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An investigation of perceptual biases in complex regional pain syndrome

(2020) PEERJ. 8.
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Abstract
Patients with complex regional pain syndrome (CRPS) report cognitive difficulties, affecting the ability to represent, perceive and use their affected limb. Moseley, Gallace & Spence (2009) observed that CRPS patients tend to bias the perception of tactile stimulation away from the pathological limb. Interestingly, this bias was reversed when CRPS patients were asked to cross their arms, implying that this bias is embedded in a complex representation of the body that takes into account the position of body-parts. Other studies have failed to replicate this finding (Filbrich et al., 2017) or have even found a bias in the opposite direction (Sumitani et al., 2007). Moreover, perceptual biases in CRPS patients have not often been compared to these of other chronic pain patients. Chronic pain patients are often characterized by an excessive focus of attention for bodily sensations. We might therefore expect that non-CRPS pain patients would show a bias towards instead of away from their affected limb. The aim of this study was to replicate the study of Moseley, Gallace & Spence (2009) and to extend it by comparing perceptual biases in a CRPS group with two non-CRPS pain control groups (i.e., chronic unilateral wrist and shoulder pain patients). In a temporal order judgment (TOJ) task, participants reported which of two tactile stimuli, one applied to either hand at various intervals, was perceived as occurring first. TOJs were made, either with the arms in a normal (uncrossed) position, or with the arms crossed over the body midline. We found no consistent perceptual biases in either of the patient groups and in either of the conditions (crossed/uncrossed). Individual differences were large and might, at least partly, be explained by other variables, such as pain duration and temperature differences between the pathological and non-pathological hand. Additional studies need to take these variables into account by, for example, comparing biases in CRPS (and non-CRPS) patients in an acute versus a chronic pain state.
Keywords
TEMPORAL-ORDER JUDGMENT, NEGLECT-LIKE SYMPTOMS, NOCICEPTIVE STIMULI, CORTICAL REORGANIZATION, CLINICAL-TESTS, SYNDROME CRPS, TACTILE, BODY, SPACE, DIAGNOSIS, Pain, Complex regional pain syndrome, Spatial attention, Body, representation

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Citation

Please use this url to cite or link to this publication:

MLA
De Paepe, Annick, et al. “An Investigation of Perceptual Biases in Complex Regional Pain Syndrome.” PEERJ, vol. 8, Peerj Inc, 2020, doi:10.7717/peerj.8819.
APA
De Paepe, A., Legrain, V., Van der Biest, L., Hollevoet, N., Van Tongel, A., De Wilde, L., … Crombez, G. (2020). An investigation of perceptual biases in complex regional pain syndrome. PEERJ, 8. https://doi.org/10.7717/peerj.8819
Chicago author-date
De Paepe, Annick, Valéry Legrain, Lien Van der Biest, Nadine Hollevoet, Alexander Van Tongel, Lieven De Wilde, Herlinde Jacobs, and Geert Crombez. 2020. “An Investigation of Perceptual Biases in Complex Regional Pain Syndrome.” PEERJ 8. https://doi.org/10.7717/peerj.8819.
Chicago author-date (all authors)
De Paepe, Annick, Valéry Legrain, Lien Van der Biest, Nadine Hollevoet, Alexander Van Tongel, Lieven De Wilde, Herlinde Jacobs, and Geert Crombez. 2020. “An Investigation of Perceptual Biases in Complex Regional Pain Syndrome.” PEERJ 8. doi:10.7717/peerj.8819.
Vancouver
1.
De Paepe A, Legrain V, Van der Biest L, Hollevoet N, Van Tongel A, De Wilde L, et al. An investigation of perceptual biases in complex regional pain syndrome. PEERJ. 2020;8.
IEEE
[1]
A. De Paepe et al., “An investigation of perceptual biases in complex regional pain syndrome,” PEERJ, vol. 8, 2020.
@article{8668246,
  abstract     = {Patients with complex regional pain syndrome (CRPS) report cognitive difficulties, affecting the ability to represent, perceive and use their affected limb. Moseley, Gallace & Spence (2009) observed that CRPS patients tend to bias the perception of tactile stimulation away from the pathological limb. Interestingly, this bias was reversed when CRPS patients were asked to cross their arms, implying that this bias is embedded in a complex representation of the body that takes into account the position of body-parts. Other studies have failed to replicate this finding (Filbrich et al., 2017) or have even found a bias in the opposite direction (Sumitani et al., 2007). Moreover, perceptual biases in CRPS patients have not often been compared to these of other chronic pain patients. Chronic pain patients are often characterized by an excessive focus of attention for bodily sensations. We might therefore expect that non-CRPS pain patients would show a bias towards instead of away from their affected limb. The aim of this study was to replicate the study of Moseley, Gallace & Spence (2009) and to extend it by comparing perceptual biases in a CRPS group with two non-CRPS pain control groups (i.e., chronic unilateral wrist and shoulder pain patients). In a temporal order judgment (TOJ) task, participants reported which of two tactile stimuli, one applied to either hand at various intervals, was perceived as occurring first. TOJs were made, either with the arms in a normal (uncrossed) position, or with the arms crossed over the body midline. We found no consistent perceptual biases in either of the patient groups and in either of the conditions (crossed/uncrossed). Individual differences were large and might, at least partly, be explained by other variables, such as pain duration and temperature differences between the pathological and non-pathological hand. Additional studies need to take these variables into account by, for example, comparing biases in CRPS (and non-CRPS) patients in an acute versus a chronic pain state.},
  articleno    = {e8819},
  author       = {De Paepe, Annick and Legrain, Valéry and Van der Biest, Lien and Hollevoet, Nadine and Van Tongel, Alexander and De Wilde, Lieven and Jacobs, Herlinde and Crombez, Geert},
  issn         = {2167-8359},
  journal      = {PEERJ},
  keywords     = {TEMPORAL-ORDER JUDGMENT,NEGLECT-LIKE SYMPTOMS,NOCICEPTIVE STIMULI,CORTICAL REORGANIZATION,CLINICAL-TESTS,SYNDROME CRPS,TACTILE,BODY,SPACE,DIAGNOSIS,Pain,Complex regional pain syndrome,Spatial attention,Body,representation},
  language     = {eng},
  pages        = {26},
  publisher    = {Peerj Inc},
  title        = {An investigation of perceptual biases in complex regional pain syndrome},
  url          = {http://dx.doi.org/10.7717/peerj.8819},
  volume       = {8},
  year         = {2020},
}

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