Psychophysical and electrophysiological evidence for nociceptive dysfunction in CRPS
(2013) PAIN® — Vol. 154, n° 11, p. 2521-2528 (2013)
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- (en) The aim of this study was to assess the function of the thermo-nociceptive system in 25 patients with long-lasting, medium to severe refractory CRPS-1 using behavioral (detection rates and reaction times) and electrophysiological (event-related brain potentials) responses to brief (50 ms) and intense (suprathreshold for Aδ-nociceptors) CO2 laser stimuli delivered to the affected and contralateral limbs, and by comparing these responses to the responses obtained in the left and right limbs of age- and sex-matched healthy controls. As compared to healthy controls and as compared to the contralateral limb, the detection rate of pricking pain related to the activation of Aδ-fibers was markedly reduced at the affected limb. Furthermore, reaction times were substantially prolonged (>100 ms in 84% of patients and >300 ms in 50% of patients). Finally, the N2 and P2 waves of laser evoked brain potentials were significantly reduced in amplitude, and their latencies were significantly increased. Taken together, our results show that in the majority of patients with chronic CRPS-1, thermo-nociceptive pathways are dysfunctional. A number of pathological mechanisms involving the peripheral nervous system and/or the central nervous system could explain our results. However, the primary or secondary nature of these observed changes remains an open question.
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Caty, G., Hu, L., Legrain, V., Plaghki, L., & Mouraux, A. (2013). Psychophysical and electrophysiological evidence for nociceptive dysfunction in CRPS. PAIN®, 154(11), 2521-2528. https://doi.org/10.1016/j.pain.2013.07.038 (Original work published 2013)