title: Limb-specific autonomic dysfunction in complex regional pain syndrome modulated by wearing prism glasses.
abstract: In unilateral upper-limb complex regional pain syndrome (CRPS), the temperature of the hands is modulated by where the arms are located relative to the body midline. We hypothesized that this effect depends on the perceived location of the hands, not on their actual location, nor on their anatomical alignment. In 2 separate cross-sectional randomized experiments, 10 (6 female) unilateral CRPS patients wore prism glasses that laterally shifted the visual field by 20°. Skin temperature was measured before and after 9-minute periods in which the position of one hand was changed. Placing the affected hand on the healthy side of the body midline increased its temperature (Δ°C=+0.47 ± 0.14°C), but not if prism glasses made the hand appear to be on the body midline (Δ°C=+0.07 ± 0.06°C). Similarly, when prism glasses made the affected hand appear to be on the healthy side of the body midline, even though it was not, the affected hand warmed up (Δ°C=+0.28 ± 0.14°C). When prism glasses made the healthy hand appear to be on the affected side of the body midline, even though it was not, the healthy hand cooled down (Δ°C=-0.30 ± 0.15°C). Friedman's analysis of variance and Wilcoxon pairs tests upheld the results (P<0.01 for all). We conclude that, in CRPS, cortical mechanisms responsible for encoding the perceived location of the limbs in space modulate the temperature of the hands.
authors.affiliation: The Sansom Institute for Health Research, University of South Australia, Adelaide, Australia Neuroscience Research Australia, Barker Street, Randwick 2031, Australia Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy Department of psychology, South parks road, Oxford OX1 3UD, UK Department of Neuroscience, Physiology and Pharmacology, University College London, Gower Street, WC1E 6BT, London, UK.
authors.forename: Lorimer G
authors.initials: LG
authors.lastname: Moseley
authors.forename: Alberto
authors.initials: A
authors.lastname: Gallace
authors.forename: Flavia
authors.initials: F
authors.lastname: Di Pietro
authors.forename: Charles
authors.initials: C
authors.lastname: Spence
authors.forename: Gian Domenico
authors.initials: GD
authors.lastname: Iannetti
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000704:Analysis of Variance; D001342:Autonomic Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology; D020918:Complex Regional Pain Syndromes / Q000150:complications* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005139:Eyeglasses; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006225:Hand / Q000502:physiology; D006801:Humans; D006875:Hydrotherapy; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D012881:Skin Temperature; D034941:Upper Extremity / Q000502:physiology; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: Attention; Neglect; Pain; RSD; Reflex sympathetic dystrophy; Representation