Der Schmerz
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In patients with complex regional pain syndrome (CRPS) a disruption of the body schema has been shown in an altered cortical representation of the hand and in delayed reaction times (RT) in the hand laterality recognition task. However, the role of attentional processes or the effect of isolated limb laterality training has not yet been clarified. The performance of healthy subjects (n = 38), CRPS patients (n = 12) and phantom limb pain (PLP) patients (n = 12) in a test battery of attentional performance (TAP) and in a limb laterality recognition task was compared and the effect of limb laterality training in CRPS patients and healthy subjects evaluated. ⋯ Through training RTs improved significantly but the RTs of CRPS patients remained slower than those of healthy subjects. In this study an equal disruption of the body schema was found in both CRPS and PLP patients which cannot be accounted for by attentional processes. For CRPS patients this disorder cannot be fully reversed by isolated limb laterality recognition training.
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Besides the responses to nociceptive stimuli other neural function modes of the brain are necessary to obtain a comprehensive understanding of pain processing in humans. During a resting state without extrinsic stimulation the human brain generates spontaneous low frequency fluctuations of neural activity. This intrinsic activity does not reflect random background noise but is highly organized in several networks. Based on the findings of recent functional imaging studies, the role of these resting state networks in acute and chronic pain is discussed.
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Comparative Study
[The German version of parents' postoperative pain measure (PPPM-D). Validation on children 2-12 years old].
Parents become increasingly more responsible for the postoperative pain management of their children. Useful and valid pain assessments for parents may improve pain measurement. The aim of this study was to evaluate a German version of the parents' postoperative pain measure (PPPM-D). ⋯ The results of this study provide evidence of the reliability, validity and high acceptance of the PPPM-D as an assessment tool of postoperative pain among children aged 2 through to 12 years of age after orthopedic or trauma surgery.