• Burkhard Pleger, Martin Tegenthoff, Peter Schwenkreis, Frank Janssen, Patrick Ragert, Hubert R Dinse, Birgit Völker, Michael Zenz, and Christoph Maier.
• Department of Neurology, BG-Kliniken Bergmannsheil, Ruhr University Bochum, Buerkle-de-la-Camp Platz 1, 44789, Bochum, Germany.
• Exp Brain Res. 2004 Mar 1;155(1):115-9.

AbstractChronic back pain as well as phantom-limb pain is characterized by a close relationship between the amount of cortical reorganization and the magnitude of pain. In patients with positively assessed complex regional pain syndrome type I (CRPS I), we found a positive correlation between representational changes of primary somatosensory cortex (SI) and mean sustained pain levels. We investigated seven right-handed patients with CRPS I of one upper limb by means of somatosensory evoked potential (SSEP) mapping. Cortical representation of the CRPS-affected hand was significantly smaller than that of the contralateral healthy hand, giving rise to a substantial side difference. Subjective pain levels experienced over the last 4 weeks were estimated according to the visual analogue scale (VAS). Individual expansion of hand representation contralateral to the CRPS-affected limb was significantly correlated with mean pain intensity. Accordingly, low pain levels were linked to small representational side-to-side differences, while subjects with a distinctive hemispherical asymmetry reported the highest pain levels. Follow-up studies using functional imaging methods might be instrumental in providing a better understanding of this issue.

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