Abstract
Background and aims. People with CRPS can report altered attention to the affected body part, reminiscent of hemispatial neglect following brain injury. However, in CRPS this distortion is usually subtle and it is unclear whether all regions of space are affected in the same way as in neglect following brain injury. Our objective was to conduct a case-study of one CRPS patient who presented with particularly pronounced inattention.
Methods. We assessed CRPS symptoms, body representation and spatial attention in a 65-year old, right-handed woman with CRPS affecting her left upper limb. Attention was tested through neurological examination, standard neuropsychological (pen-and-paper) tests, and highly sensitive experimental measures. The patient’s data points were compared to cut-off scores for the neuropsychological tests, and to data from 12 matched controls.
Results. The patient had a distorted cognitive representation of her affected limb. She exhibited neglect and extinction for tactile and visual stimuli on the affected side on neurological assessment. However, there were no attention deficits on neuropsychological tests of neglect. Experimental measures showed visual attention bias away from the affected limb. Overall, her attention bias manifested in body-space and reaching-space, but not in far- or imagined space.
Conclusions. Changes in attention appear to concern not only the CRPS-affected limb, but also the corresponding side of reaching-space. Despite the patient’s pronounced attention deficits on neurological assessments and sensitive experimental measures, these were not apparent on standard neuropsychological tests of neglect. Therefore, more sensitive measures should be considered to accurately assess attention bias in CRPS.
Methods. We assessed CRPS symptoms, body representation and spatial attention in a 65-year old, right-handed woman with CRPS affecting her left upper limb. Attention was tested through neurological examination, standard neuropsychological (pen-and-paper) tests, and highly sensitive experimental measures. The patient’s data points were compared to cut-off scores for the neuropsychological tests, and to data from 12 matched controls.
Results. The patient had a distorted cognitive representation of her affected limb. She exhibited neglect and extinction for tactile and visual stimuli on the affected side on neurological assessment. However, there were no attention deficits on neuropsychological tests of neglect. Experimental measures showed visual attention bias away from the affected limb. Overall, her attention bias manifested in body-space and reaching-space, but not in far- or imagined space.
Conclusions. Changes in attention appear to concern not only the CRPS-affected limb, but also the corresponding side of reaching-space. Despite the patient’s pronounced attention deficits on neurological assessments and sensitive experimental measures, these were not apparent on standard neuropsychological tests of neglect. Therefore, more sensitive measures should be considered to accurately assess attention bias in CRPS.
| Original language | English |
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| Publication status | Published - 6 Sept 2017 |
| Event | European Federation of IASP Chapters - Copenhagen Duration: 6 Sept 2017 → 9 Sept 2017 |
Conference
| Conference | European Federation of IASP Chapters |
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| City | Copenhagen |
| Period | 6/09/17 → 9/09/17 |