Merchant Shabbir Hussain I
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.
Can J Pain. 2018 Jan 30;2(1):27-29. doi: 10.1080/24740527.2017.1422976. eCollection 2018.
Complex regional pain syndrome (CRPS) is a disabling condition that is usually preceded by trauma or surgical procedure. Involvement of the motor system is a well-known phenomenon in CRPS, though the pathophysiologic mechanisms of motor system affliction in CRPS are poorly understood. Graded motor imagery (GMI) has been proposed to be one of the therapeutic interventions to help improve pain and other disabling symptoms associated with CRPS, though the benefits noted are modest and inconsistent. The neurophysiological mechanisms implicated in motor imagery are intended to target the aberrant prefrontal and sensorimotor integration areas, which may potentially help restore the aberrant cortical plasticity in CRPS. Detailed well-controlled experiments using insights from the existing body of literature on motor system reorganization in CRPS are required to better understand this complicated disorder. Attempts to gain pathophysiologic insights about complicated disorders like CRPS based on case reports with poorly performed and uncontrolled interventions are misguided.
复杂性区域疼痛综合征（CRPS）是一种致残性疾病，通常在创伤或外科手术后出现。运动系统受累是CRPS中一种众所周知的现象，尽管CRPS中运动系统受累的病理生理机制尚不清楚。分级运动想象（GMI）已被提议作为一种治疗干预措施，以帮助改善与CRPS相关的疼痛和其他致残症状，尽管所指出的益处不大且不一致。运动想象所涉及的神经生理机制旨在针对异常的前额叶和感觉运动整合区域，这可能有助于恢复CRPS中异常的皮质可塑性。需要利用现有关于CRPS运动系统重组的文献中的见解进行详细的严格对照实验，以更好地理解这种复杂的疾病。基于干预措施执行不佳且未得到控制的病例报告来获取关于CRPS等复杂疾病的病理生理见解的尝试是错误的。
