Tuesday, May 6, 2014

"TMS motor cortical brain mapping in patients with complex regional pain syndrome type I"

from the Journal of Neurophysiology:
"Habenula functional resting-state connectivity in pediatric CRPS"

This is exciting.  I wish more mapping of people with CRPS [including Type 2, for those of us who have both] were being done.  Perhaps it will be a growing sector in the research.

Even though this dates from 2006 (Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology [2006, 117(1):169-176]), it's new to me.  Forgive me if it's old news to you!

These scientists are located in Munich and limited their look to people with one hand/arm involvement. That's how this will have to progress for good science, I suppose, limiting the study, enhancing its specificity.

[I will momentarily bring us all down by noting a meta review article published in the Journal of Pain late last year.  It, too, is obviously worth reading.  The underlying complaint is familiar -- and explicable -- and that is that the cohorts were too small, the risk of bias is too high.  My knee-jerk reaction is that it is nigh unto impossible to assemble a sufficient number of CRPS patients to satisfy the stringent requirements necessary to good, repeatable studies.]

One fine day ("a perfect day for bananafish," at the rate this gimp is going), my cheapo-cheapo no-contract disposable flip phone will ring, anemically, and it will be the bestest CRPS researchers in the whole wide, wide, broad world, asking to map my afflicted brain.  I imagine they'll faint straightaway at the sight of its shifty hemispheres and perverse lack of neuroplasticity.

Remind me, Dear Readers (especially you, Beloved TW) to rain down upon you the hilarious story of my first ever trip to the Emergency Room (or ED, if you're WhiteCoat) for PAIN, something I swore never to do.  Well, swearing is not eternally binding.  At least not according to Tête de Hergé statutes, all put on college-ruled paper by that recently deceased Law & Morals activist, Tante Louise, about ten years ago.  Before that, we were ruled by one of those Mosaic * type tablet thingies. Very heavy, burdensome to have copied, and therefore oft ignored -- but no longer!  It will soon be available online.  We expect a total reworking to surge from that publication of all Judeo-Christian Hammurabi sorts of statute code.

According to the Bible, there were two sets [of stone tablets]. The first, inscribed by God, were smashed by Moses when he was enraged by the sight of the Children of Israel worshiping the Golden Calf; and the second, later cut by Moses and rewritten by God.

I'll give you one of the funnier tidbits about the ER visit, just to tide you elle est belle la seine addicts over until I can fix you a fix:  The radiologist who tried to interpret the x-ray of my left shoulder (the punchline is that I do not HAVE a left shoulder) was valiant in his verbiage as he tried to describe what he saw, as he had never encountered a sentient being lacking a shoulder before... and the referring ER/ED doc forgot to warn him ahead of time.  It was an agonal effort, but hilarious.  

Right!  So!  This is exciting!  
TMS = Transcranial magnetic stimulation

TMS motor cortical brain mapping in patients with complex regional pain syndrome type I

Department of Neurology, University of Munich, Klinikum Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany


OBJECTIVE: The motor cortical representation in patients with complex regional pain syndrome type I (CRPS I) was determined under the assumption that the motor cortex undergoes representational adaptations in the course of CRPS.

METHODS: A total of 14 patients with CRPS I and a group of healthy subjects without any known neurological symptoms participated in the study. The motor cortical representation, i.e. the size of representation (cm2), motor-evoked potentials (MEP), the calculated volume (cm2 mV), and the center of gravity (CoG) were measured by transcranial magnetic stimulation. Recordings were made of the long extensor muscles of the forearm of the affected and unaffected hand.

RESULTS: Analyses of the results revealed a significant asymmetry between the two hemispheres: the motor cortical representation corresponding to the unaffected hand was significantly larger. While the CoG data did not differ statistically between the two hemispheres, the CoG coordinates corresponding to the affected hand indicated a larger variability.

CONCLUSIONS: The presence of pain and other CRPS symptoms may induce lasting changes in motor cortical plasticity, as it also does in the sensory cortex.

SIGNIFICANCE: This could be of importance in rehabilitative strategies for the sensory motor system in CRPS I patients.
As I cannot access the article in its entirety from the journal Clinical Neurophysiology due to a scarcity of funds, below please put to good use the references employed in the article -- always a source of gems for background study and getting a better foundation for understanding the work, and its orientation or biases. Giving it a cursory glance, I see well-known, trustworthy, and up-to-date (for its time) sourcing.  As in, no evidence of that Turd, Ochoa, for instance.  It's a Turd Free Zone.

I don't know if I've mentioned it or not, but searchable data from was recently released by NIH listing grant fund recipients and it was appalling to see the amount of money The Turd & his Oregon associates have pilfered.

Appalling, I said.
Money that could have fed hungry people, helped sick people, protected the environment, and provided for finely-targeted extra-judicial executions by drone.  Oregonians, as a whole, are a marvelous group of non-turdish people, and so one would have to be exquisitely precise in the deployment of those drones...

Right!  So!  This is exciting! Put on your slippers and your reading glasses, brew a cuppa, and get to work understanding how TMS motor cortex brain mapping is done and why it matters for CRPS research. Fun,fun, fun!


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