS. Methods: Magnetic source imaging was used to explore changes in the cortical representation of digits (D) 1 and 5 in relation to the lower lip on the unaffected and affected CRPS side in 12 patients. Results: The authors found a significant shrinkage of the extension of the cortical hand representation for the CRPS affected side. The center of the hand was shifted toward the cortical representation of the lip. The cortical reorganization correlated with the amount of CRPS pain (r = 0.792), as measured by the McGill questionnaire, and the extent of mechanical hyperalgesia (r = 0.860). Using multiple regression analysis, the best predictor for the plastic changes was found to be mechanical hyperalgesia. Additionally, S1 sources following tactile stimulation were significantly increased on the CRPS side compared to the unaffected limb. Conclusions: This study showed reorganization of the S1 cortex contralateral to the CRPS affected side. The reorganization appeared to be linked to complaints of neuropathic pain.