Disputing space-based biases in unilateral complex regional pain syndrome

Halicka, Monika, Vitterso, Axel D, McCullough, Hayley, Goebel, Andreas ORCID: 0000-0002-3763-8206, Heelas, Leila, Proulx, Michael J and Bultitude, Janet H (2020) Disputing space-based biases in unilateral complex regional pain syndrome. CORTEX, 127. pp. 248-268.

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Official URL: http://dx.doi.org/10.1016/j.cortex.2020.02.018

Abstract

There is some evidence that people with Complex Regional Pain Syndrome (CRPS) show reduced attention to the affected relative to unaffected limb and its surrounding space, resembling hemispatial neglect after brain injury. These neuropsychological symptoms could be related to central mechanisms of pathological pain and contribute to its clinical manifestation. However, the existing evidence of changes in spatial cognition is limited and often inconsistent. We examined visuospatial attention, the mental representation of space, and spatially-defined motor function in 54 people with unilateral upper-limb CRPS and 22 pain-free controls. Contrary to our hypotheses and previous evidence, individuals with CRPS did not show any systematic spatial biases in visuospatial attention to or representation of the side of space corresponding to their affected limb (relative to the unaffected side). We found very little evidence of directional slowing of movements towards the affected relative to unaffected side that would be consistent with motor neglect. People with CRPS were, however, slower than controls to initiate and execute movements with both their affected and unaffected hands, which suggests disrupted central motor networks. Finally, we found no evidence of any clinical relevance of changes in spatial cognition because there were no relationships between the magnitude of spatial biases and the severity of pain or other CRPS symptoms. The results did reveal potential relationships between CRPS pain and symptom severity, subjective body perception disturbance, and extent of motor impairment, which would support treatments focused on normalizing body representation and improving motor function. Our findings suggest that previously reported spatial biases in CRPS might have been overstated.

Item Type:	Article
Uncontrolled Keywords:	Complex regional pain syndrome, Neuropsychological symptoms, Spatial cognition, Motor function, Body representation
Depositing User:	Symplectic Admin
Date Deposited:	28 Apr 2020 09:39
Last Modified:	18 Jan 2023 23:53
DOI:	10.1016/j.cortex.2020.02.018
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3085115