Current Pain and Headache Reports

, Volume 11, Issue 2, pp 104–108 | Cite as

Evidence for a mismatch between the brain’s movement control system and sensory system as an explanation for some pain-related disorders

Article

Abstract

The motor-control system usually operates below our conscious level, and we only become aware of the complex interaction between desired movements and actual movements when an irregularity in the system occurs. Recently, it has been proposed that such discordances in sensorimotor function may generate pain and other somaesthetic disturbances. This article describes this model of pain and determines how it may be applied to a range of chronic pain conditions in which there is a lack of obvious causal pathology, including complex regional pain syndrome. In addition, we discuss the clinical implications of such a theory and examine how enhancing sensory feedback may reduce chronic pain.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Piaget J: The Construction of Reality in the Child. New York: Basic Books; 1954.Google Scholar
  2. 2.
    Rizzolatti G, Arbib MA: Language within our grasp. Trends Neurosci 1998, 21:188–194.PubMedCrossRefGoogle Scholar
  3. 3.
    Harris AJ: Cortical origins of pathological pain. Lancet 1999, 354:1464–1466.PubMedCrossRefGoogle Scholar
  4. 4.
    McCabe CS, Haigh RC, Halligan PW, Blake DR: Simulating sensory-motor incongruence in healthy volunteers: implications for a cortical model of pain. Rheumatology 2005, 44:509–516.PubMedCrossRefGoogle Scholar
  5. 5.
    Wolpert DM, Ghahramani Z, Jordan MI: An internal model for sensorimotor integration. Science 1995, 269:1880–1882.PubMedCrossRefGoogle Scholar
  6. 6.
    Frith CD, Blakemore SJ, Wolpert DM: Abnormalities in the awareness and control of action. Philos Trans R Soc Lond B Biol Sci 2000, 355:1771–1788.PubMedCrossRefGoogle Scholar
  7. 7.
    Fourneret P, Jeannerod M: Limited conscious monitoring of motor performance in normal subjects. Neuropsychologia 1998, 9:337–342.Google Scholar
  8. 8.
    Alexander CE, Crutcher MD: Functional architecture of basal ganglia circuits: neural substrates of parallel processing. Trends Neurosci 1990, 13:266–271.PubMedCrossRefGoogle Scholar
  9. 9.
    Alexander CE, Crutcher MD: What role(s) do the basal ganglia play in the control of limb movements? Biomed Res 1993, 14:27–29.Google Scholar
  10. 10.
    Lenz FA, Suarez JL, Metman LV, et al.: Pallidal activity during dystonia: somatosensory reorganisation and changes with severity. J Neurol Neurosurgery Psychiatry 1998, 65:767–770.CrossRefGoogle Scholar
  11. 11.
    Romo R, Ruiz S, Crespo P, et al.: Representation of tactile signals in primate supplementary motor area. J Neurophysiol 1993, 70:2690–2694.PubMedGoogle Scholar
  12. 12.
    Kaji R, Urushihara R, Murase N, et al.: Abnormal sensory gating in basal ganglia disorders. J Neurol 2005, 252:13–16.CrossRefGoogle Scholar
  13. 13.
    Herrero MT, Barcia C, Navarro JM: Functional anatomy of thalamus and basal ganglia. Childs Nerv Syst 2002, 18:386–404.PubMedCrossRefGoogle Scholar
  14. 14.
    Mink J: The basal ganglia: focused selection and inhibition of competing motor programmes. Prog Neurobiol 1996, 50:381–425.PubMedCrossRefGoogle Scholar
  15. 15.
    Yan W, Suga N: Corticofugal modulation of the midbrain frequency map in the bat auditory system. Nat Neurosci 1998, 1:54–58.PubMedCrossRefGoogle Scholar
  16. 16.
    Csibra G: Mirror neurons and action understanding. Is simulation involved? Available at http://www.interdisciplines.org/mirror. Accessed January 15, 2007.
  17. 17.
    Wall PD: Introduction to the fourth edition. In Textbook of Pain, edn 4. Edited by Wall PD, Melzack R. Edinburgh: Churchill Livingston; 1999:165–181.Google Scholar
  18. 18.
    Fink GR, Marshall JC, Halligan PW, et al.: The neural consequences of conflict between intention and the senses. Brain 1999, 122:497–512.PubMedCrossRefGoogle Scholar
  19. 19.
    Flor H, Elbert T, Knecht S, et al.: Phantom-limb pain as a perceptual correlate of cortical reorganisation following arm amputation. Nature 1995, 375:482–484.PubMedCrossRefGoogle Scholar
  20. 20.
    Flor H, Braun C, Elbert T, Birbaumer N: Extensive reorganization of primary somatosensory cortex in chronic back pain patients. Neurosci Lett 1997, 224:5–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Grüsser S, Mühlnickel W, Schafer M, et al.: Remote activation of referred phantom sensations and cortical reorganization in human upper limb extremity amputees. Exp Brain Res 2004, 154:97–102.PubMedCrossRefGoogle Scholar
  22. 22.
    Churchill JD, Arnold LL, Garraghty PE: Somatotopic reorganization in the brainstem and thalamus following peripheral nerve injury in adult primates. Brain Res 2001, 910:142–152.PubMedCrossRefGoogle Scholar
  23. 23.
    Jones EG, Pons TP: Thalamic and brainstem contributions to large-scale plasticity of primate somatosensory cortex. Science 1998, 282:1062–1063.CrossRefGoogle Scholar
  24. 24.
    Snider SR, Fahn S, Isgreen WP, Cote LJ: Primary sensory symptoms in parkinsonism. Neurology 1976, 26:423–429.PubMedGoogle Scholar
  25. 25.
    Snider SR, Sandyk R: Sensory dysfunction. In Handbook of Parkinson’s Disease. Edited by Koller WC. New York: Marcel Dekker; 1987:171–180.Google Scholar
  26. 26.
    Olesen J, Tfelt-Hansen P, Welch KMA: The Headaches, edn 2. Philadelphia: Lippincott Williams & Wilkins; 2000.Google Scholar
  27. 27.
    Goadsby PJ, Zagami AS, Lambert GA: Neural processing of craniovascular pain: a synthesis of the central structure involved in migraine. Headache 1991, 31:365–371.PubMedCrossRefGoogle Scholar
  28. 28.
    Goadsby PJ, Lipton RB, Ferrari MD: Migraine—current understanding and treatment. N Engl J Med 2002, 346:257–270.PubMedCrossRefGoogle Scholar
  29. 29.
    Cacace AT, Lovely TJ, Parnes SM, et al.: Gaze-evoked tinnitus following unilateral peripheral auditory deafferentation: a case for anomalous cross modality plasticity. In Auditory System Plasticity and Regeneration. Edited by Salvi RJ, Henderson D, Fiorino F, Colletti V. New York: Thieme Medical Publishers; 1996:1354–1358.Google Scholar
  30. 30.
    Rubenstein B, Axelsson A, Carlsson G: Prevelance of signs and symptoms of craniomandibular disorders in tinnitus patients. J Craniomandib Disord 1990, 4:186–192.Google Scholar
  31. 31.
    Stanton-Hicks M, Jänig W, Hassenbusch S, et al.: Reflex sympathetic dystrophy: changing concepts and taxonomy. Pain 1995, 63:127–133.PubMedCrossRefGoogle Scholar
  32. 32.
    Baron R, Fields HL, Jänig W, et al.: National Institutes of Health Workshop: reflex sympathetic dystrophy/complex regional pain syndromes—state-of-the-science. Anesth Analg 2002, 95:1812–1816.PubMedCrossRefGoogle Scholar
  33. 33.
    McCabe CS, Lewis J, Shenker NG, et al.: Impaired self-perception of the hand in complex regional pain syndrome (CRPS). Pain 2005, 114:518–519.PubMedCrossRefGoogle Scholar
  34. 34.
    Förderreuther S, Sailer U, Straube A: Impaired self-perception of the hand in complex regional pain syndrome (CRPS). Pain 2004, 110:756–761.PubMedCrossRefGoogle Scholar
  35. 35.
    McCabe CS, Haigh RC, Halligan PW, Blake DR: Referred sensations in complex regional pain syndrome type 1. Rheumatology 2003, 42:1067–1073.PubMedCrossRefGoogle Scholar
  36. 36.
    Galer BS, Butler S, Jensen M: Case reports and hypothesis: a neglect-like syndrome may be responsible for the motor disturbances in reflex sympathetic dystrophy. J Pain Symptom Manage 1995, 10:358–392.CrossRefGoogle Scholar
  37. 37.
    Lewis J, McCabe C, Shenker N, Blake D: Experiences of complex regional pain syndrome: a neglect syndrome? Rheumatology 2003, 42:2.CrossRefGoogle Scholar
  38. 38.
    Juottonen K, Gockel M, Silen T, et al.: Altered central sensorimotor processing in patients with complex regional pain syndrome. Pain 2002, 98:315–323.PubMedCrossRefGoogle Scholar
  39. 39.
    Maihöfner C, Handwerker H, Neundörfer B, Birklein F: Patterns of cortical reorganisation in complex regional pain syndrome. Neurology 2003, 61:1707–1715.PubMedGoogle Scholar
  40. 40.
    Maihöfner C, Handwerker H, Neundörfer B, Birklein F: Cortical reorganisation during recovery from complex regional pain syndrome. Neurology 2004, 63:693–701.PubMedGoogle Scholar
  41. 41.
    Pleger B, Tegenthoff M, Ragert P, et al.: Sensorimotor returning in complex regional pain syndrome parallels pain reduction. Ann Neurol 2005, 57:425–429.PubMedCrossRefGoogle Scholar
  42. 42.
    Schwoebel J, Friedman R, Duda N, Coslett H: Pain and the body schema. Evidence for peripheral effects on mental representations of movement. Brain 2001, 124:2098–2104.PubMedCrossRefGoogle Scholar
  43. 43.
    Moseley GL: Imagined movements cause pain and swelling in a patient with complex regional pain syndrome. Neurology 2004, 62:1644.PubMedGoogle Scholar
  44. 44.
    McCabe CS, Haigh RC, Ring EFR, et al.: A controlled pilot study of the utility of mirror visual feedback in the treatment of complex regional pain syndrome (type 1). Rheumatology 2003, 42:97–101.PubMedCrossRefGoogle Scholar
  45. 45.
    Moseley GL: Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial. Pain 2004, 108:192–198.PubMedCrossRefGoogle Scholar
  46. 46.
    Moseley GL: Is successful rehabilitation of complex regional pain syndrome simply sustained attention to the affected limb? A randomised clinical trial. Pain 2005, 114:54–61.PubMedCrossRefGoogle Scholar
  47. 47.
    Flor H: The modification of cortical reorganisation and chronic pain by sensory feedback. Appl Psychophysiol Biofeedback 2002, 27:215–225.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2007

Authors and Affiliations

  1. 1.The Royal National Hospital for Rheumatic Diseases and School for HealthUniversity of BathBathUK

Personalised recommendations