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Neuropsychological Changes in Complex Regional Pain Syndrome (CRPS).
Behavioural Neurology ( IF 2.8 ) Pub Date : 2020-01-14 , DOI: 10.1155/2020/4561831
Monika Halicka 1, 2 , Axel D Vittersø 1, 2, 3 , Michael J Proulx 2, 4 , Janet H Bultitude 1, 2
Affiliation  

Complex Regional Pain Syndrome (CRPS) is a poorly understood chronic pain condition of multifactorial origin. CRPS involves sensory, motor, and autonomic symptoms primarily affecting one extremity. Patients can also present with neuropsychological changes such as reduced attention to the CRPS-affected extremity, reminiscent of hemispatial neglect, yet in the absence of any brain lesions. However, this “neglect-like” framework is not sufficient to characterise the range of higher cognitive functions that can be altered in CRPS. This comprehensive literature review synthesises evidence of neuropsychological changes in CRPS in the context of potential central mechanisms of the disorder. The affected neuropsychological functions constitute three distinct but not independent groups: distorted body representation, deficits in lateralised spatial cognition, and impairment of non-spatially-lateralised higher cognitive functions. We suggest that many of these symptoms appear to be consistent with a broader disruption to parietal function beyond merely what could be considered “neglect-like.” Moreover, the extent of neuropsychological symptoms might be related to the clinical signs of CRPS, and rehabilitation methods that target the neuropsychological changes can improve clinical outcomes in CRPS and other chronic pain conditions. Based on the limitations and gaps in the reviewed literature, we provide several suggestions to improve further research on neuropsychological changes in chronic pain.

中文翻译:

复杂区域性疼痛综合征(CRPS)的神经心理变化。

复杂的区域性疼痛综合征(CRPS)是一种多因素起源的慢性疼痛病,人们对此知之甚少。CRPS涉及主要影响一个肢体的感觉,运动和自主神经症状。患者还会出现神经心理学改变,例如对CRPS受影响的肢体的注意力减少,使人联想起半he骨的疏忽,但没有任何脑部病变。但是,这种“类似忽视”的框架不足以表征可在CRPS中改变的更高认知功能的范围。这篇综合性的文献综述综合了在疾病的潜在中枢机制中CRPS的神经心理学变化的证据。受影响的神经心理学功能由三个不同但并非独立的组组成:扭曲的身体表现,空间化的空间认知能力不足,以及非空间化的较高认知功能受损。我们建议,这些症状中的许多似乎与更广泛的顶叶功能破坏相符,而不仅仅是被认为是“忽视”。此外,神经心理症状的程度可能与CRPS的临床症状有关,针对神经心理变化的康复方法可以改善CRPS和其他慢性疼痛状况的临床结局。基于所审查文献的局限性和不足,我们提供了一些建议,以改善对慢性疼痛的神经心理学变化的进一步研究。我们建议,这些症状中的许多似乎与更广泛的顶叶功能破坏相一致,而不仅仅是被认为是“类似忽视”的现象。此外,神经心理症状的程度可能与CRPS的临床症状有关,针对神经心理变化的康复方法可以改善CRPS和其他慢性疼痛状况的临床结局。基于所审查文献的局限性和不足,我们提供了一些建议,以改善对慢性疼痛的神经心理学变化的进一步研究。我们建议,这些症状中的许多似乎与更广泛的顶叶功能破坏相一致,而不仅仅是被认为是“类似忽视”的现象。此外,神经心理症状的程度可能与CRPS的临床症状有关,针对神经心理变化的康复方法可以改善CRPS和其他慢性疼痛状况的临床结局。基于所审查文献的局限性和不足,我们提供了一些建议,以改善对慢性疼痛的神经心理学变化的进一步研究。针对神经心理学改变的康复方法可以改善CRPS和其他慢性疼痛状况的临床疗效。基于所审查文献的局限性和不足,我们提供了一些建议,以改善对慢性疼痛的神经心理学变化的进一步研究。针对神经心理学改变的康复方法可以改善CRPS和其他慢性疼痛状况的临床疗效。基于所审查文献的局限性和不足,我们提供了一些建议,以改善对慢性疼痛的神经心理学变化的进一步研究。
更新日期:2020-01-14
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