Space-based, but not arm-based, shift in tactile processing in complex regional pain syndrome and its relationship to cooling of the affected limb.

Complex regional pain syndrome (CRPS) occurs after stroke, but most cases develop after peripheral trauma and without evidence of brain trauma. However, CRPS is associated with symptoms that appear similar to those observed in patients suffering from hemispatial neglect. Ten participants (four males) with CRPS of one arm performed temporal order judgements of pairs of vibrotactile stimuli, one delivered to each hand, at one of 10 possible stimulus onset asynchronies, under two conditions: arms held each side of the midline and arms crossed over the midline. Participants released a foot switch to indicate which hand had been stimulated first. The order of conditions was randomized and the foot under which the switch was positioned was counterbalanced. There were two blocks of 150 trials in each condition. The stimulus onset asynchronicity at which the participants were equally likely to select either hand, the point of subjective simultaneity (PSS), was compared between conditions and between those with left or right-sided symptoms. When arms were not crossed, the participants prioritized stimuli from the unaffected limb over those from the affected limb (mean +/- SD PSS = 25 +/- 7.5 ms) and the magnitude of the PSS strongly related to the degree to which the affected hand was cooler than the unaffected hand (r = 0.942, P < 0.001). When the arms were crossed, the effect was reversed: the participants prioritized stimuli from the affected limb over those from the unaffected limb [PSS = -18 +/- 13 ms; main effect of condition F (1, 9) = 98.6, P < 0.001]. There was no effect of the side of symptoms. These results show that CRPS is associated with a deficit in tactile processing that is defined by the space in which the affected limb normally resides, not by the affected limb itself, and which relates to the relative cooling of the affected limb. This pattern is consistent with data from those with hemispatial neglect after stroke and raises the possibility that chronic CRPS involves a type of spatial neglect.

[1]  Charles Spence,et al.  Response Requirements Modulate Tactile Spatial Congruency Evects for Example, given That the Body Can Adopt a Variety of Diverent Postures, a Tactile Sensation Arising , 2022 .

[2]  J. Marshall,et al.  Left on the right: allochiria in a case of left visuo-spatial neglect. , 1992, Journal of neurology, neurosurgery, and psychiatry.

[3]  S. Miyauchi,et al.  Pathologic pain distorts visuospatial perception , 2007, Neurology.

[4]  J. Paysant,et al.  Temporary phantom limbs evoked by vestibular caloric stimulation in amputees. , 2001, Neuropsychiatry, neuropsychology, and behavioral neurology.

[5]  E. Bisiach,et al.  Feeling touches in someone else's hand , 2002, Neuroreport.

[6]  C. Spence,et al.  Confusing the mind by crossing the hands. , 2002, Brain research. Cognitive brain research.

[7]  C. Maier,et al.  Severity and specificity of neglect-like symptoms in patients with complex regional pain syndrome (CRPS) compared to chronic limb pain of other origins , 2006, Pain.

[8]  Charles Spence,et al.  ‘Prior entry’ for pain: Attention speeds the perceptual processing of painful stimuli , 2007, Neuroscience Letters.

[9]  G. Vallar,et al.  Somatoparaphrenia: a body delusion. A review of the neuropsychological literature , 2008, Experimental Brain Research.

[10]  T. Loetscher,et al.  Misoplegia: a review of the literature and a case without hemiplegia , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[11]  B. Galer.  Hemisensory impairment in patients with complex regional pain syndrome. , 2000, Pain.

[12]  G. Vallar.  Extrapersonal Visual Unilateral Spatial Neglect and Its Neuroanatomy , 2001, NeuroImage.

[13]  R. Baron,et al.  Complex regional pain syndrome is a disease of the central nervous system , 2002, Clinical Autonomic Research.

[14]  M. Perenin,et al.  Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect , 1998, Nature.

[15]  H. Troeger.  [Complex regional pain syndrome (CRPS)]. , 2010, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V....

[16]  G. Moseley,et al.  Expectation of pain replicates the effect of pain in a hand laterality recognition task: Bias in information processing toward the painful side? , 2006, European journal of pain.

[17]  Jonas F. Vibell,et al.  Temporal Order is Coded Temporally in the Brain: Early Event-related Potential Latency Shifts Underlying Prior Entry in a Cross-modal Temporal Order Judgment Task , 2007, Journal of Cognitive Neuroscience.

[18]  J. Marshall,et al.  Line bisection in a case of visual neglect: Psychophysical studies with implications for theory , 1990 .

[19]  C. Spence,et al.  Psychologically induced cooling of a specific body part caused by the illusory ownership of an artificial counterpart , 2008, Proceedings of the National Academy of Sciences.

[20]  C. Spence,et al.  Multisensory prior entry. , 2001, Journal of experimental psychology. General.

[21]  C. Spence,et al.  The cognitive and neural correlates of “tactile consciousness”: A multisensory perspective , 2008, Consciousness and Cognition.

[22]  A. Young,et al.  Disentangling neglect and hemianopia , 1991, Neuropsychologia.

[23]  C. Spence,et al.  Visual distortion of a limb modulates the pain and swelling evoked by movement , 2008, Current Biology.

[24]  J. Krauss,et al.  The shoulder–hand syndrome after stroke: A prospective clinical trial , 1994, Annals of neurology.

[25]  B. Neundörfer,et al.  Cortical reorganization during recovery from complex regional pain syndrome , 2004, Neurology.

[26]  Edoardo Bisiach,et al.  Line bisection and cognitive plasticity of unilateral neglect of space , 1983, Brain and Cognition.

[27]  Body perception disturbance: A contribution to pain , 2007 .

[28]  G. Vallar,et al.  Improvement of left visuo-spatial hemineglect by left-sided transcutaneous electrical stimulation , 1995, Neuropsychologia.

[29]  Y. Rossetti,et al.  Prism adaptation to optical deviation alleviates pathologic pain , 2007, Neurology.

[30]  G. Crombez,et al.  Keeping pain in mind: A motivational account of attention to pain , 2010, Neuroscience & Biobehavioral Reviews.

[31]  A. Rubens.  Caloric stimulation and unilateral visual neglect , 1985, Neurology.

[32]  G. Moseley,et al.  Why do people with complex regional pain syndrome take longer to recognize their affected hand? , 2004, Neurology.

[33]  J. Mattingley,et al.  Visual extinction and prior entry: Impaired perception of temporal order with intact motion perception after unilateral parietal damage , 1997, Neuropsychologia.

[34]  G. Moseley,et al.  Stroke, complex regional pain syndrome and phantom limb pain: can commonalities direct future management? , 2007, Journal of rehabilitation medicine.

[35]  H. Branch Coslett,et al.  Evidence for a Disturbance of the Body Schema in Neglect , 1998, Brain and Cognition.

[36]  J. Lewald,et al.  Impaired perception of temporal order in auditory extinction , 2002, Neuropsychologia.

[37]  H. Karnath,et al.  Decrease of contralateral neglect by neck muscle vibration and spatial orientation of trunk midline. , 1993, Brain : a journal of neurology.

[38]  H. Coslett,et al.  Pain and the body schema: Effects of pain severity on mental representations of movement , 2002, Neurology.

[39]  G. Moseley,et al.  Faulty proprioceptive information disrupts motor imagery: an experimental study. , 2007, The Australian journal of physiotherapy.

[40]  Karen Faith Berman,et al.  Unilateral decrease in thalamic activity observed with positron emission tomography in patients with chronic neuropathic pain , 1995, Pain.

[41]  D. Weiss,et al.  Reassessment of the Incidence of Complex Regional Pain Syndrome Type 1 Following Stroke , 2000, Neurorehabilitation and neural repair.

[42]  A. Reiss,et al.  Syndrome , 1990, Biological Psychiatry.

[43]  D. Wolpert,et al.  Disorders of Body Scheme , 2004 .

[44]  R. Andersen,et al.  Multimodal representation of space in the posterior parietal cortex and its use in planning movements. , 1997, Annual review of neuroscience.

[45]  E. Bisiach,et al.  Unilateral neglect and disambiguation of the Necker cube. , 1999, Brain : a journal of neurology.

[46]  S. Aglioti,et al.  Temporal Modulation of Spatial Tactile Extinction in Right-Brain-Damaged Patients , 2003, Journal of Cognitive Neuroscience.

[47]  G. Moseley,et al.  Dysynchiria: Watching the mirror image of the unaffected limb elicits pain on the affected side , 2005, Neurology.

[48]  H. Freund,et al.  Cerebral network underlying unilateral motor neglect: evidence from positron emission tomography , 1994, Journal of the Neurological Sciences.

[49]  Y. Rossetti,et al.  Sensorimotor effects on central space representation: prism adaptation influences haptic and visual representations in normal subjects , 2004, Neuropsychologia.

[50]  Laura M. Jelsone,et al.  The effect of ipsilesional cues on line-bisection errors: the importance of predictive value , 2004, Neuropsychologia.

[51]  S. Kitazawa,et al.  Reversal of subjective temporal order due to arm crossing , 2001, Nature Neuroscience.

[52]  B. Galer,et al.  Neglect-like symptoms in complex regional pain syndrome: results of a self-administered survey. , 1999, Journal of pain and symptom management.

[53]  Giuseppe Vallar,et al.  Deficits of position sense, unilateral neglect and optokinetic stimulation , 1993, Neuropsychologia.

[54]  Katja Wiech,et al.  Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain , 2008, PAIN®.

[55]  C. Spence.  Prior entry: attention and temporal perception , 2010 .

[56]  G. Moseley,et al.  Experimental hand pain delays recognition of the contralateral hand--evidence that acute and chronic pain have opposite effects on information processing? , 2005, Brain research. Cognitive brain research.

[57]  John C. Marshall,et al.  When seeing is feeling: Acquired synaesthesia or phantom touch? , 1996 .

[58]  Jennifer T. Coull,et al.  Attention and Time , 2010 .

[59]  L. A. N. Esq.,et al.  LXI. Observations on some remarkable optical phænomena seen in Switzerland; and on an optical phænomenon which occurs on viewing a figure of a crystal or geometrical solid , 1832 .

[60]  H. Coslett,et al.  Pain and the body schema: evidence for peripheral effects on mental representations of movement. , 2001, Brain : a journal of neurology.

[61]  Harald Breivik,et al.  International Association for the Study of Pain: update on WHO-IASP activities. , 2002, Journal of pain and symptom management.

[62]  D. S. Chu,et al.  Shoulder-hand syndrome in a hemiplegic population: a 5-year retrospective study. , 1977, Archives of physical medicine and rehabilitation.

[63]  Patrick Ragert,et al.  Patterns of cortical reorganization parallel impaired tactile discrimination and pain intensity in complex regional pain syndrome , 2006, NeuroImage.

[64]  I. Hirsh,et al.  Perceived order in different sense modalities. , 1961, Journal of experimental psychology.

[65]  Attention and pain: merging behavioural and neuroscience investigations , 2005, Pain.

[66]  G. Baylis,et al.  Visual extinction with double simultaneous stimulation: what is simultaneous? , 2002, Neuropsychologia.

[67]  S. Kitazawa.  Where conscious sensation takes place , 2002, Consciousness and Cognition.

[68]  G. Fink,et al.  REVIEW: The functional organization of the intraparietal sulcus in humans and monkeys , 2005, Journal of anatomy.

[69]  F. Meneghello,et al.  Long-lasting amelioration of visuospatial neglect by prism adaptation. , 2002, Brain : a journal of neurology.

[70]  Marlene Behrmann,et al.  Spatial and temporal influences on extinction , 2002, Neuropsychologia.

[71]  P. Drummond,et al.  Sensory changes in the forehead of patients with complex regional pain syndrome , 2006, Pain.

[72]  Jason B. Mattingley,et al.  Prismatic adaptation reduces biased temporal order judgements in spatial neglect , 2004, Neuroreport.

[73]  Y. Iwamura.  Hierarchical somatosensory processing , 1998, Current Opinion in Neurobiology.

[74]  Jordan Grafman,et al.  Handbook of Neuropsychology , 1991 .

[75]  C Luzzatti,et al.  Unilateral neglect, representational schema and consciousness. , 1979, Brain : a journal of neurology.

[76]  Katja Wiech,et al.  The effect of tactile discrimination training is enhanced when patients watch the reflected image of their unaffected limb during training , 2009, PAIN®.

[77]  A. Iriki,et al.  Bilateral hand representation in the postcentral somatosensory cortex , 1994, Nature.

[78]  Scott Sinnett,et al.  A dissociation between visual and auditory hemi-inattention: Evidence from temporal order judgements , 2007, Neuropsychologia.

[79]  L. Parsons,et al.  Integrating cognitive psychology, neurology and neuroimaging. , 2001, Acta psychologica.

[80]  G. Deuschl,et al.  The motor system shows adaptive changes in complex regional pain syndrome. , 2007, Brain : a journal of neurology.

[81]  R. Harden,et al.  External validation of IASP diagnostic criteria for Complex Regional Pain Syndrome and proposed research diagnostic criteria , 1999, Pain.

[82]  Neil G. Muggleton,et al.  TMS over right posterior parietal cortex induces neglect in a scene-based frame of reference , 2006, Neuropsychologia.

[83]  B. Neundörfer,et al.  Patterns of cortical reorganization in complex regional pain syndrome , 2003, Neurology.

[84]  C. Spence,et al.  Does the sight of physical threat induce a tactile processing bias? Modality-specific attentional facilitation induced by viewing threatening pictures , 2009, Brain Research.

[85]  A. Samii,et al.  Complex regional pain syndrome as a stress response , 2004, Pain.

[86]  D. Nico.  Effectiveness of sensory stimulation on tactile extinction , 1999, Experimental Brain Research.