Cortical changes and musculoskeletal pain

Tactile fMRI study of cortical changes in Complex Regional Pain Syndrome

Complex Regional Pain Syndrome is a painful and debilitating disease that is characterised by oedema, inflammation and excessive pain. It is thought to be caused most often by a precipitating injury, eg, bruising or fracture, but it can also occur spontaneously. The aetiology is poorly understood. There is clear evidence of changes in the affected body part, however, such a wide range of symptoms are reported that a localised disease is insufficient to explain all of them.

Therefore, it is thought that the brain's image of the body is somehow altered and sensory-motor signals are processed differently. This altered signal processing then manifests itself as the symptoms experienced by sufferers. The aim of this project is to determine if this theory is correct by using functional magnetic resonance imaging (fMRI). When information is processed in the brain there are changes in oxygen consumption in localised regions and these can be detected with fMRI.

The cortical changes will be investigated using vibrotactile equipment which will stimulate the subject's fingertips during scanning. The areas associated with the somatosensory activity can be determined and a comparison between a healthy control group and CRPS patients should then reveal any cortical reorganisation that is taking place. If reorganisation is discovered then another study will be carried out to investigate if treatment can reverse these changes.

This project is supported by DARRT and is in collaboration with clinicians at the Royal Devon and Exeter Hospital and The Royal National Hospital for Rheumatic Diseases.