Prisms to Shift Pain Away: Pathophysiological and Therapeutic Exploration of CRPS with Prism Adaptation.
Complex Regional Pain Syndrome (CRPS) is an invalidating chronic condition subsequent to peripheral lesions. There is growing consensus for a central contribution to CRPS. However, the nature of this central body representation disorder is increasingly debated. Although it has been repeatedly argued that CRPS results in motor neglect of the affected side, visual egocentric reference frame was found to be deviated toward the pain, that is, neglect of the healthy side. Accordingly, prism adaptation has been successfully used to normalize this deviation. This study aimed at clarifying whether 7 CRPS patients exhibited neglect as well as exploring the pathophysiological mechanisms of this manifestation and of the therapeutic effects of prism adaptation. Pain and quality of life, egocentric reference frames (visual and proprioceptive straight-ahead), and neglect tests (line bisection, kinematic analyses of motor neglect and motor extinction) were repeatedly assessed prior to, during, and following a one-week intense prism adaptation intervention. First, our results provide no support for visual and motor neglect in CRPS. Second, reference frames for body representations were not systematically deviated. Third, intensive prism adaptation intervention durably ameliorated pain and quality of life. As for spatial neglect, understanding the therapeutic effects of prism adaptation deserves further investigations.
Service de Rééducation Neurologique, Pavillon Bourret, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20 route de Vourles, Saint-Genis-Laval, France; Plateforme "Mouvement et Handicap" and Plateforme NeuroImmersion, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20 route de Vourles, Saint-Genis-Laval, France; Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, Université Lyon 1, 16 avenue Lépine, 69676 Bron, France.
Laure
0000-0003-0169-1010
L
Christophe
Plateforme "Mouvement et Handicap" and Plateforme NeuroImmersion, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20 route de Vourles, Saint-Genis-Laval, France.
Eric
0000-0001-6069-7346
E
Chabanat
Plateforme "Mouvement et Handicap" and Plateforme NeuroImmersion, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20 route de Vourles, Saint-Genis-Laval, France; Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, Université Lyon 1, 16 avenue Lépine, 69676 Bron, France.
Ludovic
0000-0002-4387-6200
L
Delporte
Plateforme "Mouvement et Handicap" and Plateforme NeuroImmersion, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20 route de Vourles, Saint-Genis-Laval, France; Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, Université Lyon 1, 16 avenue Lépine, 69676 Bron, France.
Patrice
0000-0001-6063-6551
P
Revol
Centre Orthopédique Paul Santy, 24 avenue Paul Santy, 69008 Lyon, France.
Pierre
P
Volckmann
Service de Rééducation Neurologique, Pavillon Bourret, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20 route de Vourles, Saint-Genis-Laval, France; Plateforme "Mouvement et Handicap" and Plateforme NeuroImmersion, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20 route de Vourles, Saint-Genis-Laval, France; Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, Université Lyon 1, 16 avenue Lépine, 69676 Bron, France.
Sophie
S
Jacquin-Courtois
Plateforme "Mouvement et Handicap" and Plateforme NeuroImmersion, Hôpital Henry-Gabrielle, Hospices Civils de Lyon, 20 route de Vourles, Saint-Genis-Laval, France; Inserm UMR-S 1028, CNRS UMR 5292, ImpAct, Centre de Recherche en Neurosciences de Lyon, Université Lyon 1, 16 avenue Lépine, 69676 Bron, France.
Yves
0000-0001-8867-4496
Y
Rossetti
Pain. 2006 Sep;124(1-2):184-9
16730904
Ann Phys Rehabil Med. 2015 Apr;58(2):40-53
25543183
Eur J Pain. 2010 May;14(5):510-3
19793666
Brain. 2012 Dec;135(Pt 12):3676-86
23250885
Exp Brain Res. 2015 Nov;233(11):3291-9
26238407
Neurosci Lett. 2010 Dec 17;486(3):240-5
20887773
Neurology. 2007 Jan 9;68(2):152-4
17210898
Ann Phys Rehabil Med. 2016 Apr 18;:null
27103056
Eur J Pain. 2009 Apr;13(4):339-53
18619873
Pain. 2004 Aug;110(3):756-61
15288417
Neuropsychologia. 2014 Jan;53:165-70
24291512
J Pain Symptom Manage. 1999 Sep;18(3):213-7
10517043
Pain. 2004 Mar;108(1-2):192-8
15109523
Prog Neurobiol. 2011 Jan;93(1):111-24
21040755
J Pain. 2013 Jan;14(1):3-13
23158879
Neurorehabil Neural Repair. 2011 Oct;25(8):711-20
21700922
Pain. 2013 Feb;154(2):200-3
23290549
J Rehabil Med. 2007 Mar;39(2):109-14
17351691
Prog Brain Res. 2003;142:273-87
12693267
Front Hum Neurosci. 2013 Oct 16;7:644
24137119
Brain. 2009 Nov;132(Pt 11):3142-51
19752177
Neuropsychologia. 2000;38(7):1087-97
10775718
Neurosci Biobehav Rev. 2006;30(7):961-82
16647754
Pain. 2012 May;153(5):1063-73
22424691
Cochrane Database Syst Rev. 2013 Apr 30;(4):CD009416
23633371
Neuropsychologia. 2002;40(3):327-34
11684165
Eur J Pain. 2016 Jan;20(1):64-9
26095341
Neuroreport. 2000 Jun 26;11(9):1899-902
10884040
Restor Neurol Neurosci. 2006;24(4-6):409-18
17119314
Brain Cogn. 2014 Oct;90:151-6
25086215
Brain. 2001 Oct;124(Pt 10):2098-104
11571225
Lancet Neurol. 2011 Jul;10(7):637-48
21683929
Neurology. 2007 Jan 9;68(2):128-33
17210893
Brain. 2010 Mar;133(Pt 3):895-908
20110244
Neuropsychologia. 2003;41(1):25-39
12427563
Pain. 2012 Nov;153(11):2174-81
22841878
Brain Cogn. 1983 Jan;2(1):32-8
6546011
Exp Brain Res. 2010 Jul;204(3):409-18
19967390
Pain. 2015 Apr;156 Suppl 1:S94-103
25789441
Pain. 2012 May;153(5):948-51
22245555
Neurosci Biobehav Rev. 2013 May;37(4):594-609
23428624
J Pain Symptom Manage. 1995 Jul;10(5):385-91
7673771
Nature. 1998 Sep 10;395(6698):166-9
9744273
Ann Neurol. 2016 Apr;79(4):701-4
26878698
Neurology. 2005 Sep 13;65(5):773
16157921