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      Cognitive correlates of "neglect-like syndrome" in patients with complex regional pain syndrome.

      1 , , ,
      Pain

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          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.

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          Author and article information

          Journal
          Pain
          Pain
          1872-6623
          0304-3959
          May 2012
          : 153
          : 5
          Affiliations
          [1 ] Department of Neurology, University Hospital Erlangen, Erlangen, Germany.
          Article
          S0304-3959(12)00089-9
          10.1016/j.pain.2012.02.014
          22424691
          846fadfb-747e-41ce-ab53-6026e8eaad3b
          Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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