+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Prisms to shift pain away: Physiopathological and therapeutic exploration of CRPS with prism adaptation



Prisms to shift pain away: Physiopathological and therapeutic exploration of CRPS with prism adaptation



Annals of Physical and Rehabilitation Medicine 59s(): E145-E146



Complex regional pain syndrome (CRPS) is an invalidating chronic condition subsequent to peripheral lesions, with frequent therapeutic failure. There is growing consensus for a central contribution to CRPS. However, the nature of this central body representation disorder is increasingly debated. Although it has been repeatedly argued that CRPS results in motor neglect of the affected side, visual egocentric reference frame was found to be deviated towards the pain, i.e. neglect of the healthy side. Accordingly, prism adaptation has been successfully used to normalize this deviation by some teams, leading to clinical improvement. This study aimed at exploring a CRPS group's spatial references modifications as well as investigating the pathophysiological mechanisms of this manifestation and of the therapeutic effects of prism adaptation. On a CRPS patients group (n=7), pain and quality of life, egocentric reference frames (visual and proprioceptive straight-ahead), and neglect-tests (line-bisection, kinematic analyses of motor neglect and motor extinction) were repeatedly assessed prior to, during and following a week of prism adaptation (twice a day for five days). First, our results provide no support for visual and motor neglect in CRPS. Second, reference frames for body representations were not systematically deviated. Third, prism adaptation intervention durably ameliorated pain and quality of life (effect was maintained 2 weeks after intervention). Prism adaptation, which is inexpensive and non-invasive, seems to be a promising tool to use in addition to usual methods to alleviate pain in therapeutic failure situations for CRPS patients. Indeed, our results suggest a sustainable improvement of pain and quality of life. Moreover, these results overturn the neglect-like theory and provide wide physiopathological data on spatial references' modifications. As for spatial neglect, understanding the therapeutic effects of prism adaptation deserves further investigations.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 058627457

Download citation: RISBibTeXText

PMID: 27676803

DOI: 10.1016/j.rehab.2016.07.324


Related references

Prisms to Shift Pain Away: Pathophysiological and Therapeutic Exploration of CRPS with Prism Adaptation. Neural Plasticity 2016: 1694256, 2016

Complex Regional Pain Syndrome (CRPS): High risk of CRPS after trauma in another limb in patients who already have CRPS in one hand or foot: Lasting changes in neural pain modulating systems?. Scandinavian Journal of Pain 14: 82-83, 2017

Prisms for timing better: A review on application of prism adaptation on temporal domain. Cortex; a Journal Devoted to the Study of the Nervous System and Behavior 2018, 2018

Wearing prisms to hear differently: After-effects of prism adaptation on auditory perception. Cortex; a Journal Devoted to the Study of the Nervous System and Behavior 115: 123-132, 2019

Preserved prism adaptation in bilateral optic ataxia: strategic versus adaptive reaction to prisms. Experimental Brain Research 156(4): 399-408, 2004

Long lasting aftereffect of a single prism adaptation: Directionally biased shift in proprioception and late onset shift of internal egocentric reference frame. Experimental Brain Research 174(1): 189-198, 2006

Differential effects of expressive anger regulation on chronic pain intensity in CRPS and non-CRPS limb pain patients. Pain 104(3): 647-654, 2003

Predictors of prism response during prism adaptation. Prism Adaptation Study Research Group. Journal of Pediatric Ophthalmology and Strabismus 28(4): 202-205, 1991

Complex regional pain syndrome (CRPS)--is severe pain a good indicator for CRPS?. Zeitschrift für Orthopadie und Unfallchirurgie 152(1): 12, 2015

Modulation of prism adaptation by a shift of background in the monkey. Behavioural Brain Research 297: 59-66, 2016

The roles of target and eye motion in the production of the visual shift in prism adaptation. Journal of General Psychology 110(2d Half): 251-262, 1984

Efficacy of prism adaptation in the surgical management of acquired esotropia. Prism Adaptation Study Research Group. Archives of Ophthalmology 108(9): 1248-1256, 1990

Prism Adaptation in Rehabilitation? No Additional Effects of Prism Adaptation on Neglect Recovery in the Subacute Phase Poststroke: A Randomized Controlled Trial. Neurorehabilitation and Neural Repair 31(12): 1017-1028, 2017

Comparison of symmetrical prism adaptation to asymmetrical prism adaptation in those with normal binocular vision. Vision Research 149: 59-65, 2018

The role of the posterior parietal lobe in prism adaptation: Failure to adapt to optical prisms in a patient with bilateral damage to posterior parietal cortex. Cortex; A Journal Devoted to the Study of the Nervous System and Behavior 42(5): 720-729, 2006