Brain Research Unit, Low Temperature Laboratory, Aalto University, School of Science and Technology, Finland.
Clin Neurophysiol. 2010 Jul;121(7):1085-91. doi: 10.1016/j.clinph.2010.01.032. Epub 2010 Feb 24.
Most patients with complex regional pain syndrome (CRPS) exhibit debilitating motor symptoms. The effect of continuous pain on motor system in CRPS, however, is not well known. We searched for signs of motor cortex dysfunction in chronic CRPS type 1 patients with motor impairment.
We recorded rhythmic brain activity with magnetoencephalography (MEG) during noxious thulium-laser stimulation of both hands in eight CRPS patients and eight control subjects. We measured excitability of the motor cortex by monitoring the reactivity of the approximately 20-Hz motor cortex rhythm to laser stimuli. The reactivity was defined as a sum of the stimulus-induced suppression and the subsequent rebound of the approximately 20-Hz rhythm.
In CRPS, the reactivity of the approximately 20-Hz rhythm in the hemisphere contralateral to the painful hand was significantly weaker than in control subjects. The reactivity correlated with the mean level of the spontaneous pain (r=-0.64, P=0.04). Suppression of the approximately 20-Hz rhythm correlated with the grip strength in the painful hand (r=0.66, P=0.04).
Continuous pain in CRPS is associated with attenuated motor cortex reactivity.
Abnormal motor cortex reactivity may be linked with motor dysfunction of the affected hand in CRPS.
大多数复杂性区域疼痛综合征（CRPS）患者表现出使人虚弱的运动症状。然而，CRPS 中连续疼痛对运动系统的影响尚不清楚。我们在慢性 CRPS 1 型伴有运动障碍的患者中寻找运动皮层功能障碍的迹象。
我们在 8 名 CRPS 患者和 8 名对照受试者双手接受钬激光刺激时，使用脑磁图（MEG）记录节律性脑活动。我们通过监测大约 20Hz 运动皮层节律对激光刺激的反应性来测量运动皮层的兴奋性。反应性定义为刺激诱导的抑制和大约 20Hz 节律的随后反弹之和。
在 CRPS 中，对侧痛手半球的大约 20Hz 节律的反应性明显弱于对照组。反应性与自发痛的平均水平呈负相关（r=-0.64，P=0.04）。大约 20Hz 节律的抑制与痛手的握力呈正相关（r=0.66，P=0.04）。
CRPS 中的持续性疼痛与运动皮层反应性减弱有关。
异常的运动皮层反应性可能与 CRPS 受影响手的运动功能障碍有关。
