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  Complex regional pain syndrome type I affects brain structure in prefrontal and motor cortex

Pleger, B., Draganski, B., Schwenkreis, P., Lenz, M., Nicolas, V., Maier, C., et al. (2014). Complex regional pain syndrome type I affects brain structure in prefrontal and motor cortex. PLoS One, 9(1): e85372. doi:10.1371/journal.pone.0085372.

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© 2014 Pleger et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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 Creators:
Pleger, Burkhard1, 2, Author              
Draganski, Bogdan3, Author              
Schwenkreis, Peter4, Author
Lenz, Melanie4, Author
Nicolas, Volkmar5, Author
Maier, Christoph6, Author
Tegenthoff, Martin4, Author
Affiliations:
1Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
2Clinic for Cognitive Neurology, University Hospital Leipzig, Germany, ou_persistent22              
3Laboratoire de Recherche en Neuroimagerie (LREN), Centre hospitalier universitaire vaudois, Lausanne, Switzerland, ou_persistent22              
4Department of Neurology, University Hospital Bergmannsheil, Bochum, Germany, ou_persistent22              
5Department of Radiology, University Hospital Bergmannsheil, Bochum, Germany, ou_persistent22              
6Department of Pain Treatment, University Hospital Bergmannsheil, Bochum, Germany, ou_persistent22              

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 Abstract: The complex regional pain syndrome (CRPS) is a rare but debilitating pain disorder that mostly occurs after injuries to the upper limb. A number of studies indicated altered brain function in CRPS, whereas possible influences on brain structure remain poorly investigated. We acquired structural magnetic resonance imaging data from CRPS type I patients and applied voxel-by-voxel statistics to compare white and gray matter brain segments of CRPS patients with matched controls. Patients and controls were statistically compared in two different ways: First, we applied a 2-sample ttest to compare whole brain white and gray matter structure between patients and controls. Second, we aimed to assess structural alterations specifically of the primary somatosensory (S1) and motor cortex (M1) contralateral to the CRPS affected side. To this end, MRI scans of patients with left-sided CRPS (and matched controls) were horizontally flipped before preprocessing and region-of-interest-based group comparison. The unpaired ttest of the “non-flipped” data revealed that CRPS patients presented increased gray matter density in the dorsomedial prefrontal cortex. The same test applied to the “flipped” data showed further increases in gray matter density, not in the S1, but in the M1 contralateral to the CRPS-affected limb which were inversely related to decreased white matter density of the internal capsule within the ipsilateral brain hemisphere. The gray-white matter interaction between motor cortex and internal capsule suggests compensatory mechanisms within the central motor system possibly due to motor dysfunction. Altered gray matter structure in dorsomedial prefrontal cortex may occur in response to emotional processes such as pain-related suffering or elevated analgesic top-down control.

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Language(s): eng - English
 Dates: 2013-09-112013-11-252014-01-09
 Publication Status: Published online
 Pages: -
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 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1371/journal.pone.0085372
PMID: 24416397
PMC: PMC3887056
Other: eCollection 2014
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Title: PLoS One
Source Genre: Journal
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Publ. Info: San Francisco, CA : Public Library of Science
Pages: - Volume / Issue: 9 (1) Sequence Number: e85372 Start / End Page: - Identifier: ISSN: 1932-6203
CoNE: https://pure.mpg.de/cone/journals/resource/1000000000277850