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复杂性区域疼痛综合征与对健侧的过度关注而非忽视有关:一项综合病例研究。

Complex regional pain syndrome associated with hyperattention rather than neglect for the healthy side: A comprehensive case study.

作者信息

Christophe Laure, Delporte Ludovic, Revol Patrice, DePaepe Annick, Rode Gilles, Jacquin-Courtois Sophie, Rossetti Yves

机构信息

Plate-forme 'Mouvement et Handicap' and Neuro-Immersion, Hôpital Henry-Gabrielle and Hôpital neurologique, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Service de rééducation neurologique, pavillon Bourret, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, université Lyon-1, 16, avenue Lépine, 69676 Bron, France.

Service de rééducation neurologique, pavillon Bourret, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20, route de Vourles, 69230 Saint-Genis-Laval, France; Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, université Lyon-1, 16, avenue Lépine, 69676 Bron, France.

出版信息

Ann Phys Rehabil Med. 2016 Dec;59(5-6):294-301. doi: 10.1016/j.rehab.2016.10.001. Epub 2016 Nov 23.

Abstract

Complex regional pain syndrome (CRPS) is a dehabilitating chronic condition occurring with peripheral lesions. There is growing consensus for a central contribution to CRPS. Although the nature of this central body representation disorder is increasingly debated, it has been repeatedly argued that CRPS results in motor neglect of the affected side. The present article describes a comprehensive and quantitative case report demonstrating that: (1) not all patients with chronic CRPS exhibit decreased spatial attention for the affected side and (2) patients may actually exhibit a substantial, broad and reliable attentional bias toward the painful side, akin to spatial neglect for the healthy side. This unexpected result agrees with the idea that patients can be hyper-attentive toward their pathological side as a manifestation of lowered pain threshold, allodynia and kinesiophobia.

摘要

复杂性区域疼痛综合征(CRPS)是一种伴随周围神经损伤出现的使人衰弱的慢性病症。目前越来越多的人认为中枢神经系统在CRPS的发病机制中起到一定作用。尽管关于这种中枢性身体表征障碍的本质仍存在诸多争议,但反复有人提出CRPS会导致对患侧的运动忽视。本文通过一个全面且定量的病例报告表明:(1)并非所有慢性CRPS患者对患侧的空间注意力都会下降;(2)患者实际上可能会对疼痛侧表现出显著、广泛且可靠的注意力偏向,类似于对健侧的空间忽视。这一意外结果支持了这样一种观点,即患者可能会因疼痛阈值降低、痛觉过敏和运动恐惧而对其患病侧过度关注。

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