Ignoring space around a painful limb?: No evidence for a body-related visuospatial attention bias in complex regional pain syndrome

Antonia F Ten Brink; Monika Halicka; Axel Davies Vittersø; Edmund Keogh; Janet Bultitude

doi:10.1016/j.cortex.2020.12.007

Ignoring space around a painful limb? No evidence for a body-related visuospatial attention bias in complex regional pain syndrome

Antonia F Ten Brink^*, Monika Halicka, Axel Davies Vittersø, Edmund Keogh, Janet Bultitude

^*Corresponding author for this work

Bristol Medical School (PHS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

11 Citations (Scopus)

Abstract

BACKGROUND: Complex Regional Pain Syndrome (CRPS) is a disorder of severe chronic pain in one or more limb(s). People with CRPS report unusual perceptions of the painful limb suggesting altered body representations, as well as difficulty attending to their affected limb (i.e., a 'neglect-like' attention bias). Altered body representations and attention in CRPS might be related, however, existing evidence is unclear. We hypothesized that if there were a body-related visuospatial attention bias in CRPS, then any attention bias away from the affected side should be larger for or limited to circumstances when the (impaired) body representation is involved in the task versus when this is not the case.

METHODS: We included 40 people with CRPS, 40 with other limb pain conditions, and 40 pain-free controls. In half of the people with pain, their upper limb was affected, in the other half their lower limb. We administered computerized tasks of spatial attention, including free viewing of images, shape cancellation, temporal order judgement, and dot-probe. The degree to which different versions of each task involved body representation was manipulated by one or more of the following: (1) presenting stimuli nearer versus further away from the body, (2) using body related versus neutral stimuli, and (3) inducing mental rotation of body parts versus no mental rotation. In addition to perceptual judgements, eye movements were recorded as a sensitive index of spatial attention. Bayesian repeated measures analyses were performed.

RESULTS: We found no evidence for a (body-related) visuospatial attention bias in upper limb CRPS. Secondary analyses suggested the presence of a body-related visuospatial attention bias away from the affected side in some participants with lower limb CRPS.

DISCUSSION: Our results add to growing evidence that there might be no general visuospatial attention bias away from the affected side in CRPS.

Original language	English
Pages (from-to)	89-108
Number of pages	20
Journal	Cortex
Volume	136
Early online date	24 Dec 2020
DOIs	https://doi.org/10.1016/j.cortex.2020.12.007
Publication status	Published - 23 Jan 2021

Bibliographical note

Keywords

Attentional Bias
Bayes Theorem
Complex Regional Pain Syndromes
Humans
Pain Measurement
Perceptual Disorders

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@article{203c66521a374d4494f336d6131ca7a7,

title = "Ignoring space around a painful limb?: No evidence for a body-related visuospatial attention bias in complex regional pain syndrome",

abstract = "BACKGROUND: Complex Regional Pain Syndrome (CRPS) is a disorder of severe chronic pain in one or more limb(s). People with CRPS report unusual perceptions of the painful limb suggesting altered body representations, as well as difficulty attending to their affected limb (i.e., a 'neglect-like' attention bias). Altered body representations and attention in CRPS might be related, however, existing evidence is unclear. We hypothesized that if there were a body-related visuospatial attention bias in CRPS, then any attention bias away from the affected side should be larger for or limited to circumstances when the (impaired) body representation is involved in the task versus when this is not the case.METHODS: We included 40 people with CRPS, 40 with other limb pain conditions, and 40 pain-free controls. In half of the people with pain, their upper limb was affected, in the other half their lower limb. We administered computerized tasks of spatial attention, including free viewing of images, shape cancellation, temporal order judgement, and dot-probe. The degree to which different versions of each task involved body representation was manipulated by one or more of the following: (1) presenting stimuli nearer versus further away from the body, (2) using body related versus neutral stimuli, and (3) inducing mental rotation of body parts versus no mental rotation. In addition to perceptual judgements, eye movements were recorded as a sensitive index of spatial attention. Bayesian repeated measures analyses were performed.RESULTS: We found no evidence for a (body-related) visuospatial attention bias in upper limb CRPS. Secondary analyses suggested the presence of a body-related visuospatial attention bias away from the affected side in some participants with lower limb CRPS.DISCUSSION: Our results add to growing evidence that there might be no general visuospatial attention bias away from the affected side in CRPS.",

keywords = "Attentional Bias, Bayes Theorem, Complex Regional Pain Syndromes, Humans, Pain Measurement, Perceptual Disorders",

author = "{Ten Brink}, {Antonia F} and Monika Halicka and Vitters{\o}, {Axel Davies} and Edmund Keogh and Janet Bultitude",

year = "2021",

month = jan,

day = "23",

doi = "10.1016/j.cortex.2020.12.007",

language = "English",

volume = "136",

pages = "89--108",

journal = "Cortex",

issn = "0010-9452",

publisher = "Elsevier Masson SAS",

}

TY - JOUR

T1 - Ignoring space around a painful limb?

T2 - No evidence for a body-related visuospatial attention bias in complex regional pain syndrome

AU - Ten Brink, Antonia F

AU - Halicka, Monika

AU - Vittersø, Axel Davies

AU - Keogh, Edmund

AU - Bultitude, Janet

PY - 2021/1/23

Y1 - 2021/1/23

N2 - BACKGROUND: Complex Regional Pain Syndrome (CRPS) is a disorder of severe chronic pain in one or more limb(s). People with CRPS report unusual perceptions of the painful limb suggesting altered body representations, as well as difficulty attending to their affected limb (i.e., a 'neglect-like' attention bias). Altered body representations and attention in CRPS might be related, however, existing evidence is unclear. We hypothesized that if there were a body-related visuospatial attention bias in CRPS, then any attention bias away from the affected side should be larger for or limited to circumstances when the (impaired) body representation is involved in the task versus when this is not the case.METHODS: We included 40 people with CRPS, 40 with other limb pain conditions, and 40 pain-free controls. In half of the people with pain, their upper limb was affected, in the other half their lower limb. We administered computerized tasks of spatial attention, including free viewing of images, shape cancellation, temporal order judgement, and dot-probe. The degree to which different versions of each task involved body representation was manipulated by one or more of the following: (1) presenting stimuli nearer versus further away from the body, (2) using body related versus neutral stimuli, and (3) inducing mental rotation of body parts versus no mental rotation. In addition to perceptual judgements, eye movements were recorded as a sensitive index of spatial attention. Bayesian repeated measures analyses were performed.RESULTS: We found no evidence for a (body-related) visuospatial attention bias in upper limb CRPS. Secondary analyses suggested the presence of a body-related visuospatial attention bias away from the affected side in some participants with lower limb CRPS.DISCUSSION: Our results add to growing evidence that there might be no general visuospatial attention bias away from the affected side in CRPS.

AB - BACKGROUND: Complex Regional Pain Syndrome (CRPS) is a disorder of severe chronic pain in one or more limb(s). People with CRPS report unusual perceptions of the painful limb suggesting altered body representations, as well as difficulty attending to their affected limb (i.e., a 'neglect-like' attention bias). Altered body representations and attention in CRPS might be related, however, existing evidence is unclear. We hypothesized that if there were a body-related visuospatial attention bias in CRPS, then any attention bias away from the affected side should be larger for or limited to circumstances when the (impaired) body representation is involved in the task versus when this is not the case.METHODS: We included 40 people with CRPS, 40 with other limb pain conditions, and 40 pain-free controls. In half of the people with pain, their upper limb was affected, in the other half their lower limb. We administered computerized tasks of spatial attention, including free viewing of images, shape cancellation, temporal order judgement, and dot-probe. The degree to which different versions of each task involved body representation was manipulated by one or more of the following: (1) presenting stimuli nearer versus further away from the body, (2) using body related versus neutral stimuli, and (3) inducing mental rotation of body parts versus no mental rotation. In addition to perceptual judgements, eye movements were recorded as a sensitive index of spatial attention. Bayesian repeated measures analyses were performed.RESULTS: We found no evidence for a (body-related) visuospatial attention bias in upper limb CRPS. Secondary analyses suggested the presence of a body-related visuospatial attention bias away from the affected side in some participants with lower limb CRPS.DISCUSSION: Our results add to growing evidence that there might be no general visuospatial attention bias away from the affected side in CRPS.

KW - Attentional Bias

KW - Bayes Theorem

KW - Complex Regional Pain Syndromes

KW - Humans

KW - Pain Measurement

KW - Perceptual Disorders

U2 - 10.1016/j.cortex.2020.12.007

DO - 10.1016/j.cortex.2020.12.007

M3 - Article (Academic Journal)

C2 - 33494023

SN - 0010-9452

VL - 136

SP - 89

EP - 108

JO - Cortex

JF - Cortex

ER -