title: Stretch reflex responses in Complex Regional Pain Syndrome-related dystonia are not characterized by hyperreflexia.
abstract: OBJECTIVE
  To evaluate if hyperreflexia (exaggerated reflexes) due to disinhibition is associated with dystonia in Complex Regional Pain Syndrome (CRPS).
  
  
  METHODS
  Stretch reflexes at the wrist were assessed in healthy controls (n=10) and CRPS-patients with dystonia (n=10). Subjects exerted a wrist flexion torque of 5% of maximum voluntary contraction torque (T(MVC)) to a manipulandum which applied ramp-and-hold stretches to the wrist flexors. Since reflex responses scale with background contraction, controls additionally performed the task at 1% and 3% T(MVC) to attain similar torques as patients who have reduced T(MVC). The M1 onset and the magnitudes of the short latency M1 and long latency M2 were assessed using the electromyographic signals (EMG) of the flexor carpi radialis. EMG of the extensor carpi radialis was recorded to monitor cocontraction.
  
  
  RESULTS
  Compared to controls, patients had a substantially reduced T(MVC). Ramp velocity had a significant effect on M1 onset time and magnitude.
  
  
  CONCLUSIONS
  Since M1 magnitude decreased with flexion torque, no significant difference was found between patients and controls at 5% T(MVC), while comparison at similar absolute torques (controls at 1% T(MVC)) resulted in significantly smaller M1 magnitudes for patients with dystonia.
  
  
  CONCLUSIONS
  This study suggests that CRPS-patients with dystonia are not hyperreflexive.
authors: Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, The Netherlands. w.mugge@tudelft.nl
authors: Winfred
authors: W
authors: Mugge
authors: Alfred C
authors: AC
authors: Schouten
authors: Gijsbert J
authors: GJ
authors: Bast
authors: Jasper
authors: J
authors: Schuurmans
authors: Jacobus J
authors: JJ
authors: van Hilten
authors: Frans C T
authors: FC
authors: van der Helm
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D020918:Complex Regional Pain Syndromes / Q000150:complications* / Q000503:physiopathology*; D004421:Dystonia / Q000209:etiology* / Q000503:physiopathology*; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D010147:Pain Measurement; D012021:Reflex, Abnormal / Q000502:physiology*; D012026:Reflex, Stretch / Q000502:physiology*; D019415:Torque; D014955:Wrist Joint / Q000503:physiopathology; D055815:Young Adult