忽略患肢周围的空间？复杂性区域疼痛综合征中与身体相关的视空间注意偏向并无证据。
Ignoring space around a painful limb? No evidence for a body-related visuospatial attention bias in complex regional pain syndrome.
机构信息
Department of Psychology, University of Bath, Bath, United Kingdom; Centre for Pain Research, University of Bath, Bath, United Kingdom; Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands.
Department of Psychology, University of Bath, Bath, United Kingdom; Centre for Pain Research, University of Bath, Bath, United Kingdom.
出版信息
Cortex. 2021 Mar;136:89-108. doi: 10.1016/j.cortex.2020.12.007. Epub 2020 Dec 24.
BACKGROUND
Complex Regional Pain Syndrome (CRPS) is a disorder of severe chronic pain in one or more limb(s). People with CRPS report unusual perceptions of the painful limb suggesting altered body representations, as well as difficulty attending to their affected limb (i.e., a 'neglect-like' attention bias). Altered body representations and attention in CRPS might be related, however, existing evidence is unclear. We hypothesized that if there were a body-related visuospatial attention bias in CRPS, then any attention bias away from the affected side should be larger for or limited to circumstances when the (impaired) body representation is involved in the task versus when this is not the case.
METHODS
We included 40 people with CRPS, 40 with other limb pain conditions, and 40 pain-free controls. In half of the people with pain, their upper limb was affected, in the other half their lower limb. We administered computerized tasks of spatial attention, including free viewing of images, shape cancellation, temporal order judgement, and dot-probe. The degree to which different versions of each task involved body representation was manipulated by one or more of the following: (1) presenting stimuli nearer versus further away from the body, (2) using body related versus neutral stimuli, and (3) inducing mental rotation of body parts versus no mental rotation. In addition to perceptual judgements, eye movements were recorded as a sensitive index of spatial attention. Bayesian repeated measures analyses were performed.
RESULTS
We found no evidence for a (body-related) visuospatial attention bias in upper limb CRPS. Secondary analyses suggested the presence of a body-related visuospatial attention bias away from the affected side in some participants with lower limb CRPS.
DISCUSSION
Our results add to growing evidence that there might be no general visuospatial attention bias away from the affected side in CRPS.
背景
复杂性区域疼痛综合征（CRPS）是一种单侧或多侧肢体严重慢性疼痛的疾病。患有 CRPS 的人报告说，他们对疼痛肢体有异常的感知，这表明身体的表象发生了改变，以及难以关注到受影响的肢体（即“类似忽视”的注意力偏向）。然而，CRPS 中身体表象和注意力的改变可能是相关的，但是，现有证据并不清楚。我们假设，如果 CRPS 存在与身体相关的视空间注意力偏向，那么任何远离受影响侧的注意力偏向都应该更大，或者仅限于涉及到身体表象的任务，而不是在不涉及到身体表象的情况下。
方法
我们纳入了 40 名 CRPS 患者、40 名其他肢体疼痛患者和 40 名无痛对照者。疼痛患者中，一半为上肢受累，另一半为下肢受累。我们使用计算机化的空间注意力任务，包括图像自由观察、形状取消、时间顺序判断和点探测。通过以下一种或多种方式来操纵每个任务的不同版本涉及身体表象的程度：（1）将刺激物呈现得更靠近或更远离身体；（2）使用与身体相关的刺激物或中性刺激物；（3）诱导身体部位的心理旋转或不进行心理旋转。除了知觉判断外，还记录了眼动作为空间注意力的敏感指标。进行了贝叶斯重复测量分析。
结果
我们没有发现上肢 CRPS 存在（与身体相关的）视空间注意力偏向的证据。二次分析表明，一些下肢 CRPS 患者存在远离受影响侧的与身体相关的视空间注意力偏向。
讨论
我们的结果增加了越来越多的证据，表明在 CRPS 中，可能不存在普遍的远离受影响侧的视空间注意力偏向。
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