Cortical changes in complex regional pain syndrome (CRPS)

Eur J Pain. 2009 Oct;13(9):902-7. doi: 10.1016/j.ejpain.2008.11.010. Epub 2008 Dec 19.

Abstract

Recent research suggests that changes in cortical structures can contribute to the pathophysiology of Complex Regional Pain Syndrome (CRPS). This review provides an overview of studies showing cortical involvement in CRPS, including mislocalizations of tactile stimuli, changes in size and organization of the somatosensory map, changes in motor cortex representation and body perception disturbances. In addition, we review experimental treatment approaches, such as mirror therapy and motor imagery programs, aimed at restoring the integrity of neural processing in the sensory-motor cortex in individuals with CRPS. The intervention effects are promising and can be theoretically motivated on the basis of established principles of neural organization, although important questions concerning the precise neural mechanisms of action remain unanswered.

Publication types

  • Review

MeSH terms

  • Animals
  • Cerebral Cortex / anatomy & histology
  • Cerebral Cortex / physiopathology*
  • Complex Regional Pain Syndromes / physiopathology*
  • Complex Regional Pain Syndromes / therapy
  • Humans
  • Imagery, Psychotherapy / methods
  • Motor Cortex / physiopathology
  • Movement Disorders / etiology
  • Movement Disorders / physiopathology
  • Movement Disorders / therapy
  • Neuronal Plasticity / physiology*
  • Perceptual Disorders / etiology
  • Perceptual Disorders / physiopathology*
  • Perceptual Disorders / therapy
  • Physical Therapy Modalities
  • Somatosensory Cortex / anatomy & histology
  • Somatosensory Cortex / physiopathology