• Jaakko Hotta, Jukka Saari, Miika Koskinen, Yevhen Hlushchuk, Nina Forss, and Riitta Hari.
• Systems and Clinical Neuroscience, Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland; Department of Neurology, Helsinki University Hospital, and Clinical Neurosciences, Neurology, University of Helsinki, Finland. Electronic address: jaakko.hotta@aalto.fi.
• J Pain. 2017 Mar 1; 18 (3): 255-265.

AbstractPatients with complex regional pain syndrome (CRPS) display various abnormalities in central motor function, and their pain is intensified when they perform or just observe motor actions. In this study, we examined the abnormalities of brain responses to action observation in CRPS. We analyzed 3-T functional magnetic resonance images from 13 upper limb CRPS patients (all female, ages 31-58 years) and 13 healthy, age- and sex-matched control subjects. The functional magnetic resonance imaging data were acquired while the subjects viewed brief videos of hand actions shown in the first-person perspective. A pattern-classification analysis was applied to characterize brain areas where the activation pattern differed between CRPS patients and healthy subjects. Brain areas with statistically significant group differences (q < .05, false discovery rate-corrected) included the hand representation area in the sensorimotor cortex, inferior frontal gyrus, secondary somatosensory cortex, inferior parietal lobule, orbitofrontal cortex, and thalamus. Our findings indicate that CRPS impairs action observation by affecting brain areas related to pain processing and motor control.Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

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