Maihöfner Christian, DeCol Roberto
Department of Neurology and Institute for Physiology and Experimental Pathophysiology, University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany.
Eur J Pain. 2007 Nov;11(8):903-9. doi: 10.1016/j.ejpain.2007.03.006. Epub 2007 Apr 23.
Recently, several functional imaging studies have shown that sensorimotor cortical representations may be changed in complex regional pain syndromes (CRPS). Therefore, we investigated tactile performance and tactile learning as indirect markers of cortical changes in patients with CRPS type I and controls. Patients had significant higher spatial discrimination thresholds at CRPS-affected extremities compared to both unaffected sides and control subjects. Furthermore, in order to improve tactile spatial acuity we used a Hebbian stimulation protocol of tactile coactivation. This consistently improved tactile acuity, both in controls and patients. However, the gain of performance was significantly lower on the CRPS-affected side implying an impaired perceptual learning ability. Therefore, we provide further support for an involvement of the CNS in CRPS, which may have implications to future neurorehabilitation strategies for this disease.
最近，几项功能成像研究表明，感觉运动皮层表征在复杂性区域疼痛综合征（CRPS）中可能会发生变化。因此，我们研究了I型CRPS患者和对照组的触觉表现及触觉学习情况，以此作为皮层变化的间接指标。与未受影响的肢体及对照组相比，CRPS患者受影响肢体的空间辨别阈值显著更高。此外，为提高触觉空间敏锐度，我们采用了触觉共同激活的赫布式刺激方案。这在对照组和患者中均持续改善了触觉敏锐度。然而，CRPS受影响一侧的表现增益显著更低，这意味着其知觉学习能力受损。因此，我们进一步支持中枢神经系统参与了CRPS，这可能对该疾病未来的神经康复策略具有启示意义。
