201. Sensorimotor integration in Complex Regional Pain Syndrome: A transcranial magnetic stimulation study
- Author
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Candida S. McCabe, Saša R. Filipović, Nigel Harris, and Ailie J. Turton
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Central nervous system ,Sensory system ,Electromyography ,Physical medicine and rehabilitation ,Reaction Time ,medicine ,Humans ,medicine.diagnostic_test ,Motor Cortex ,Electroencephalography ,Somatosensory Cortex ,Middle Aged ,Evoked Potentials, Motor ,medicine.disease ,Transcranial Magnetic Stimulation ,Median nerve ,Transcranial magnetic stimulation ,Electrophysiology ,Anesthesiology and Pain Medicine ,Complex regional pain syndrome ,medicine.anatomical_structure ,Neurology ,Female ,Neurology (clinical) ,Psychology ,Neuroscience ,Complex Regional Pain Syndromes ,Motor cortex - Abstract
There is evidence that patients with Complex Regional Pain Syndrome (CRPS) have altered central sensorimotor processing. Sensory input can influence motor output either through indirect pathways or through direct connections from the sensory to motor cortex. The purpose of this study was to investigate sensorimotor interaction via direct connections in patients with CRPS and to compare the results with normal subjects'. Direct short-latency sensory-motor interaction was evaluated in eight patients with CRPS1 affecting a hand. Modulation of EMG responses to transcranial magnetic stimulation (TMS) induced by concomitant median nerve stimulation was measured, the so-called, short-latency afferent inhibition (SAI). Results were compared with eight normal subjects who were age and sex matched with the patients. As expected, all the normal subjects' EMG responses to TMS with median nerve stimulation were smaller than responses to TMS alone. In seven of the eight CRPS patients EMG responses to TMS were suppressed when paired with median nerve stimulation. Only one CRPS patient's results showed no suppression of EMG responses. These results suggest that the disease mechanisms of CRPS1 do not typically affect the direct neural circuit between sensory and motor cortex and that normal sensorimotor interaction is occurring via this route.
- Published
- 2007