title: Cognitive correlates of "neglect-like syndrome" in patients with complex regional pain syndrome.
abstract: Patients with complex regional pain syndrome (CRPS) often show distinct neurocognitive dysfunctions, which were initially termed "neglect-like symptoms." So far, particularly the patients' feelings about the affected extremity, motor, and sensory aspects of the "neglect-like symptoms" have been investigated, possibly pointing to a disturbed body schema. Because patients with classical neurological neglect show diminished awareness regarding the perception of their body, as well as of the space around them, our hypothesis was that CRPS patients exhibit some signs of personal neglect and extrapersonal visuospatial problems over and beyond those seen in patients simply suffering from limb pain. We used quantitative sensory testing and motor assessment aimed at detecting motor and sensory loss, a standardized questionnaire calculating a neglect score, and applied a detailed neuropsychological test battery assessing different parietal lobe functions, including visual neglect. We examined 20 CRPS patients and 2 matched control groups, one consisting of healthy subjects and the other one of patients with limb pain other than CRPS. Results show significant higher neglect scores for CRPS patients and the pain control group, but interestingly, CRPS patients and pain patients were indistinguishable. The results of the neuropsychological test battery did not demonstrate systematic variances, which would be indicative of a classical neurological neglect in CRPS patients, even though there were 3 CRPS patients who differed ≥ 2 SD from the mean of our healthy control group, with poorer results in ≥ 3 different tests. We assume that the "neglect-like syndrome" in most CRPS patients is different from typical neglect.
authors.affiliation: Department of Neurology, University Hospital Erlangen, Erlangen, Germany Department of Experimental Physiology and Pathophysiology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Leonie
authors.initials: L
authors.lastname: Kolb
authors.forename: Christoph
authors.initials: C
authors.lastname: Lang
authors.forename: Frank
authors.initials: F
authors.lastname: Seifert
authors.forename: Christian
authors.initials: C
authors.lastname: Maihöfner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D020918:Complex Regional Pain Syndromes / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement / Q000523:psychology*; D010468:Perceptual Disorders / Q000503:physiopathology* / Q000523:psychology