Harvey Marie-Philippe, Maher-Bussières Samuel, Emery Elysa, Martel Marylie, Houde Francis, Tousignant-Laflamme Yannick, Léonard Guillaume
Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Québec, Canada.
Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Sherbrooke, Québec, Canada.
Can J Pain. 2018 Jan 30;2(1):21-26. doi: 10.1080/24740527.2017.1422116. eCollection 2018.
Central nervous system reorganization, particularly in networks devoted to somatosensation, is thought to be a significant feature of complex regional pain syndrome (CRPS).
In the present case report, we evaluated the corticomotor system of a woman suffering from CRPS, as she started and completed her rehabilitation, in order to explore whether CRPS could also be linked to changes in motor networks.
The patient, a 58-year-old woman, was diagnosed with right-hand CRPS. Transcranial magnetic stimulation measures, reflecting the strength of the corticospinal projections, were evaluated before, during, and after an 8-week graded motor imagery (GMI) program.
Before treatment, the patient reported significant pain and disability, and the strength of the corticospinal projections of the first dorsal interosseous of the affected hand was reduced compared to the healthy, unaffected hand. Pain and disability decreased as the patient completed the GMI program. These changes were paralleled by an increase in the strength of the corticospinal projections.
These observations suggest that corticomotor changes can be observed in individuals suffering from CRPS and that some of the clinical manifestations observed in these patients (e.g., pain, disability) could possibly be linked to these neurophysiological changes.
中枢神经系统重组，尤其是在负责躯体感觉的神经网络中，被认为是复杂性区域疼痛综合征（CRPS）的一个重要特征。
在本病例报告中，我们评估了一名患有CRPS的女性在开始和完成康复治疗时的皮质运动系统，以探讨CRPS是否也与运动网络的变化有关。
该患者为一名58岁女性，被诊断为右手CRPS。在为期8周的分级运动想象（GMI）计划之前、期间和之后，评估反映皮质脊髓投射强度的经颅磁刺激测量结果。
治疗前，患者报告有明显疼痛和功能障碍，与健康未受影响的手相比，患手第一背侧骨间肌的皮质脊髓投射强度降低。随着患者完成GMI计划，疼痛和功能障碍减轻。这些变化与皮质脊髓投射强度的增加同时出现。
这些观察结果表明，在患有CRPS的个体中可以观察到皮质运动变化，并且在这些患者中观察到的一些临床表现（例如疼痛、功能障碍）可能与这些神经生理学变化有关。
