Dr. Collin Clarke has been featured on CTV news, discussing his research on Complex Regional Pain Syndrome. Newly diagnosed patients underwent MRI scans in order to see if there were any neurological changes. View the video on the CTV website.
The study behind this story is co-authored by Dr. Clarke with colleagues from Lawson Health Research Institute, Western’s Department of Clinical Neurosciences and Oncology, and University of Toronto, on structural and functional brain changes. Read more:
J Pain. 2018 Feb;19(2):146-157. doi: 10.1016/j.jpain.2017.09.007. Epub 2017 Oct 14.
Structural and Functional Brain Changes at Early and Late Stages of Complex Regional Pain Syndrome.
Shokouhi M, Clarke C, Morley-Forster P, Moulin DE, Davis KD, St Lawrence K.
Brain plasticity is demonstrated in complex regional pain syndrome (CRPS), although it is unclear how it modulates at different stages of CRPS. The observation that symptoms can progress over time suggests that the pattern of brain changes might also evolve. We measured structural and functional changes as well as sensorimotor integration at the early stage (ES) and late stage (LS) of CRPS. Twelve ES patients, 16 LS patients, and 16 age- and sex-matched controls were recruited. Gray matter (GM) volume was estimated using voxel-based morphometry. Cerebral perfusion was measured using arterial spin labeling, because it provides a measure of resting neural activity. Connectivity to sensorimotor regions was evaluated using blood-oxygen level-dependent images. The ES group showed reduced GM volume and perfusion in areas associated with spatial body perception, somatosensory cortex, and the limbic system, whereas the LS group exhibited increased perfusion in the motor cortex but no changes in GM volume. However, in the LS group, GM volume in areas associated with pain processing was negatively correlated with average pain levels, likely reflecting a response to ongoing pain. Furthermore, connectivity to sensorimotor cortex showed disruptions in regions associated with motor control and planning, implying impairment of higher-order motor control.
This article presents brain changes at ES and LS of CRPS. We found different patterns of brain changes between these 2 stages. Understanding modulation of brain plasticity at different stages of CRPS could help understand the diversity in outcomes and treatment response and hopefully improve treatment planning.
Learn more on PubMed