Body Structural Description Impairment in Complex Regional Pain Syndrome Type I

Abstract

BackgroundComplex Regional Pain Syndrome (CRPS) is a clinical syndrome composed of chronic pain, motor impairment, and autonomic dysfunction, usually affecting a limb. Although CRPS seems to be a peripheral disorder, it is accompanied by parietal alterations leading to body schema impairments (the online representations of the body). Impairments to body structural description (the topographical bodily map) were not assessed systematically in CRPS. A patient we encountered with severe disruption to her bodily structural description led us to study this domain further.AimsTo document aberrant body structural description in subjects with CRPS using an object assembly task.MethodsBody Schema Study: 6 subjects with CRPS-I and six age and sex-matched healthy controls completed visual puzzles taken from WAIS-III and WAIS-R. The puzzles were either related to the human body or non-human body objects. Mann–Whitney U-tests were performed to compare groups’ performances.ResultsThe CRPS group received relatively lower scores compared to controls for human body objects (u = 3, p < 0.05), whereas the non-human object scoring did not reveal significant differences between groups (u = 9, p > 0.05).ConclusionCRPS subjects suffer from impaired body structural description, taking the form of body parts disassembly and body parts discontinuity. This impairment can serve as a nidus for aberrant psychological representation of the body.

Altered bodily perceptions in chronic neuropathic pain conditions and implications for treatment using immersive virtual reality

“…In a task where schematic drawings were compressed or expanded from 85% to 120% of the original size, patients with CRPS claimed their affected limb was bigger than it really was, compared with healthy controls (Peltz et al, 2011 ). Moreover, there was a positive relationship between the overestimation and disorder duration, neglect-score, and decreased tactile thresholds, which suggests a disruption in the integration between motor processes and the body schema (a dynamic representation of the human body based on its localization in space, Biran et al, 2022 ) in the central nervous system (Peltz et al, 2011 ). Lewis and Schweinhardt ( 2012 ) studied the relationships between pain levels, body perception disturbance, and tactile acuity.…”