Sensory disturbances induced by sensorimotor conflicts are higher in complex regional pain syndrome and fibromyalgia compared to arthritis and healthy people, and positively relate to pain intensity

Brun, Clémentine; Mercier, Catherine; Grieve, Sharon; Palmer, Shea; Bailey, Jacqueline; McCabe, Candida S.

Abstract

© 2018 European Pain Federation - EFIC® Background: Sensorimotor conflicts are well known to induce sensory disturbances. However, explanations as to why patients with chronic pain are more sensitive to sensorimotor conflicts remain elusive. The main objectives of this study were (a) to assess and compare the sensory disturbances induced by sensorimotor conflict in complex regional pain syndrome (n=38), fibromyalgia (n=36), arthritis (n=34) as well as in healthy volunteers (HV) (n=32); (b) to assess whether these disturbances were related to the intensity and duration of pain, or to other clinical variables assessed using questionnaires (abnormalities in sensory perception, depression and anxiety); and (c) to categorize different subgroups of conflict-induced sensory disturbances. Methods: One hundred and forty participants performed in phase or anti-phase movements with their arms while viewing a reflection of one arm in a mirror (and the other arm obscured). They were asked to report changes in sensory disturbances using a questionnaire. Results: First, results showed that patients with complex regional pain syndrome and fibromyalgia were more prone to report sensory disturbances than arthritis patients and HV in response to conflicts (small effect size). Second, conflict-induced sensory disturbances were correlated with pain intensity (large effect size) and abnormalities in sensory perception (only in the CRPS group) but were not related to the duration of the disease or psychological factors. Finally, we identified two distinct subgroups of conflict-induced sensory disturbances. Conclusions: Our results suggest that pain lowers the threshold for the detection of sensorimotor conflicts, a phenomenon that could contribute to the maintenance of pain in clinical populations. Significance: Individuals with complex regional pain syndrome and fibromyalgia were more sensitive to sensorimotor conflicts than arthritis patients and controls. Moreover, conflict-induced sensory disturbances were specific to higher pain intensity and higher sensory abnormalities in all groups, suggesting that pain lowers the threshold for the detection of sensorimotor conflicts.

• Journal Article Type: Article
• Acceptance Date: Oct 1, 2018
• Online Publication Date: Oct 5, 2018
• Publication Date: Mar 1, 2019
• Deposit Date: Oct 22, 2018
• Publicly Available Date: Oct 6, 2019
• Journal: European Journal of Pain (United Kingdom)
• Print ISSN: 1090-3801
• Electronic ISSN: 1532-2149
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 23
• Issue: 3
• Pages: 483-494
• DOI: https://doi.org/10.1002/ejp.1322
• Keywords: sensorimotor conflicts, chronic pain, arthritis, fibromyalgia, complex regional pain syndrome, healthy controls
• Public URL: https://uwe-repository.worktribe.com/output/849656
• Publisher URL: http://dx.doi.org/10.1002/ejp.1322
• Additional Information: Additional Information : This is the peer reviewed version of the following article: [Brun, Clémentine, Mercier, C., Grieve, S., Palmer, S., Bailey, J. and McCabe, C. (2018) Sensory disturbances induced by sensorimotor conflicts are higher in complex regional pain syndrome and fibromyalgia compared to arthritis and healthy people, and positively relate to pain intensity. European Journal of Pain. ISSN 1090-3801], which has been published in final form at http://dx.doi.org/10.1002/ejp.1322. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
• Contract Date: Oct 22, 2018